Cognitive dysfunctions in patients with hypertension — pathogenesis and treatment

Memory disorders are one of the most frequent abnormalities found in the elderly. The dominant cause of the disorder is dementia of Alzheimer’s type (about 60%), vascular dementia is responsible for 15–20% of cases, and the rest are mixed forms. One of the basic symptoms is a weakening of the ability to remember. With time, dementia becomes more severe and the cognitive and mental disorders are accompanied by progressive somatic infirmity, leading in the final stage to bed immobilization and total dependence on the care of other people. Treatment of vascular dementia comes down to counteracting stroke risk factors and treating hypertension, as well as diabetes and other cardiovascular diseases. It has been clearly demonstrated that hypotensive drugs can reduce the risk of dementia. When choosing therapy for elderly patients, we should also bear in mind the effects on blood pressure and blood pressure variability, as these have been shown to be associated with a higher risk of dementia. The guidelines indicate the benefit of using a combination of a thiazide-like diuretic (indapamide) and a calcium antagonist (amlodipine) in elderly. Combination treatment with a converting enzyme inhibitor (perindopril) and a thiazide-like diuretic (indapamide) is also particularly beneficial in this age group.