[Impact of antihypertensive therapy on clinical status and quality of life in patients with initial manifestations of hypertensive encephalopathy].

AIM: To study the clinical and instrumental characteristics of hypertensive encephalopathy (HE) in early stages, as well as the time course of their changes during long-term antihypertensive therapy (AHT). SUBJECTS AND METHODS: Prior to and after 9-month AHT, 57 patients aged 50-70 years who had uncomplicated grades 1-2 arterial hypertension (AH) with grades I-II HE underwent comprehensive examination comprising the studies of cognitive functions, quality of life (QL), hemorheology, and hemostasis, duplex scanning of great and intracerebral vessels, echocardiography, 24-hour blood pressure monitoring, magnetic resonance imaging. RESULTS: Early-stage HE was characterized by more cerebral complaints, higher rates of hypertensive crises, a greater degree of psychoautonomic syndrome, and worse QL. Focal brain lesions were detected in 74%; left ventricular hypertrophy (LVH) was diagnosed in 61% of cases. All the patients were observed to have cognitive dysfunctions. AHT (amlodipine, lisinopril) produced a good antihypertensive effect and substantial improvements of the patients' cognitive functions, health status, and QL. LVH regression was achieved. CONCLUSION: HE is a clinical manifestation of damage to the brain as the principal target organ in AH and should be therefore kept in mind in estimating the cardiovascular risk. The diagnosis of HE requires the use of tests to evaluate cognitive functions.

[Risk factors of vascular brain disorders in patients with diabetes mellitus]. / Faktory riska sosudistykh porazhenii mozga u bol'nykh sakharnym diabetom.

Several studies of patients with diabetes mellitus were analyzed in review. The aim of these studies was to determine the most significant risk factors of vascular brain disorders. The pattern and peculiarities of microvascular disorders which progress simultaneously with changes in brain vessels are discussed. The interaction between several risk factors of major arteries atherosclerosis is analyzed what is of reasonable practical importance.

[Retrospective analysis of cerebrovascular disorders in patients with lesions of the major arteries of the head]. / Retrospektivnyi analiz tserebrovaskuliarnykh narushenii u bol'nykh s porazheniiami magistral'nykh arterii golovy.

378 cases of cerebrovascular disorders with the history of apoplexy were analyzed retrospectively. It was found that initial symptoms of cerebrovascular insufficiency occurred in 7.4%, episodes of cerebrovascular failure were registered in 31.2% of cases. In most of the patients the stroke came as a debut of vascular abnormalities in the brain. They had no stages in the development of cerebrovascular pathology. It is necessary to detect asymptomatic disturbances of major cerebral vessels using modern non-invasive diagnostic techniques--ultrasonic dopplerography and duplex scanning.

[Physical activity and physical work capacity of patients with initial manifestations of cerebrovascular disorders in arterial hypertension]. / Fizicheskaia aktivnost' i fizicheskaia rabotosposobnost' bol'nykh s nachal'nymi proiavleniiami nedostatochnosti krovoobrashheniia mozga pri arterial'noi gipertonii.

The routine protocol of general and neurological examinations and some special questionnaires were used to examine physical activity (FA) and physical working capacity (FWC) in a random population from one of the Moscow districts which included 1200 persons (males and females aged 30-64 years). The majority of the examinees were those who had slight and moderate exercises, mainly sitting work, did few or no physical exercises. The proportion of persons with low physical activity increased with age both among males and females. The ratios generally remained despite the presence of early signs of abnormal blood supply. Bicycle ergometer testings showed a significant reduction in the physical working capacity of the patients with abnormal brain blood supply, in a greater extent, in arterial hypertension. Decreased functional activity and functional working capacity may regarded as one of the risk factors for cerebrovascular disorders, in arterial hypertension in particular, and should be borne in mind in implementing preventive measures.

[Neurological aspects of medical ecology]. / Nevrologicheskii aspekt meditsinskoi ékologii.

The paper deals with a number of problems facing clinical neurology. They arise in neurological disorders stemming from unfavourable ecological conditions.

[Characteristics of cerebral hemodynamics and the resistance to major cardiovascular diseases based on the data of an epidemiologic survey]. / Osobennosti mozgovoi gemodinamiki i ustoichivost k osnovnym serdechno-sosudistym zabolevaniiam po dannym épidemiologiches- kogo issledovaniia.

In the cross-sectional population study of 411 subjects aged 35-64 years and longitudinal 5.5-year follow-up of 157 aged 20-54 years, a relationship was examined between pulse blood flow to the cerebral vessels, their tone as assessed by rheoencephalography and resistance to arterial hypertension, coronary heart disease, and brain vascular lesions. The proportion of healthy persons (without the above-mentioned diseases) was shown to be larger if the pulse blood flow to the cerebral vessels was higher and their tone was lower. In the longitudinal study, the probability to remain healthy was demonstrated to be increased with elevated pulse flow to the cerebral vessels.