Выбор антигипертензивной терапии для коррекции когнитивных нарушений и профилактики деменции: возможности валсартана и его фиксированной комбинации с гидрохлоротиазидом
Выбор антигипертензивной терапии для коррекции когнитивных нарушений и профилактики деменции: возможности валсартана и его фиксированной комбинации с гидрохлоротиазидом
Остроумова О.Д., Гарелик И.А., Каравашкина Е.А. Выбор антигипертензивной терапии для коррекции когнитивных нарушений и профилактики деменции: возможности валсартана и его фиксированной комбинации с гидрохлортиазидом. Системные гипертензии. 2016; 13 (4): 47–55.
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Ostroumova O.D., Garelik I.A., Karavashkina E.A. The choice of antihypertensive therapy in correction of cognitive impairments and prevention of dementia: possibilities of valsartan and fixed-dose combination of valsartan and hydrochlorothiazide. Systemic Hypertension. 2016; 13 (4): 47–55.
Выбор антигипертензивной терапии для коррекции когнитивных нарушений и профилактики деменции: возможности валсартана и его фиксированной комбинации с гидрохлоротиазидом
Остроумова О.Д., Гарелик И.А., Каравашкина Е.А. Выбор антигипертензивной терапии для коррекции когнитивных нарушений и профилактики деменции: возможности валсартана и его фиксированной комбинации с гидрохлортиазидом. Системные гипертензии. 2016; 13 (4): 47–55.
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Ostroumova O.D., Garelik I.A., Karavashkina E.A. The choice of antihypertensive therapy in correction of cognitive impairments and prevention of dementia: possibilities of valsartan and fixed-dose combination of valsartan and hydrochlorothiazide. Systemic Hypertension. 2016; 13 (4): 47–55.
В статье приведены определение, классификация и патогенетические механизмы нарушения когнитивных функций при артериальной гипертонии. Обсуждаются возможности антигипертензивных препаратов разных классов в коррекции когнитивных нарушений и профилактике деменции. Рассмотрены преимущества блокаторов рецепторов к ангиотензину II в профилактике деменции и их потенциальные механизмы церебропротекции. Подробно описаны возможности валсартана в коррекции когнитивных нарушений при артериальной гипертонии, его преимущества перед другими блокаторами ренин-ангиотензин-альдостероновой системы и его уникальные нейропротективные механизмы. Приведены результаты собственного исследования фиксированной комбинации валсартан/гидрохлоротиазид, в котором выявлены ее высокая антигипертензивая и церебропротективная (способность улучшать когнитивные функции) эффективность.
Ключевые слова: артериальная гипертония, когнитивные функции, деменция, антигипертензивная терапия, антагонисты рецепторов к ангиотензину II, валсартан, гидрохлоротиазид, фиксированные комбинации антигипертензивных препаратов.
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This article discusses the definition, classification and pathogenetic mechanisms of cognitive functions in arterial hypertension. The authors discuss the capabilities of the different classes of antihypertensive drugs in correction of cognitive impairments and prevention of dementia. The authors also discuss the advantages of the angiotensin II receptor blockers in prevention of dementia and in their potential mechanisms of cerebral protection. The article describes in detail the possibilities of valsartan in correction of cognitive impairments associated with arterial hypertension, the advantages of valsartan in comparison with calcium antagonists and its unique neuroprotective mechanisms. We show our own results of the study concerning fixed-dose combination of valsartan and hydrochlorothiazide, and find out that this combination has high antihypertensive and cerebral protection (capacity to improve cognitive function) and effectiveness.
Key words: arterial hypertension, cognitive functions, dementia, antihypertensive therapy, angiotensin II receptor antagonists, valsartan, hydrochlorothiazide, fixed-dose combinations of antihypertensive drugs.
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1. Zakharov V.V., Lokshina A.B. Kognitivnye narusheniia v obshcheklinicheskoi praktike. M., 2009. [in Russian]
2. Larrieu S, Letenneur L, Orgogozo JM. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002; 59: 1594–9.
3. Levin O.S. Diagnostika i lechenie dementsii v klinicheskoi praktike. M.: MEDpress-inform, 2010. [in Russian]
4. Diagnostika i lechenie arterial'noi gipertenzii. Sistemic Hypertension. 2010; 3: 5–26. [in Russian]
5. Henderson AS. Dementia. World Health Organization, Geneva 1994; p. 70.
6. Amaducci L, Andrea L. The epidemiology of the dementia in Europe. In: A.Culebras, J.Matias Cuiu, G.Roman: New concepts in vascular dementia. Barselona: Prous Science Publishers, 1993; p. 1927.
7. Levin O.S., Damulin I.V. Diffuznye izmeneniia belogo veshchestva (leikoareoz) i problema sosudistoi dementsii. V kn.: Dostizheniia v neirogeriatrii. Ch. 2. Pod red. N.N.Iakhno, I.V.Damulina. M., 1995; s.189–231. [in Russian]
8. Awad IA, Masaryk T, Magdinec M. Pathogenesis of subcortical hypertense lesions on MRI of the brain. Stroke 1993; 24: 1339–46.
9. Inzitari D, Marinoni M, Ginanneschi A. Pathophysiology of leucoaraiosis. In: New concepts in vascular dementia. A.Culebras, J.Matias Guiu, G.Roman (eds). Barcelona: Prous Science Publishers, 1993; p. 103–13.
10. Damulin I.V. Sosudistaia dementsiia. Nevrol. zhurn. 1999; 3 (4): 411. [in Russian]
11. Luriia A.R. Vysshie korkovye funktsii cheloveka. M.: Izd-vo MGU, 1969. [in Russian]
12. Luriia A.R. Osnovy neiropsikhologii. M.: Izd-vo MGU, 1973. [in Russian]
13. Luriia.A.R. Lobnye doli i reguliatsiia psikhicheskikh protsessov. M.: Izd-vo MGU, 1966. [in Russian]
14. Skoog I, Lernfelt B, Landahl S et al. 15-years longitudinal study of blood pressure and dementia. Lancet 1996; 347: 1141–5.
15. Launer LJ, Masaki K, Petrovitch H et al. The assotiation between midlife blood pressure levels and late–life cognitive function. The Honolulu–Asia Aging Study. JAMA 1995; 274: 1846–51.
16. Cacciatore F, Abete P, Ferrara N et al. The role of blood pressure in cognitive impairment in an elderly population. J Hypertens 2002; 15: 135–42.
17. Elias PK, D’Agostino RB, Elias MF, Wolf PA. Blood pressure, hypertension, and age as risk factors for poor cognitive performance. Exp Aging Res 1995; 21: 393–417.
18. Singh-Manoux A, Marmot M. High blood pressure was associated with cognitive function in middle-age in the Whitehall II study. J Clin Epidemiol 2005; 58: 1308–15.
19. Parfenov V.A., Starchina Iu.A. Kognitivnye narusheniia u patsientov s arterial'noi gipertenziei i ikh lechenie. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2011; 1: 27–33. [in Russian]
20. Starchina Iu.A., Parfenov V.A., Chazova I.E. i dr. Kognitivnye rasstroistva u patsientov s arterial'noi gipertenziei. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova 2008; 4: 39–43. [in Russian]
21. Sharp SI, Aarsland D, Day S et al. Hypertension is a potential risk factor for vascular dementia: systematic review. Int J Geriatr Psychiatry 2011; 26: 661–9.
22. Gifford KA, Badaracco M, Liu D et al. Blood pressure and cognition among older adults: a meta-analysis. [References]. Arch Clin Neuropsychol 2013; 28: 649–64.
23. Forette F, Seux M-L, Staessen JA et al. for the Syst-Eur Investigators. The Prevention of Dementia with Antihypertensive Treatment. New evidence from the Systolic Hypertension (Syst-Eur) Study. Arch Intern Med 2002; 162 (18): 2046–52.
24. Lithell H, Hansson L, Skoog I et al. SCOPE Study Group. The study on cognition and prognosis in the elderly (SCOPE). Principal results of a randomised double-blind intervention trial. J Hypertens 2003; 21: 875–86.
25. PROGRESS collaborative study group. Randomised trial of perindopril based blood pressure-lowering regimen among 6108 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 1033–41.
26. Marpillat NL, Macquin-Mavier I, Tropeano A-I et al. Antihypertensive classes, cognitive decline andincidence of dementia: a networkmeta-analysis. J Hypertens 2013, 31 (6): 1073–82.
27. Chiu W-C, Ho W-C, Lin M-H et al. Health Data Analysis in Taiwan (hDATa) Research Group. Angiotension receptor blockers reduce the risk of dementia. J Hypertens 2014, 32: 938–47.
28. Li NC, Lee A, Whitmer RA et al. Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis. BMJ 2010; 340: b5465.
29. Davies NM, Kehoe PG, Ben-Shlomo Y, Martin RM. Associations of antihypertensive treatments with Alzheimer’s disease, vascular dementia, and other dementias. J Alzheimers Dis 2011; 26: 699–708.
30. Hajjar I, Brown L, Mack WJ, Chui H. Impact of Angiotensin Receptor Blockers on Alzheimer Disease Neuropathology in a Large Brain Autopsy Series. Arch Neurol 2012; 69 (12): 1632–8.
31. 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.
32. Karpov Iu.A. Valsartan: tsentral'noe mesto v lechenii kardiologicheskogo bol'nogo. Novosti kardiologii. 2014; 2: 52–6. [in Russian]
33. Julius S, Kjeldsen SE, Weber M et al. VALUE trial group. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363 (9426): 2022–31.
34. McMurray J, Solomon S, Pieper K et al. The effect of valsartan, captopril, or both on atherosclerotic events after acute myocardial infarction: an analysis of the Valsartan in Acute Myocardial Infarction Trial (VALIANT). J Am Coll Cardiol 2006; 47 (4): 726–33.
35. Peters S, Götting B, Trümmel M et al. Valsartan for prevention of restenosis after stenting of type B2/C lesions: the VAL-PREST trial. J Invasive Cardiol 2001; 13 (2): 93–7.
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1 ФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ФГБОУ ВО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ostroumova.olga@mail.ru
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ostroumova.olga@mail.ru