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Значение артериальной гипертензии в развитии поражения головного мозга – от легких когнитивных нарушений к деменции
Значение артериальной гипертензии в развитии поражения головного мозга – от легких когнитивных нарушений к деменции
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Аннотация
Проблема нарушений когнитивных функций у пациентов с соматическими заболеваниями сегодня занимает ведущую позицию, поскольку представляет собой одно из наиболее распространенных проявлений органического поражения головного мозга. Роль артериальной гипертензии (АГ) в формировании когнитивных нарушений (КН) была показана в крупных эпидемиологических исследованиях. КН выявляются у 73% пациентов как среднего, так и пожилого возраста с длительностью АГ более 5 лет. Раннее выявление потенциально излечимых когнитивных расстройств – одна из важных задач современного врача-терапевта, кардиолога, эндокринолога, семейного врача, поскольку пациенты на ранних стадиях КН составляют большинство из обратившихся за помощью. В современном мире часто действия врачей первичного звена являются определяющими в прогнозе развития деменции, так как выявление ранних недементных форм КН и своевременное адекватное лечение сердечно-сосудистой патологии, в первую очередь АГ, часто вполне достаточно, чтобы выраженность КН у пациента значимо уменьшилась, а деменция никогда не наступила.
Ключевые слова: когнитивные нарушения, деменция, артериальная гипертензия, лозартан, амлодипин.
Key words: cognitive disorders, dementia, arterial hypertension, losartan, amlodipine.
Ключевые слова: когнитивные нарушения, деменция, артериальная гипертензия, лозартан, амлодипин.
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Key words: cognitive disorders, dementia, arterial hypertension, losartan, amlodipine.
Полный текст
Список литературы
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16. Danlof B, Devereux RB, Kieldsen SE et al for the LIFE study group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.
17. Sierra C, de la Sierra A. Antihypertensive, cardiovascular, and pleiotropic effects of angiotensin-receptor blockers. Curr Opin Nephrol Hypertens 2005; 14: 435–41.
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21. Lithell H, Hansson L, Skoog I et al for the SCOPE Study Group. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. Hypertension 2003; 21: 875–6.
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23. Diener HC, Sacco R, Yusuf S. Rationale, design and baseline data of a randomized, double-blind, controlled trial comparing two antithrombotic regimens (a fixed-dose combination of extended-release dipyridamole plus ASA with clopidogrel) and telmisartan versus placebo in patients with strokes: the Prevention Regimen for Effectively Avoiding Second Strokes trial (PRoFESS). Cerebrovasc Dis 2007; 23: 368–80.
24. Tedesco MA, Ratti G, Mennella G et al. Comparison of losartan and hydrochloroth-iazide on cognitive function and quality of life in hypertensive patients. Am J Hypertens 1999; 12: 1130–4.
25. Fogari R, Mugellini A. Influence of losartan and atenolol on memory function in very elderly hypertensive patients. J Hum Hypertension 2003; 17: 781–5.
26. Schrader J et al. Effects of long-term antihypertensive therapy with losartan on blood pressure and cognitive function in patients with essential hypertension and other cerebrovascular risk factors (AWARE observational study) Med Klin (Munich) 2008; 103 (7): 491–9.
27. Hanon O. Effects of Antihypertensive Therapy on Cognitive Decline in Alzheimer's N Engl J Med 2003; 348: 1333–41.
28. Braszko J. The contribution of AT1 and AT2 angiotensin receptors to its cognitive effects. Acta Neirobiol Exp 1996; 56: 49–54.
29. Wright JW, Harding JW. The angiotensin AT4 receptor subtype as a target for the treatment of memory dysfunction associated with Alzheimers disease. J Renin Angiotensin Aldosterone Syst 2008; 9: 226–37.
30. Hanon O, Pequignot R. Relationship between antihypertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints. J Hypertens 2006; 24 (10): 2101–7.
31. Zeng F. Adherence and persistence of single-pill ARB/CCB combination therapy compared to multiple-pill ARB/CCB regimens. Curr Med Res Opin 2010; 26 (12): 2877–87.
32. Coca A. Ambulatory Blood Pressure in Stroke and Cognitive Dysfunction. Curr Hypertens Rep 2013; 15: 150–9.
2. Ferri CP, Prince M. Global prevalence of dementia: a Delphi consensus study. Lancet 2005; 366 (9503): 2112–7.
3. Суслина З.А., Варакин Ю.Я., Верещагин Н.В. Сосудистые заболевания головного мозга: Эпидемиология. Основы профилактики. М.: МЕДпресс-информ, 2009.
4. Гусев Е.И., Боголепова А.Н. Когнитивные нарушения при цереброваскулярных заболеваниях. М.: МЕДпреcс-информ, 2013.
5. Гусев Е.И., Скворцова В.И. Ишемия головного мозга. М.: Медицина, 2001.
6. Левин О.С. Диагностика и лечение деменции в клинической практике. М.: МЕДпресс-информ, 2010.
7. Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол. журн. 2006; 11 (Прил. 1): 4–12.
8. Petersen RS, Smith GE, Waring SC et al. Mild cognitive impairement: clinical characterization and outcome. Arch Neurol 1999; 56: 303–8.
9. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Int Med 2004; 256: 183–94.
10. Дамулин И.В. Легкие когнитивные нарушения. Cons. Med. 2004; 2: 138–41.
11. Преображенская И.С. Легкие и умеренные когнитивные нарушения – клинические проявления, этиология, патогенез, возможности использования ноотропной терапии. Спецвыпуск: Психиатрия. Неврология. Фарматека, 2013; 4: 14–8.
12. Elias MF, Wolf PA, D`Agostino et al. Untreated blood pressure level is inversely reated to cognitive functioning: the Framingham Study. Am J Epidemiol 1993; 138 (6): 353–64.
13. Tzourio C, Dufouil C, Ducimetiere P et al. Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of Vascular Aging. Neurology 1999; 53 (9): 1948–52.
14. Ruitenberg A, Skoog I, Ott A et al. Blood pressure and risk of dementia: results from the Rotterdam study and the Gothenburg H-70 Study. Dement Geriatr Cogn Disord 2001; 12 (1): 33–9.
15. Launer LJ, Masaki K, Petrovitch H et al. The association between midlife blood pressure level and late-life cognitive function. The Honolulu–Asia Aging Study. JAMA 1995; 274 (23): 1846–51.
16. Danlof B, Devereux RB, Kieldsen SE et al for the LIFE study group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.
17. Sierra C, de la Sierra A. Antihypertensive, cardiovascular, and pleiotropic effects of angiotensin-receptor blockers. Curr Opin Nephrol Hypertens 2005; 14: 435–41.
18. Hernandez RH, Armas-Hernandez MJ, Velasco M. Calcium antagonists and atherosclerosis protection in hypertension. Am J Ther 2003; 10 (6): 409–14.
19. Mancini GBJ, Michael E Miller, Ward Riley (for the PREVENT Investigators) Effect of Amlodipine on the Progression of Atherosclerosis and the Occurrence of Clinical Events. Circulation 2000; 102: 1503–10.
20. Forette F, Seux ML. The prevention of dementia with antihypertensive treatment: new evidence from the systolic hypertension in europe (syst-eur) study. Arch Intern Med 2002; 162 (18): 2046–52.
21. Lithell H, Hansson L, Skoog I et al for the SCOPE Study Group. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. Hypertension 2003; 21: 875–6.
22. Schrader J, Luders S, Kulschewski A et al. Morbidity and Mortality after Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: principal results of a prospective randomized controlled study (MOSES). Stroke 2005; 36: 1218–26.
23. Diener HC, Sacco R, Yusuf S. Rationale, design and baseline data of a randomized, double-blind, controlled trial comparing two antithrombotic regimens (a fixed-dose combination of extended-release dipyridamole plus ASA with clopidogrel) and telmisartan versus placebo in patients with strokes: the Prevention Regimen for Effectively Avoiding Second Strokes trial (PRoFESS). Cerebrovasc Dis 2007; 23: 368–80.
24. Tedesco MA, Ratti G, Mennella G et al. Comparison of losartan and hydrochloroth-iazide on cognitive function and quality of life in hypertensive patients. Am J Hypertens 1999; 12: 1130–4.
25. Fogari R, Mugellini A. Influence of losartan and atenolol on memory function in very elderly hypertensive patients. J Hum Hypertension 2003; 17: 781–5.
26. Schrader J et al. Effects of long-term antihypertensive therapy with losartan on blood pressure and cognitive function in patients with essential hypertension and other cerebrovascular risk factors (AWARE observational study) Med Klin (Munich) 2008; 103 (7): 491–9.
27. Hanon O. Effects of Antihypertensive Therapy on Cognitive Decline in Alzheimer's N Engl J Med 2003; 348: 1333–41.
28. Braszko J. The contribution of AT1 and AT2 angiotensin receptors to its cognitive effects. Acta Neirobiol Exp 1996; 56: 49–54.
29. Wright JW, Harding JW. The angiotensin AT4 receptor subtype as a target for the treatment of memory dysfunction associated with Alzheimers disease. J Renin Angiotensin Aldosterone Syst 2008; 9: 226–37.
30. Hanon O, Pequignot R. Relationship between antihypertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints. J Hypertens 2006; 24 (10): 2101–7.
31. Zeng F. Adherence and persistence of single-pill ARB/CCB combination therapy compared to multiple-pill ARB/CCB regimens. Curr Med Res Opin 2010; 26 (12): 2877–87.
32. Coca A. Ambulatory Blood Pressure in Stroke and Cognitive Dysfunction. Curr Hypertens Rep 2013; 15: 150–9.
2. Ferri CP, Prince M. Global prevalence of dementia: a Delphi consensus study. Lancet 2005; 366 (9503): 2112–7.
3. Суслина З.А., Варакин Ю.Я., Верещагин Н.В. Сосудистые заболевания головного мозга: Эпидемиология. Основы профилактики. М.: МЕДпресс-информ, 2009.
4. Гусев Е.И., Боголепова А.Н. Когнитивные нарушения при цереброваскулярных заболеваниях. М.: МЕДпреcс-информ, 2013.
5. Гусев Е.И., Скворцова В.И. Ишемия головного мозга. М.: Медицина, 2001.
6. Левин О.С. Диагностика и лечение деменции в клинической практике. М.: МЕДпресс-информ, 2010.
7. Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол. журн. 2006; 11 (Прил. 1): 4–12.
8. Petersen RS, Smith GE, Waring SC et al. Mild cognitive impairement: clinical characterization and outcome. Arch Neurol 1999; 56: 303–8.
9. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Int Med 2004; 256: 183–94.
10. Дамулин И.В. Легкие когнитивные нарушения. Cons. Med. 2004; 2: 138–41.
11. Преображенская И.С. Легкие и умеренные когнитивные нарушения – клинические проявления, этиология, патогенез, возможности использования ноотропной терапии. Спецвыпуск: Психиатрия. Неврология. Фарматека, 2013; 4: 14–8.
12. Elias MF, Wolf PA, D`Agostino et al. Untreated blood pressure level is inversely reated to cognitive functioning: the Framingham Study. Am J Epidemiol 1993; 138 (6): 353–64.
13. Tzourio C, Dufouil C, Ducimetiere P et al. Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of Vascular Aging. Neurology 1999; 53 (9): 1948–52.
14. Ruitenberg A, Skoog I, Ott A et al. Blood pressure and risk of dementia: results from the Rotterdam study and the Gothenburg H-70 Study. Dement Geriatr Cogn Disord 2001; 12 (1): 33–9.
15. Launer LJ, Masaki K, Petrovitch H et al. The association between midlife blood pressure level and late-life cognitive function. The Honolulu–Asia Aging Study. JAMA 1995; 274 (23): 1846–51.
16. Danlof B, Devereux RB, Kieldsen SE et al for the LIFE study group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.
17. Sierra C, de la Sierra A. Antihypertensive, cardiovascular, and pleiotropic effects of angiotensin-receptor blockers. Curr Opin Nephrol Hypertens 2005; 14: 435–41.
18. Hernandez RH, Armas-Hernandez MJ, Velasco M. Calcium antagonists and atherosclerosis protection in hypertension. Am J Ther 2003; 10 (6): 409–14.
19. Mancini GBJ, Michael E Miller, Ward Riley (for the PREVENT Investigators) Effect of Amlodipine on the Progression of Atherosclerosis and the Occurrence of Clinical Events. Circulation 2000; 102: 1503–10.
20. Forette F, Seux ML. The prevention of dementia with antihypertensive treatment: new evidence from the systolic hypertension in europe (syst-eur) study. Arch Intern Med 2002; 162 (18): 2046–52.
21. Lithell H, Hansson L, Skoog I et al for the SCOPE Study Group. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. Hypertension 2003; 21: 875–6.
22. Schrader J, Luders S, Kulschewski A et al. Morbidity and Mortality after Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: principal results of a prospective randomized controlled study (MOSES). Stroke 2005; 36: 1218–26.
23. Diener HC, Sacco R, Yusuf S. Rationale, design and baseline data of a randomized, double-blind, controlled trial comparing two antithrombotic regimens (a fixed-dose combination of extended-release dipyridamole plus ASA with clopidogrel) and telmisartan versus placebo in patients with strokes: the Prevention Regimen for Effectively Avoiding Second Strokes trial (PRoFESS). Cerebrovasc Dis 2007; 23: 368–80.
24. Tedesco MA, Ratti G, Mennella G et al. Comparison of losartan and hydrochloroth-iazide on cognitive function and quality of life in hypertensive patients. Am J Hypertens 1999; 12: 1130–4.
25. Fogari R, Mugellini A. Influence of losartan and atenolol on memory function in very elderly hypertensive patients. J Hum Hypertension 2003; 17: 781–5.
26. Schrader J et al. Effects of long-term antihypertensive therapy with losartan on blood pressure and cognitive function in patients with essential hypertension and other cerebrovascular risk factors (AWARE observational study) Med Klin (Munich) 2008; 103 (7): 491–9.
27. Hanon O. Effects of Antihypertensive Therapy on Cognitive Decline in Alzheimer's N Engl J Med 2003; 348: 1333–41.
28. Braszko J. The contribution of AT1 and AT2 angiotensin receptors to its cognitive effects. Acta Neirobiol Exp 1996; 56: 49–54.
29. Wright JW, Harding JW. The angiotensin AT4 receptor subtype as a target for the treatment of memory dysfunction associated with Alzheimers disease. J Renin Angiotensin Aldosterone Syst 2008; 9: 226–37.
30. Hanon O, Pequignot R. Relationship between antihypertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints. J Hypertens 2006; 24 (10): 2101–7.
31. Zeng F. Adherence and persistence of single-pill ARB/CCB combination therapy compared to multiple-pill ARB/CCB regimens. Curr Med Res Opin 2010; 26 (12): 2877–87.
32. Coca A. Ambulatory Blood Pressure in Stroke and Cognitive Dysfunction. Curr Hypertens Rep 2013; 15: 150–9.
________________________________________________
2. Ferri CP, Prince M. Global prevalence of dementia: a Delphi consensus study. Lancet 2005; 366 (9503): 2112–7.
3. Суслина З.А., Варакин Ю.Я., Верещагин Н.В. Сосудистые заболевания головного мозга: Эпидемиология. Основы профилактики. М.: МЕДпресс-информ, 2009.
4. Гусев Е.И., Боголепова А.Н. Когнитивные нарушения при цереброваскулярных заболеваниях. М.: МЕДпреcс-информ, 2013.
5. Гусев Е.И., Скворцова В.И. Ишемия головного мозга. М.: Медицина, 2001.
6. Левин О.С. Диагностика и лечение деменции в клинической практике. М.: МЕДпресс-информ, 2010.
7. Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол. журн. 2006; 11 (Прил. 1): 4–12.
8. Petersen RS, Smith GE, Waring SC et al. Mild cognitive impairement: clinical characterization and outcome. Arch Neurol 1999; 56: 303–8.
9. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Int Med 2004; 256: 183–94.
10. Дамулин И.В. Легкие когнитивные нарушения. Cons. Med. 2004; 2: 138–41.
11. Преображенская И.С. Легкие и умеренные когнитивные нарушения – клинические проявления, этиология, патогенез, возможности использования ноотропной терапии. Спецвыпуск: Психиатрия. Неврология. Фарматека, 2013; 4: 14–8.
12. Elias MF, Wolf PA, D`Agostino et al. Untreated blood pressure level is inversely reated to cognitive functioning: the Framingham Study. Am J Epidemiol 1993; 138 (6): 353–64.
13. Tzourio C, Dufouil C, Ducimetiere P et al. Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of Vascular Aging. Neurology 1999; 53 (9): 1948–52.
14. Ruitenberg A, Skoog I, Ott A et al. Blood pressure and risk of dementia: results from the Rotterdam study and the Gothenburg H-70 Study. Dement Geriatr Cogn Disord 2001; 12 (1): 33–9.
15. Launer LJ, Masaki K, Petrovitch H et al. The association between midlife blood pressure level and late-life cognitive function. The Honolulu–Asia Aging Study. JAMA 1995; 274 (23): 1846–51.
16. Danlof B, Devereux RB, Kieldsen SE et al for the LIFE study group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.
17. Sierra C, de la Sierra A. Antihypertensive, cardiovascular, and pleiotropic effects of angiotensin-receptor blockers. Curr Opin Nephrol Hypertens 2005; 14: 435–41.
18. Hernandez RH, Armas-Hernandez MJ, Velasco M. Calcium antagonists and atherosclerosis protection in hypertension. Am J Ther 2003; 10 (6): 409–14.
19. Mancini GBJ, Michael E Miller, Ward Riley (for the PREVENT Investigators) Effect of Amlodipine on the Progression of Atherosclerosis and the Occurrence of Clinical Events. Circulation 2000; 102: 1503–10.
20. Forette F, Seux ML. The prevention of dementia with antihypertensive treatment: new evidence from the systolic hypertension in europe (syst-eur) study. Arch Intern Med 2002; 162 (18): 2046–52.
21. Lithell H, Hansson L, Skoog I et al for the SCOPE Study Group. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. Hypertension 2003; 21: 875–6.
22. Schrader J, Luders S, Kulschewski A et al. Morbidity and Mortality after Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: principal results of a prospective randomized controlled study (MOSES). Stroke 2005; 36: 1218–26.
23. Diener HC, Sacco R, Yusuf S. Rationale, design and baseline data of a randomized, double-blind, controlled trial comparing two antithrombotic regimens (a fixed-dose combination of extended-release dipyridamole plus ASA with clopidogrel) and telmisartan versus placebo in patients with strokes: the Prevention Regimen for Effectively Avoiding Second Strokes trial (PRoFESS). Cerebrovasc Dis 2007; 23: 368–80.
24. Tedesco MA, Ratti G, Mennella G et al. Comparison of losartan and hydrochloroth-iazide on cognitive function and quality of life in hypertensive patients. Am J Hypertens 1999; 12: 1130–4.
25. Fogari R, Mugellini A. Influence of losartan and atenolol on memory function in very elderly hypertensive patients. J Hum Hypertension 2003; 17: 781–5.
26. Schrader J et al. Effects of long-term antihypertensive therapy with losartan on blood pressure and cognitive function in patients with essential hypertension and other cerebrovascular risk factors (AWARE observational study) Med Klin (Munich) 2008; 103 (7): 491–9.
27. Hanon O. Effects of Antihypertensive Therapy on Cognitive Decline in Alzheimer's N Engl J Med 2003; 348: 1333–41.
28. Braszko J. The contribution of AT1 and AT2 angiotensin receptors to its cognitive effects. Acta Neirobiol Exp 1996; 56: 49–54.
29. Wright JW, Harding JW. The angiotensin AT4 receptor subtype as a target for the treatment of memory dysfunction associated with Alzheimers disease. J Renin Angiotensin Aldosterone Syst 2008; 9: 226–37.
30. Hanon O, Pequignot R. Relationship between antihypertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints. J Hypertens 2006; 24 (10): 2101–7.
31. Zeng F. Adherence and persistence of single-pill ARB/CCB combination therapy compared to multiple-pill ARB/CCB regimens. Curr Med Res Opin 2010; 26 (12): 2877–87.
32. Coca A. Ambulatory Blood Pressure in Stroke and Cognitive Dysfunction. Curr Hypertens Rep 2013; 15: 150–9.
Авторы
В.Н.Шишкова
ГУЗ Центр патологии речи и нейрореабилитации, Москва
ГУЗ Центр патологии речи и нейрореабилитации, Москва
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