Introduction: Leukoaraiosis is known as an independent prognostic factor for stroke, myocardial infarction, cognitive impairment or dementia. However, the possibilities of antihypertensive therapy in regression of leukoaraiosis are not well studied. Objective: To compare of antihypertensive and cerebroprotective effects of 6 months-long treatment with felodipin (F) (FELODIP®, «TEVA») and verapamil (V) (ISOPTIN SR®, «Abbott») in hypertensive patients. Methods: We studied 53 hypertensive pts (24 men, aged 30 to 67 y.o). Among them, 29 pts (16 men) were receiving F 5–10 mg once-daily, and 24 pts (8 men) were taken V 240 -480 mg per day (once- or twice-daily) through 6 months. Following parameters were estimated: 24-hours blood pressure (BP) monitoring and brain MRI. Results: In all patients there was a significant fall of blood pressure (p < 0.05) that was did not differ with respect to the antihypertensive agent used. F decreased systolic/diastolic BP level at 10.4/10.4% and V reduced BP at 10.0/8.5%. However, there was a difference in the effect of therapy on nocturnal BP dipping: in F-group there was normalization index nocturnal systolic BP (SBP) fall in non-dippers (from 4.4 ± 1.9% to 10.0 ± 3.9%, p < 0.05), over-dippers (from 23.0 ± 2.8% to 15.0 ± 7.7%, p < 0.05) and not change that in dippers (from 12.5 ± 3.2% to 11.0 ± 4.0%). In V-group there was decrease of index nocturnal SBP fall in dippers (from 13.4 ± 2,8% to 8.0 ± 4.0% p < 0.05), not change that in non-dippers (from 5.0 ± 1.6% to 7.2 ± 4.4%, p > 0.05) and non significant decrease that in over-dippers (from 22.5 ± 2.1% to 16.0 ± 1.4%, p > 0.05). In all patients there was significant decrease of depth of leukoaraiosis (from 2.5 ± 0.9 to 2.0 ± 0.8 mm, p < 0.05 for F-group, and from 2.2 ± 0.7 to 1.5 ± 0.9 mm, p < 0.05 for V-group). At the same time, regression of leukoaraiosis was achieved more frequently of pts in F-group, than of pts in V-group (50% vs. n = 14%, p < 0.05). Conclusion: Antihypertensive therapy by felodipin in hypertensive patients exerted a more favorable influence on the circadian rhythm of blood pressure and was more effective for the regression of leukoaraiosis than treatment by verapamil.

Aim. The study addresses antihypertensive and cerebroprotective effects of long acting metoprolol (Egiloc retard, Egis, Hungary). Materials and methods. 47 objects with I-II stages of hypertension without serious concomitant diseases (25 males and 22 females, average age 51,7 ± 10,6 years) were included. Long acting metoprolol was administered (Egiloc retard, Egis, Hungary) in a dose of 25-100 mg given 1-2 times per day. 24-hour ambulatory blood pressure monitoring (ABPM), magnetic resonance tomography and dynamic contrast-enhanced perfusion computer scan of the brain with brain blood flow estimation were performed in all patients initially and after 6-month-therapy. Results. Egiloc retard showed a significant antihypertensive effect according to office and ABPM blood pressure. Egiloc retard normalizes 24-hour blood pressure profile in over-dippers and night-peakers. Subjective amelioration and improvement of functional and structural changes were found in hypertensive patients after 6-month therapy by Egiloc retard. Good tolerance and no significant abnormal changes of glucose and lipid metabolism were observed in patients taking Egiloc retard. It is also shown that Egiloc retard has the cerebroprotective effects.

The aim of our work was studying influence of calcium antagonist felodipine on the blood pressure (BP) daily index (DI) in patients with arterial hypertension. 24-h BP monitoring was performed at 29 patients with essential hypertension initially and after 1, 2, 3 and 6 months of felodipine therapy in a dose of 2,5-15 mg per day. Significant reduction of the office BP and 24-h monitoring BP was noted. Favourable influence of felodipine on DI in patients with DI abnormalities was revealed as well. The revealed peculiarities of felodipine allow to recommend it for preventive maintenance of cardiovascular complications in patients with DI complications.

Dynamics of hypertensive encephalopathy signs and brain perfusion under influence 6-month therapy by felodipine was estimated. The study included 29 patients having hypertension of the II stage. The treatment with felodipine resulted in decreased arterial pressure and signs of intracranial hypertension and increased blood flow in the area of periventricular edema. It is concluded that felodipine has expressed cerebroprotective efficacy besides its hypertensive action.

Results of 5-years clinical follow up study of 137 arterial hypertension (1-2 stages) patients aged 48,9±6 years are presented in the article. Twenty five (18,2%) of patients revealed cardiovascular complications within five years of follow-up. The link of complicated arterial hypertension development with arterial pressure level was revealed. Hypertrophy of the left ventricle was more expressed in patients with complications in initial observation according to echocardiographic data. The data obtained demonstrate that arterial pressure level is associated more with cardiovascular complications development than office arterial pressure. Thus one should take this fact into account while prognosing possibilities of cardiovascular complications development.