PATHOGENETIC BASIS OF CHRONIC CEREBRAL ISCHEMIA DEVELOPMENT IN ARTERIAL HYPERTENSION

Аннотация

Chronic cerebral ischemia (CCI) is a common form of cerebrovascular disease (CVD) that leads to cognitive impairment and disability. The main risk factor is arterial hypertension. The pathogenesis of CCI is associated with inflammation, oxidative stress, cytokines (TNF-α), demyelination, and apoptosis. The disease mechanisms remain insufficiently studied, highlighting the need for further research. Objective. To assess cerebral blood flow characteristics, structural changes in brain matter, indices of lipid peroxidation processes and antioxidant system activity, hemostatic parameters, as well as markers of endothelial dysfunction and apoptosis depending on the severity of arterial hypertension (AH). Material and Methods. A comprehensive examination was conducted in 84 patients with AH aged 43–64 years. Results and Conclusion. It was established that as AH progresses, atherosclerotic lesions of the major vessels become more pronounced, along with the development of cerebral atrophy and white matter changes in the brain. These alterations are accompanied by increased oxidative stress against the background of insufficient antioxidant defense, procoagulant shifts in the hemostatic system with moderate activation of fibrinolysis, elevated levels of proinflammatory cytokines, apoptosis markers, and endothelin-1, as well as reduced nitric oxide concentration.