International Medical Journal, Vol. 21., Iss. 3, 2015, P. 50−54.
BLOOD PRESSURE AND COGNITIVE FUNCTIONS IN PATIENTS WITH ARTERIAL HYPERTENSION IN THE REMOTE PERIOD AFTER STROKE
Ukrainian State Research Institute of Medical Social Problems of Disability of Ministry of Health of Ukraine, Dnipropetrovsk, Ukraine
Dnipropetrovsk State Medical Academy of Ministry of Health of Ukraine, Ukraine
One of the leading risk factors (RF) of cognitive impairment (CI) is arterial hypertension (AH), which leads to the necessity of examining the interrelation of blood pressure (BP) and cognitive functions (CF) of the patients with arterial hypertension in the remote period after stroke. The study involved 39 patients with stage III АН, with the period after stroke no less than 6 months. All patients got daily BP monitoring, and their СF were examined with generally recognized methods. Slight and moderate CI occurred in 74.2 and 25.8 % of the patients. Patients which survived stroke showed the most significant changes in the processes of memory (in 97.3 %), attention (to 90.6 %), intellect (75.6 %) and thinking (in 64.9 % of the cases). It was shown that the daily minimum systolic ВР and diastolic ВР were associated with attention and thinking, their average daily values with memory, attention and thinking, the maximum with memory. Daytime systolic ВР was associated with memory, attention and intelligence, while the daytime diastolic ВР with memory and attention; variability of daytime systolic ВР− with memory, while the daytime diastolic ВР variability with memory, attention, emotional intelligence. Nighttime systolic ВР was associated with memory and attention, and diastolic ВР with memory, attention and thinking; variability of systolic ВР at night −− with memory and diastolic ВР at night with attention. The distinctive features of the influence of daytime systolic ВР were their impact on the emotional intelligence of patients, the daytime variability of systolic ВР on memory, daytime diastolic ВР on attention and emotional intelligence, nighttime diastolic ВР on thinking, night variability in systolic ВР on memory and night diastolic ВР on the attention of patients. The results of the studies indicate the need in search for new criteria and indices of assessment of daily changes in ВР, which could evaluate their interrelations with cognitive functions as well as develop individual programs for rehabilitation of these patients.
Key words: arterial hypertension, stroke, cognitive functions, daily blood pressure monitoring, rehabilitation.