arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2018-24-5-496-507arthyper-1746Research ArticleРЕДАКЦИОННАЯ СТАТЬЯEDITORIALАртериальная гипертензия и когнитивные нарушения: причины и механизмы возникновенияHypertension and cognitive disorders: causes and underlying mechanismsЦырлинВ. А.TsyrlinV. A.

Цырлин Виталий Александрович — доктор медицинских наук, главный научный сотрудник отдела экспериментальной физиологии и фармакологии. 

 Санкт-Петербург.

Vitaliy A. Tsyrlin, MD, PhD, DSc, Professor, Leading Researcher, Department for Experimental Physiology and Pharmacology, Almazov National Medical Research Centre.

St Petersburg.

КузьменкоН. В.KuzmenkoN. V.

Кузьменко Наталия Владимировна — кандидат биологических наук, старший научный сотрудник отдела экспериментальной физиологии и фармакологии ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России, лаборатории биофизики кровообращения ГБОУ ВПО ПСПбГМУ им. акад. И. П. Павлова Минздрава России.

ул. Аккуратова, д. 2, Санкт-Петербург, 197341. 

Nataliya V. Kuzmenko, PhD in Biology Sciences, Senior Researcher, Department for Experimental Physiology and Pharmacology, Almazov National Medical Research Cents, Senior Researcher, Laboratory of Byophysics of Blood Circulation, First Pavlov State Medical University of St. Petersburg.

2 Akkuratov street, St Petersburg, 197341. 

kuzmenko@niiekf.ruПлиссМ. Г.PlissN. G.

Плисс Михаил Гениевич — кандидат медицинских наук, заведующий отделом экспериментальной физиологии и фармакологии ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России, заведующий лабораторией биофизики кровообращения ГБОУ ВПО ПСПбГМУ им. акад. И. П. Павлова Минздрава России.

 Санкт-Петербург.

Mikhail  G.  Pliss, MD, PhD, Head, Department for Experimental Physiology and Pharmacology, Almazov National Medical Research Centre, Head, Laboratory of Byophysics of Blood Circulation, First Pavlov State Medical University of St. Petersburg.

Федеральное государственное бюджетное учреждение  «Национальный медицинский исследовательский центр  имени В. А. Алмазова» Министерства здравоохранения  Российской Федерации.РоссияAlmazov National Medical Research Centre.Russian FederationФедеральное государственное бюджетное учреждение  «Национальный медицинский исследовательский центр  имени В. А. Алмазова» Министерства здравоохранения  Российской Федерации; Государственное бюджетное образовательное учреждение  высшего профессионального образования «Первый Санкт-Петербургский государственный медицинский университет  имени академика И. П. Павлова» Министерства  здравоохранения Российской Федерации.РоссияAlmazov National Medical Research Centre; First Pavlov State Medical University of St. Petersburg.Russian FederationФедеральное государственное бюджетное учреждение  «Национальный медицинский исследовательский центр  имени В. А. Алмазова» Министерства здравоохранения  Российской Федерации; Государственное бюджетное образовательное учреждение  высшего профессионального образования «Первый Санкт-Петербургский государственный медицинский университет  имени академика И. П. Павлова» Министерства  здравоохранения Российской Федерации.РоссияAlmazov National Medical Research Centre; First Pavlov State Medical University of St. PetersburgRussian Federation201822112018245496507Copyright © Цырлин В.А., Кузьменко Н.В., Плисс М.Г., 20182018Цырлин В.А., Кузьменко Н.В., Плисс М.Г.Tsyrlin V.A., Kuzmenko N.V., Pliss N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1746

Известно, что при артериальной гипертензии (АГ) развиваются значительные изменения в структуре сосудов головного мозга. Существует тесная зависимость между функциональной активностью нейронов и интенсивностью их кровоснабжения. Сосудистая деменция — гетерогенная группа заболеваний, обусловленных патологией нейронов, глии и сосудов. Наиболее типичными проявлениями патологии мозга при сосудистой деменции являются когнитивные расстройства — нарушение памяти, способности к обучению, отсутствие собственного мнения, нарушение эмоционального контроля и социального поведения. В статье приводятся литературные данные об организации церебрального кровообращения и характере его изменений при АГ. Анализируются причины, приводящие к гипоперфузии мозга при повышенном артериальном давлении. Описываются механизмы, обусловливающие когнитивные нарушения у людей с АГ. Освещается вопрос о тактике врача по отношению к пациентам с АГ и когнитивными нарушениями: «Насколько нужно снижать артериальное давление?».

Arterial hypertension (HTN) is associated with significant changes in the structure of cerebral vessels. There is a close relationship between the functional activity of neurons and the intensity of their blood supply. Vascular dementia is a heterogeneous group of diseases resulting from the pathology of neurons, glia and vessels. Cognitive disorders are the most typical manifestations of brain pathology in vascular dementia and include memory impairment, decreased learning ability, lack of personal opinion, violation of emotional control and social behavior. The article overviews the data on the organization of cerebral circulation and the mechanisms of its changes in HTN. The article analyzes the causes leading to brain hypoperfusion in elevated blood pressure. The authors discuss the mechanisms resulting in cognitive disorders in hypertensive subjects. We also address the question arising in relation of HTN and cognitive impairments: “To which extent blood pressure should be lowered in hypertensive patients with cognitive decline?”.

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The authors declare that there are no conflicts of interest present.