Impairment of cerebrovascular regulation and of cognitive function in hypertensive patients: A possibility for correction by angiotensin II receptor blocker
Objective. To evaluate cerebrovascular reactivity (CVR) in hypercapnia (HC) and hyperoxia (HO) in hypertensive patients before and after treatment by eprosartan (E). Design and methods. 40 healthy volunteers and 66 hypertensive patients, without cerebral stroke (age 21-56 years), were examined. We used 24-hour ambulatory blood pressure monitoring, ultrasonography of cerebral arteries (CA), and we assessed the changes of flow velocity in HC and HO, coefficient and indices of CVR and results of psychological testing. Eprosartan 600 mg/day was administered for 24 weeks. Results. Three types of CVR alteration were found: 1) decrease of HC reactions, 2) decrease of HO reactions, and 3) distortion of HО reactions of CA. Significant changes of CVR indicators were observed after treatment: normal CVR was found in HC, indicators did not reach normal values in HO, but had unidirectional natural character. We also observed improvement of abstract thinking, memory, concentration and attention switching. Conclusions. CVR and cognitive functions are decreased and altered in hypertensive patients without cerebral stroke. Eprosartan treatment is shown to be effective and safe.