Conceptual approaches to cerebral blood flow correction in postmenopausal women with arterial hypertension

Abstract

Aim. To assess cerebral blood flow and cholesterol (CH) metabolism in postmenopausal women with arterial hypertension (AH); to evaluate dynamics of cerebral blood flow and lipid profile during 6-month antihypertensive and hypolipidemic therapy.
Material and methods. Postmenopausal women (n=47) with Stage I-II AH were examined. Leading clinical symptoms were explained by cerebrovascular pathology. All participants were divided into two groups: moexipril monotherapy (7.5-15 mg/d; n=15) and fosinopril monotherapy (10-20 mg/d; n=15). Women with dyslipidemia were administered atorvastatin, 10 mg/d: 10 patients in moexipril group, and 7 in fosinopril group. At baseline and 6 months later, Doppler ultrasound and lipoprotein profile assessment were performed in all participants.
Results. At baseline, increased systolic blood flow velocity (S), decreased pulse index (PI), and increased cerebral vascular resistance index (RI) were observed in hypertensive women, comparing to age-specific normal levels. Six-month antihypertensive therapy was associated with S decrease, PI increase, and RI reduction, without any significant difference in cerebral hemodynamics parameters between two groups. At the same time, positive dynamics was more manifested in combined antihypertensive and hypolipidemic treatment. In these patients, cerebral hemodynamics improvement was combined with improvements in lipid profile and quality of life. Conclusion. In women with long-term AH duration, cerebral hemodynamics is typically disturbed. Combined antihypertensive and hypolipidemic therapy has the greatest beneficial effect on cerebral perfusion.