Arterial hypertension in the elderly and higher mental functions. Possibilities of an-tihypertensive therapy withArifon retard in the prevention of dementia.


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Abstract

Low-dose thiazide and thiazide-like diuretics (indapamide retard) are the drugs of choice in the treatment of elderly patients with arterial hypertension (AH), including isolated systolic AH (ISAH). The problem of treatment of AH in elderly patients is associated with that of vascular dementia. Despite the fact that AH is a major risk factor in the development and progression of dementia, its impact on higher mental functions in patients, including geriatric ones, has been little studied to the present day. The paper also gives the results of Syst-Eur and HYVET clinical trials. The results of the authors\' investigation are also presented. Twenty-six elderly patients (aged 60-74 years; mean age 65.2+5.9 years) with untreated or ineffectively treated grades 1-2 essential AH (mean disease duration 17.3+5.6 years) were examined; women were 84.6%; patients with ISAH and those with grade 1 AH were 70,8 and 84.6%, respectively. The patients were given the diuretic indapamide retard (Arifon retard, (Servier, France) in a dose of 1.5 once daily in the morning; the follow-up was 24 weeks. Physical examination, routine blood pressure (BP), 24-hour BP monitoring, and neuropsychological study, as described by A.R. Lu-ria, were conducted. Following 24-week treatment, there was a significant reduction in both di-urnal and nocturnal systolic and diastolic BP. After the performed treatment, there was a signifi-cant visual-logistic improvement (p<0,05) - the number of patients who had performed tests incorrectly decreased from 37 to 12%. During Arifon retard therapy, the volume of long-term auditive-verbal memory was significantly increased and the memorizing capacity also im-proved significantly. Therefore, antihypertensive monotherapy with Arifon retard significantly improved operative thinking and some parameters of memory in elderly patients with AH.

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