[The degree of cognitive disorders and related psychovegative and hemodynamic impairments in patients with essential hypertension].

AIM

to study the specific features of clinical, hemodynamic, and psychovegetative impairments in patients with essential hypertension (EH) in relation to the degree of cognitive disorders (CD).

SUBJECTS AND METHODS

Seventy-five patients with EH were examined and, according to the presence and degree of CD were divided into 3 groups: 1) 17 patients without cognitive deficit; 2) 35 patients with mild CD; 3) 23 patients with moderate CD. Risk factors, clinical manifestations, and hemodynamic and autonomic regulation features were assessed.

RESULTS

In EH patients without cognitive deficit, blood pressure (BP) corresponded to grade 1; among cerebral disorders, there was a preponderance of early signs of dyscirculatory encephalopathy (DEP) that were accompanied by subclinical anxiety disorders, preserved autonomic adaptation, and symmetrical blood flow in the common carotid artery (CCA) bed. Sympathetic autonomic tone and the occurrence of anxiety-depressive disorders were noted in EH patients with mild CD along with progression of cerebral disorders and impairments in the 24-hour BP profile and hemodynamics in the CCA bed. In patients with EH and moderate CD, the 24-hour BP profile corresponded to grade 2 and the significant cerebral symptoms were associated with the significantly impaired elastotonic properties of the vascular wall in the CCA bed and with the presence of signs of its stenosis, with the increased sympathetic and central effects on cardiac rhythm, and with moderate anxiety-depressive disorders.

CONCLUSION

In EH patients, moderate CD is attended by significant BP circadian rhythm disturbances, the functional and structural changes in the vascular wall of the CCA bed, which are combined with autonomic disregulation and anxiety-depressive disorders. The severity of the cardiac-cerebral syndrome in patients with EH should be borne in mind on elaborating individual and preventive programs.