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Ю.М.Сіренко ДУ ННЦ Інститут кардіології ім. М.Д.Стражеска НАМН України PowerPoint PPT Presentation


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Профілактика та лікування когнітивних порушень при артеріальній гіпертензії. Ю.М.Сіренко ДУ ННЦ Інститут кардіології ім. М.Д.Стражеска НАМН України. 30 жовтня 2014, Київ. Визначення. Деменція  ( лат. dementia ) — стійке порушення когнітивних функцій в результаті органічного ураження мозку

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Ю.М.Сіренко ДУ ННЦ Інститут кардіології ім. М.Д.Стражеска НАМН України

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30 2014,


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  • 5 10% 65

  • 2 5,5

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. : ... . : 14.01.15 - 2009


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J.D.Williamson, ASH Annual Meeting, New York, 2014


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(%)

n = 53, 180/110

32.1

43.3

.., .., 2007


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(%)

41,3% : 21,7% - 23,9%

.., .., 2007


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n = 13476, 20


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Corbin Bachmeier at al. Selective dihydropyridin compounds facilitate the clearence of B amiloid across the blood-brain barrier,

European Journal of Pharmacology 659 ( 2011) 124-129


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4

3

2

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0

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Forette F, The prevention of dementia with antihypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study. Arch Intern Med.2002 Oct 14;162(18):2046-52.


Accord

ACCORD:


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BP < 140/90 mmHg

Class 1 Level A

Only two observational studies and a meta-analysis suggest that preventing WML

by lowering BP is possible, but this suggestion requires verification in a large RCT

BP < 140/85 mmHg

Class 1 Level A

A BP goal < 140/85 is recommended in patients with diabetes

BP < 150/90 mmHg

Class 1 Level A

A BP goal < 150/90 is recommended in elderly patients with hypertension

Blood Pressure Targets for Primary

Prevention of Cerebral Damage

2013 ESH/ESC Guidelines. J Hypertens 2013; 31: 12811357


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Level B

Class IIa

Blood Pressure Targets for Secondary

Prevention of Cerebral Damage

BP < 140/90 mmHg

SBP < 140 mmHg is recommended/suggested in patients with previous stroke or TIA

...DBP < 90 is recommended for these patients

2013 ESH/ESC Guidelines. J Hypertens 2013; 31: 12811357


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Meta-Analysis Forest Plot

1.62 (1.39 - 1.88) 100

P<0.001

8.0

1.0

2.0

4.0

0.4

Better statin nonuser

(n= 9682)

Better statin user

(n= 2013)

Biffi et al. Stroke 2011; 42: 1314-1319


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