Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya30529Editorial articleПередовая статьяEssential hypertension, dementia, and antihypertensive therapy in geriatric patientsАртериальная гипертония, деменция и антигипертензивная терапия у пациентов пожилого возрастаKobalavaZhanna DavidovnaКобалаваЖанна Давидовна

зав. кафедрой, каф. пропедевтики внутренних болезней медицинского факультета; Российский университет дружбы народов

zkobalava@mail.ruKotovskayaYuliya ViktorovnaКотовскаяЮлия Викторовна

роф. кафедры, каф. пропедевтики внутренних болезней медицинского факультета; Российский университет дружбы народов

kotovskaya@bk.ruTyul'kinaEkaterina Evgen'evnaТюлькинаЕкатерина Евгеньевна

проф. кафедры, каф. пропедевтики внутренних болезней медицинского факультетаглавный врач; Российский университет дружбы народовГКБ № 64

KobalavaZh DKotovskayaYu VTyulkinaE EРоссийский университет дружбы народовРоссийский университет дружбы народовГКБ № 64151020098110NO10 (2009)ТОМ 81, №10 (2009)647009042020Copyright ©; 2009, Consilium MedicumCopyright ©; 2009, ООО "Консилиум Медикум"2009Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/30529

The review summarizes the current views on the pathogenesis of dementia and the significance of blood pressure levels for its development. The present status of the prevention of cognitive disorders and dementia is detailed in the use of antihypertensive therapy: there are the data of prospective cohort studies of the impact of antihypertensive therapy on the risk of dementia, the results of placebo-controlled studies in the groups of elderly and senile patients with a history of cerebrovascular complications, and the data of meta-analyses of studies. As for cognitive function, the effects of different classes of the currently available antihypertensive agents, such as diuretics, calcium antagonists, angiotensin-converting enzyme inhibitors, and angiotensin II type 1 receptor antagonists, are analyzed.

В обзоре суммированы современные представления о патогенезе деменции и значении уровня артериального давления для ее развития. Подробно освещено современное состояние проблемы профилактики когнитивных нарушений и деменции при назначении антигипертензивной терапии: приведены данные проспективных когортных исследований о влиянии антигипертензивной терапии на риск развития деменции, результаты плацебо-контролируемых исследований в группах пожилых и очень пожилых пациентов с наличием в анамнезе цереброваскулярных осложнений, а также данные метаанализов исследований. Проанализированы в отношении когнитивной функции особенности эффектов различных классов современных антигипертензивных препаратов - диуретиков, антагонистов кальция, ингибиторов ангиотензинпревращающего фермента и антагонистов рецепторов 1-го типа к ангиотензину II.

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