Impact of uncontrolled hypertension on target organs — development of heart failure and cognitive impairment. Opinion on the problem: the role of imidazoline receptor agonists

Uncontrolled hypertension (HTN) is one of the leading risk factors for the development and progression of heart failure and cognitive impairment. In real-world practice, up to 75% of patients fail to achieve target blood pressure (BP) levels.

This article summarizes current Russian and international data on the impact of persistent elevated BP on the development of heart failure (HF) and cognitive impairment.

The contribution of uncontrolled HTN can be considered within a "cardiocerebral" continuum — from early, mostly asymptomatic changes to clinically evident conditions. Chronic hemodynamic overload leads to structural and functional myocardial remodeling, diastolic dysfunction and HF progression, as well as involvement to small cerebral vessels with the development of cerebral small vessel disease and cognitive decline. Pre-HF is specifically identified as a stage in which structural changes have already developed but are potentially reversible.

The literature data is supplemented by a survey of specialists, reflecting the specifics of patient management in real-world practice. In their opinion, when treating HTN, in addition to achieving target BP levels, it is necessary to also address comorbid conditions, including metabolic disorders, as well as to implement personalized patient management. In this context, moxonidine (Physiotens®), by reducing sympathetic activity, can be considered as a component of combination therapy in patients with sympathicotonia and concomitant metabolic disorders, ensuring ИЗ control and organ protection.

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