title: Influence of antihypertensive therapy on cerebral perfusion in patients with metabolic syndrome: relationship with cognitive function and 24-h arterial blood pressure monitoring.
abstract: OBJECTIVE
  To investigate the regional cerebral blood flow, cognitive function, and parameters of 24-h arterial blood pressure monitoring in patients with metabolic syndrome before and after combination antihypertensive therapy.
  
  
  METHODS
  The study involved 54 patients with metabolic syndrome (MetS) investigated by brain single-photon emission computed tomography, 24-h blood pressure monitoring (ABPM), and comprehensive neuropsychological testing before and after 24 weeks of combination antihypertensive therapy.
  
  
  RESULTS
  Patients with metabolic syndrome had significantly poorer regional cerebral blood flow compared with control group: by 7% (P = 0.003) in right anterior parietal cortex, by 6% (P = 0.028) in left anterior parietal cortex, by 8% (P = 0.007) in right superior frontal lobe, and by 10% (P = 0.00002) and 7% (P = 0.006) in right and left temporal brain regions, correspondingly. The results of neuropsychological testing showed 11% decrease in mentation (P = 0.002), and 19% (P = 0.011) and 20% (P = 0.009) decrease in immediate verbal and visual memory in patients with MetS as compared with control group. Relationships between the indices of ABPM, cerebral perfusion, and cognitive function were found. Data showed an improvement of regional cerebral blood flow, ABPM parameters, and indicators of cognitive functions after 6 months of antihypertensive therapy in patients with MetS.
  
  
  CONCLUSIONS
  The study showed the presence of diffuse disturbances in cerebral perfusion is associated with cognitive disorders in patients with metabolic syndrome. Combination antihypertensive treatment exerts beneficial effects on the 24-h blood pressure profile, increases cerebral blood flow, and improves cognitive function in patients with MetS.
authors.affiliation: Federal State Budgetary Scientific Institution, Research Institute for Cardiology, Tomsk, Russia.|National Research Tomsk Polytechnic University, Tomsk, Russia.
authors.forename: Nataliya Y
authors.initials: NY
authors.lastname: Efimova
authors.affiliation: Federal State Budgetary Scientific Institution, Research Institute for Cardiology, Tomsk, Russia.|National Research Tomsk Polytechnic University, Tomsk, Russia.
authors.forename: Vladimir I
authors.initials: VI
authors.lastname: Chernov
authors.affiliation: Federal State Budgetary Scientific Institution, Research Institute for Cardiology, Tomsk, Russia.
authors.forename: Irina Y
authors.initials: IY
authors.lastname: Efimova
authors.affiliation: Federal State Budgetary Scientific Institution, Research Institute for Cardiology, Tomsk, Russia.|National Research Tomsk Polytechnic University, Tomsk, Russia.
authors.forename: Yuri B
authors.initials: YB
authors.lastname: Lishmanov
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008568:Memory / Q000187:drug effects; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests; D055420:Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Antihypertensive treatment; Brain perfusion; Circadian rhythm of blood pressure; Cognitive function; Metabolic syndrome