Cognitive impairment treatment in arterial hypertension with diabetes mellitus 2nd type

Abstract

Aim. To develop the method and media for cognitive impairment correction in patients with arterial hypertension, combined with diabetes mellitus 2nd type. Material and methods. Totally 120 included with essential arterial hypertension (EAH), associated with diabetes 2nd type, with insufficient blood pressure (BP) level control. Patients with AH had 2nd grade of BP increase with mild of moderate compensated DM 2nd type with the level of glycosylated hemoglobin about 6, 25%. The patients had quite high number of concomitant diseases and risk factors. All patients received basic antihypertensive therapy (beta-blockers, ACE inhibitors, calcium channel blockers, angiotensin receptor inhibitors). Also the patients took the drugs for concomitant pathology (hypolipidemic drugs, nitrates, glucose lowering drugs). The necessary criteria for inclusion was informed consent. At outpatient stage of the study, first visit and in a year the complex of events was done: anamnesis and complaints clarification; palpation and auscultation of the heart and major vessels; BP measurement on upper extremities by Korotkov; ECG registration, Echocardiography. The biochemical sampling of fasting plasma was done: the level of glucose was measured, of glycosylated hemoglobin, lipid profile (cholesterol, triglycerides, LDL, HDL), clotting parameters (INR, APTT, fibrinogen), electrolytes (K, Mg). Also the patients completed medical questionnaires of a specific purpose. The score of psychic status was used: MINI-MENTAL STATE EXAMINATION (MMSE) M.F. FOLSTEIN, S.E. FOLSTEIN, P.R. HUGH, 1975. And if there were prominent cognitive disorders Kudesan® was prescribed — mitochondrial coenzyme Q10 — at the dosage of 60 mg per day during the next 2 months. Dosage of the drug used according to medical instructions. Results. The data witnesses that clinical effect was achieved in patients with Kudesan®: the significant improvement of cognitive functions in patients by MMSE score. The effectiveness of Q10 compound was measured by the clinical properties matching after the treatment. Before the treatment the clinical data compared were identical with the absence of statistical significance among them (p>0, 01). Conclusion. The positive influence of complex therapy is shown on the cognitive functions in patients with AH at the background of diabetes 2 type. The study showed that the inclusion of Q10 compound into the standard treatment of arterial hypertension with diabetes 2nd type is associated with positive clinical effect, especially in relevant cognitive function improvement, significant decrease of systolic and diastolic BP, relevant decrease of blood pressure variability, significant of glucose and glycosylated hemoglobin level decrease, significant Mg level increase.