Microcirculation in patients with arterial hypertension, coronary heart disease and cognitive impairment on treatment with Actovegin

Aim. To investigate the effect of antihypertensive and neurometabolic treatment on the microcirculation in patients with arterial hypertension, coronary heart disease and cognitive impairment. Materials and methods. In total 60 patients with arterial hypertension (AH) of 2-3 stage, coronary heart disease (extertional angina I-II functional class) and mild cognitive impairment were randomized into two groups. In first group, patients were administered antihypertensive medication and course of Actovegin (Actovegin group) while in second group patients received only antihypertensive treatment (control group). Assesment of skin microcirculation by performing of capillaroscopy and laser Doppler flowmetry and assessment of cognitive function (Shulte table) were provided three times: 1 - before antihypertensive treatment correction, 2 - at reaching of target blood pressure (BP), 3 in 4-5 weeks after. Results. Adjustment of therapy led to appropriate blood pressure control in both groups without significant differences between them. Patients in Actovegin group had significant cognitive improvement (p<0.001), significant increase in amount of functioning capillaries (p<0.05), decrease in the degree of hydration of interstitial space (p<0.05) and reduced time of reactive postocclusive hyperemia (p<0.05) at the second and third timepoint. There was no positive changes in skin microcirculation nor cognitive functions in control group. Conclusion. Reaching of target BP did not result in cognitive improvement. Concomitant use of Actovegin and antihypertensive treatment did not influence BP level but led to the reducing of functional rarefication and latent water retention in tissues as well as to cognitive impairment.

артериальная гипертензия, ишемическая болезнь сердца, микроциркуляция, когнитивные функции, капилляроскопия, лазерная допплеровская флоуметрия, рарефикация, актовегин, arterial hypertension, coronary heart disease, microcirculation, cognitive function, capillaroscopy, laser Doppler flowmetry, rarefication, actovegin

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