Potentialities of medicinal correction of cerebrovascular disturbances in patients with arterial hypertension

: The use of up-to-date diagnostic methods for the examination of 72 patients presenting with grade II-III arterial hypertension and high risk of cardiovascular complications made it possible to estimate the state of brachiocephalic arteries before and after combined antihypertensive therapy that continued during 14 days. The following variables were measured: blood flow rate, peripheral vascular resistance indices at the extra- and intracranial levels, metabolic indices of cerebrovascular responsiveness, and coefficient of variability as an indicator of the cerebrovascular reserve capacity under conditions of antihypertensive treatment. Three antihypertensive therapeutic regimens were employed, viz. lisinopril plus indapamide, bisoprolol plus indapamide, and amlodipine plus indapamide. It was shown that all the three regimen resulted in positive changes in the parameters of blood flow and peripheral vascular resistance. At the same time, the use of amlodipine plus indapamide ensured a more gradual reduction of peripheral vascular resistance and the most pronounced increase of cerebrovascular reserve capacity compared with the two remaining regimens. It is concluded that the parameters of peripheral vascular resistance and metabolic indices of cerebrovascular responsiveness are the most sensitive and informative end points for the pharmacotherapeutic treatment of cerebral hemodynamics in the patients presenting with grade II-III arterial hypertension and high risk of development of cardiovascular complications.