Антигипертензивные препараты в профилактике когнитивных нарушений и деменции: фокус на антагонисты кальция и диуретики

Артериальная гипертония ассоциирована с повышенным риском снижения когнитивных функций и развития сосудистой деменции и болезни Альцгеймера. В этом контексте антигипертензивная терапия может иметь профилактический эффект. Представленные в настоящем обзоре литературные данные свидетельствуют о том, что, несмотря на наличие некоторых противоречий в результатах исследований, антигипертензивные препараты, особенно дигидропиридиновые антагонисты кальция, диуретики и некоторые блокаторы ренин-ангиотензин-альдостероновой системы, обладают церебропротективными свойствами, причем не только за счет снижения артериального давления, но также и посредством дополнительных специфических нейропротективных механизмов. Это позволяет рассматривать антагонисты кальция и диуретики в качестве важного компонента лечения артериальной гипертонии, в т.ч. у пациентов пожилого и старческого возрастов, для профилактики снижения когнитивных функций и развития разных типов деменции.

Нитрендипин среди антагонистов кальция и индапамид среди диуретиков обладают наибольшей доказательной базой, свидетельствующей о наличии у них выраженных церебропротективных свойств.

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