A personalized approach to the correction of age-dependent endothelial dysfunction in patients with cerebrovascular diseases

The role of endothelial damage as the main pathological mechanism of a number of diseases has been studied for a long time, but in the context of identifying new risk factors for CVD (viruses, genetic mutations, congenital dysplasia, autoimmune diseases), the problem of personalized cerebroprotection, taking into account the age and state of the endothelium, becomes relevant. Currently, the stage and age dependence of the development of endothelial dysfunction has been proven. Endothelial aging is a predictor of the development of cardiovascular diseases, and it can manifest itself depending on the patient’s age and the presence of comorbidity both in the direction of vasoconstriction and prothrombotic changes, and in the direction of loss of autoregulation of vasodilation and activation of oxidative stress, changes in the concentration of glucose, lipids and immune cell infiltration. Accordingly, drug correction of endothelial dysfunction should be personalized, age-oriented. The use of nicotinoyl gammaaminobutyric acid preparations, including those combined with Ginkgo Biloba extract, can be considered as a model for choosing the correction of age-dependent endothelial dysfunction in patients with cerebrovascular diseases. In young patients, the onset of endothelial dysfunction is characterized by changes in blood pressure (fluctuations from high to low numbers and vice versa), severe asthenia, headaches, mild cognitive and autonomic disorders, so at the initial stage, preference is given to a fixed combination of nicotinoyl gamma-aminobutyric acid with Ginkgo Biloba extract. In middle-aged and older patients with a long history of hypertension, stroke, and TIA in the anamnesis, it is advisable to begin therapy with parenteral forms of nicotinoyl gamma-aminobutyric acid, followed by oral administration, which will provide a prolonged effect and a more pronounced therapeutic effect.