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Improving the cognitive functions in the middle-aged patients with essential arterial hypertension after the treatment with amlodipine/valsartan single-pill combination

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Different antihypertensive drugs differently affect cognitive function, and data on the effect of single-pill combination (SPC) of antihypertensive drugs on cognitive function are presented only in single studies.

Aim. To investigate the impact of amlodipine/valsartan SPC (A/V SPC) on blood pressure (BP) level and cognitive functions in the middle-aged antihypertensive treatment-naive patients with stage II grade 1-2 essential arterial hypertension.

Methods. A group of patients with stage II grade 1-2 essential arterial hypertension who had not previously received regular antihypertensive treatment (n=38, age 49.7±7.0 years) was retrospectively formed. All the patients were treated with A/V SPC and all of them achieved target office BP (less than 140/90 mm Hg). And after 12-week follow-up (since the time of reaching the target BP) the antihypertensive treatment efficacy assessment using ambulatory BP monitoring (ABPM) were performed in all included hypertensive patients. Age-matched healthy people with normal BP (n=20, mean age 45.4±5.1years) represented a control group. In all participants cognitive functions were evaluated by 5 different tests at baseline and at the end of follow-up: Montreal Cognitive Assessment (MoCA); Trail Making test (part A and part B), Stroop Color and Word Test; verbal fluency test; 10-item word list learning task. Baseline Hamilton depression and anxiety rating scale data were also available in all individuals.

Results. According to the ABPM data 24-hour, day-time and night-time systolic, diastolic and pulse BP significantly decreased after the treatment with A/V SPC (p<0.001 for systolic and diastolic BP and p<0.01 for pulse BP). After the treatment with A/V SPC significantly improved results of cognitive tests in hypertensive patients: decreased time in Trail Making Test part B (from 114.7±37.0 to 96.3±26.5 s; р=0.001); time difference between part B and part A of Trail Making Test (from 75.2±32.8 to 57.7±20.1 s; р=0.002); time in Stroop test part 3 (from 117.0±28.1 to 108.0±28.4 s; р=0.013); and interference score (from 50.9±19.2 to 43.1±22.0 s; р=0.011); increased MoCA score (from 28.4±1.3 to 29.4±1.2; р=0.001); as well as increased the 10-item word list learning task – immediate recall (from 5.7±1.3 to 6.5±1.2 words; р=0.001); 10-item word list learning task – delayed recall (from 6.3±2.1 to 6.9±1.7 words; р=0.006); literal fluency (from 11.7±3.4 to 13.2±3.2 words; р=0.020) and categorical fluency (from 7.3±2.5 to 9.5±2.9 words; p<0.001). In control group at the end of follow-up compared to baseline significantly increased the 10-item word list learning task – immediate recall (from 5.8±0.9 to 6.6±1.1 words; р<0.05) and delayed recall (from 5.9±1.8 to 8.2±1.4 words; р<0.001).

Conclusion. In retrospective analysis improvement of cognitive function was found in middle-aged patients with hypertension, taking A/V SPC for 12 weeks after reaching the target BP. 

About the Authors

O. D. Ostroumova
Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Head of Laboratory of Clinical Pharmacology and Pharmacotherapy, Russian Gerontology Clinical Research Center, Ostrovitianova ul. 1, Moscow, 117997;

MD, PhD, Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine, Trubetskaya ul. 8-2, Moscow, 119991

E. V. Borisova
A.I. Evdokimov Moscow State University of Medicine and Dentistry; E.O. Mukhin Municipal Clinical Hospital
Russian Federation

External PhD Student, Chair of Therapy and Occupational Diseases, Delegatskaya ul. 20/1, Moscow, 127473;

MD, Cardiologist, Cardiology Department №1, Federativnii prospect 17, Moscow, 111399

A. I. Kochetkov
Pirogov Russian National Research Medical University
Russian Federation

MD, PhD, Researcher, Laboratory of Clinical Pharmacology and Pharmacotherapy, Russian Gerontology Clinical Research Center, 

Ostrovitianova ul. 1, Moscow, 117997

T. M. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, Post-Graduate Student, Chair of Nervous Diseases and Neurosurgery, 

Trubetskaya ul. 8-2, Moscow, 119991

O. V. Bondarec
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation

MD, PhD, Associate Professor, Chair of Therapy and Occupational Diseases,

Delegatskaya ul. 20/1, Moscow, 127473


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For citations:

Ostroumova O.D., Borisova E.V., Kochetkov A.I., Ostroumova T.M., Bondarec O.V. Improving the cognitive functions in the middle-aged patients with essential arterial hypertension after the treatment with amlodipine/valsartan single-pill combination. Rational Pharmacotherapy in Cardiology. 2019;15(1):54-62. (In Russ.)

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