Abstract
Objective: To assess the severity of CI in relation to the level of RDR to antihypertensive therapy in patients with primary arterial hypertension (AH) and the features of CI on the background of RAH. Methods: A complex of modern clinical, hemodynamic and neuropsychological methods was used to assess RDR to treatment and the severity of CI in groups of patients with high and very high RDR to treatment: the group I – with controlled arterial hypertension (CAH; n=40), the group II – with RAH (n=35). Results: When screening for CI on the Montreal Cognitive Assessment (MoCA) scale, a decrease in the average number of various domains of cognitive function in patients with CAH was found against the background of increased RDR to treatment compared with RAH. The results of the neurodynamic analysis of cognitive function in the Trail Making Test (TMT) indicate the relative sustain of selective attention and information processing speed. However, the established increase in the difference between the part B and part A performance in patients with AH demonstrated a decline in flexible thinking, cognitive control, and programming. The results of the study of regulatory functions showed that frontal dysfunction was observed more often in patients of group II, although the difference was statistically insignificant (p>0.05). Based on the results of speech studies, along with the results of memory impairment testing in the Clock Drawing (CDT) and Free and Cued Selective Reminding – Immediate Recall (FCSRT-IR) tests, a more pronounced decline of semantic memory was found in patients with RAH, indicating the possibility of memory impairment not only due to secondary neurodynamic changes but also due to the neurodegenerative processes. Conclusion: A significant decrease in semantic memory in patients with RAH suggests the possibility of the transformation of cerebral vascular lesions into neurodegenerative ones or their combination. Keywords: Neuropsychological profile, cognitive impairment, hypertensive encephalopathy, risk of developing resistance to treatment, resistant arterial hypertension.
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