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Updated: Jul 10, 2025

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
[Arterial hypertension and cognitive impairment. Neurologist's view]
1Pirogov Russian National Research Medical University, Moscow, Russia.
Insights
Arterial hypertension is linked to cognitive impairment via cerebral microangiopathy. Antihypertensive therapy should consider cerebral blood flow and patient factors for effective treatment and cognitive support.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- Arterial hypertension (AH) is a significant risk factor for cognitive impairment (CI).
- Cerebral microangiopathy is a key pathogenetic mechanism linking AH and CI.
- Cerebrovascular disease and critical stenoses in cerebral arteries complicate AH management.
Conclusions:
- Antihypertensive therapy must be individualized, considering cerebral hemodynamics and patient status.
- Neurocytoprotective therapy is recommended for managing cognitive impairment in hypertensive patients.
- Optimized AHT can help mitigate cognitive decline associated with arterial hypertension.
Abstract:
The article presents a review of the literature on the relationship of cognitive impairment (CI) with arterial hypertension (AH). The pathogenetic mechanisms AH are characterized by the development of cerebral microangiopathy. Antihypertensive therapy (AHT) should take into account violations of autoregulation of cerebral blood flow in cerebrovascular disease and critical stenoses of large cerebral arteries, especially in fragile patients older than 80 years. The importance of AHT focused on the level of cerebral perfusion blood pressure, the severity of CI and the physical functioning of patients is emphasized. Neurocytoprotective therapy is recommended for correction of CI.
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