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Place of publication: a journal of neurology and psychiatry named after S.S. Korsakova / t. 125, No. 1, 2025

Resumes of
arterial hypertension (hypertension) as the main modified risk factor for the development of acute and chronic cerebrovascular accident failure, often leading to a progressive decrease in cognitive status, physical activity, requires early detection and effective pathogenetic therapy. The breadth of the therapeutic effects of the drug Mexidol (ethylmethylhydroxypyridine succinate) contributes to its widespread use. The high security profile of Mexidol and the lack of drug interactions make its use promising in the complex treatment of patients with cardiovascular diseases.

Keywords : arterial hypertension, oxidative stress, cerebrovascular insufficiency, cognitive functions, endothelial sensitivity, G-PROTEIN COUPLED Receptor 91, succinate, ethyl-methylhydroxypyrididine, mexidol.
Information about the authors:
Chukanova E.I. -https://orcid.org/0000-0002-32919615
Chukanova A.S. -https://orcid.org/0000-0003-0940-782X
Andrianov D.D. -https://orcid.org/0009-0000-6917-4277
Author responsible for correspondence: Chukanova E.I. -E-mail: chukanova-lena@yandex.ru
how to quote:
Chukanova E.I., Chukanova A.S., Andrianov D.D. Arterial hypertension is oxidative stress as a pathogenetic target of treatment of chronic cerebrovascular insufficiency. Journal of neurology and psychiatry named after S.S. Korsakova. 2025; 125 (1): 84–90. https://doi.org/10.17116/jnevro202512501184

Information about the authors:
Vlasova A.S. -https://orcid.org/0000-0002-6835-3393
Petrov S.A. -https://orcid.org/0000-0002-1566-2299
Renzyak E.V. -https://orcid.org/0007-0007-2258-2207
Author responsible for correspondence: Vlasova Anastasia Sergeevna-E-mail: okula-83@mail.ru
How to quote:
Vlasova A.S., Petrov S.A., Renzyak E.V. Neuroprotective therapy for age -related macular degeneration. Bulletin of ophthalmology. 2024; 140 (6): 152–158. https://doi.org/10.17116/oftalma2024140061152

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 10

Summary:
The article provides new information about the development of oxidative stress (OS) in chronic headaches (GB). The main biochemical characteristics of the OS are presented. Changes in MRI spectroscopy and biochemical markers are described, confirming the development of OS in migraine. The lack of significant differences in the indicators of the OS for migraine without aura and with aura is emphasized. The pathophysiological differences of migraine and chronic GB of stress are shown, at which the OS is not detected. Possible activation is discussed with the OS TRPA1 and calcitonin-genius peptide, which provokes migraine attacks. The directions of drug correction of the OS in chronic headache are considered. Key words: headache, migraine, chronic headache of tension, oxidative stress, antioxidants.

Place of publication:
cardiology and cardiovascular surgery, 2024, T. 17, No. 5

Summary:
Review of literature is dedicated to the effects of the drug Ethylmethylhydroxypyridine of succinate (reference drug - Mexidol) in patients with arterial hypertension. The analysis of 44 sources of domestic and foreign literature showed a more effective achievement of the target values ​​of blood pressure, the prevention of the development of severe complications with hypertensive crises in patients who received therapy with Mexidol. Evidence of the positive influence of cytoprotective therapy on the state of the left ventricle, the vascular wall is considered. The results of large studies are presented that demonstrate the effective correction of cognitive brain dysfunction using Mexidol. The role of the drug in the stabilization of biochemical processes, including lipid oxidation, metabolism and cholesterol, which causes the playotropic effects of Mexidol in patients with arterial hypertension, is emphasized. Keywords: arterial hypertension, endothelial dysfunction, the stiffness of the vascular wall, lipid oxidation, myocardial ducaming, cognitive impairment, ethylmethylhydroxypyridine, mexidol.

Place of publication:
New therapeutic journal Non Nocera, September, 2023

Summary:
arterial hypertension (AH) is currently a very urgent problem of modern society. Its prevalence among an adult population is an average of 30–45%, significantly increasing in older age groups. In addition, due to the expected increase in life expectancy, an increase in the number of patients with AH is predicted. From the point of view of clinical significance, special attention to AH is due to a wide range of complications caused by the disease and involved target organs, including the heart, blood vessels, kidneys, organ of vision and brain. Several large population studies showed that the higher the office blood pressure (blood pressure), the higher the risk of stroke, coronary heart disease, heart failure, peripheral arterial diseases, and the terminal stage of renal failure and sudden death. AH is also recognized as one of the pathogenetic factors of the development of vascular cognitive impairment (KN) and Alzheimer's disease. However, before achieving the final stage - dementia, patients are sequentially intermediate stages between the normal level of cognitive functioning and the very difficult KN, as the cognitive status develops progressively, gradually violating the quality of life and negatively affecting the adaptation of a person in various fields of daily activities. There are many studies that clearly established the relationship between increased blood pressure and KN and demonstrated that the latter are one of the earliest manifestations of brain damage against the background of hypertension.

Place of publication:
therapy No. 10 (72) 2023

Resume by resolution:

• The brain of AH is one of the target organs , the first symptoms of the lesion of which are vascular cognitive impairment (SKN).
• It is necessary to carry out neuropsychological testing to identify and assess the severity of SKN. The management and examination of patients with AG is carried out by the primary outpatient doctor.
• For effective treatment of SKN, antihypertensional therapy is not enough, a neuroprotection program is needed.
• The choice of a neuroprotector should be based on the evidence base and good tolerance of the drug. In order to reduce polypragmasis, it is necessary to focus on drugs with a multimodal action mechanism ( Mexidol ^® ).
• The recommended scheme of sequential therapy with Mexidol, according to the results of clinical studies, including randomized, 200-500 mg/day intravenously or intramuscularly for 14 days with a transition to a periral form, 250 mg 3 times/day for 60 days.
• Neuroprotection should serve as an integral part of patients with AG. It is recommended to supplement the algorithm for drug treatment of patients with hypertension by turning on ethylmethylhydroxypyridine of succinate (Mexidol ^® ) in the clinical recommendations “Arterial hypertension in adults” (i10/i11/i12/i13/i15, according to ICD-10).

Place of publication: Polyclinic Journal / No. 5, 2023

The demographic situation of recent decades is characterized by an increase in the number of elderly and senile people, for which, due to age -related physiological characteristics, the development of chronic brain ischemia (Khim) is characteristic. Currently, Khim is 60–75% of all cerebrovascular diseases.
Ichechemic strokes in most cases develop against the background of chemical and are a factor leading to the growth of focal and diffuse ischemic or ischemic-depths of the brain that aggravate the course of chemical and accelerating the development of dementia in patients. With ischemia, there is a sharp increase in oxidative processes, which, in combination with the insufficiency of the antioxidant protection system, leads to oxidative stress. It is pathogenetically explainable to include antioxidant drugs in the therapy diagram, one of the bright representatives of which is the drug Mexidol with a convincing evidence base.
If you do not carry out treatment and not eliminate the excess of active forms of oxygen generated by ischemia, the cascade of reactions that cause chaotic (necrosis) or programmable (apoptosis) cell death is activated. The successful solution to this problem is feasible when providing medical workers with the necessary medical information.

Keywords: chronic brain ischemia, aging, elderly, senile age, oxidative stress, antioxidant effect, neuroprotection, Mexidol

Within the framework of the 17th National Congress of therapists with international participation, which was held in Moscow from October 12 to October 14, 2022, a satellite symposium of the Vectorfarm company-“Brain: Myshin organ of arterial hypertension. Minimization of a negative forecast. ” It discussed the issues of conducting polymorbid patients and the possibilities of the drug therapy used.

With the first report-“The leading of patients with chronic brain ischemia from the perspective of evidence-based medicine”-said the neurologist, professor of the Department of Nervous Diseases Faculty of Faculty of Medicine at the first MGMU named after THEM. Sechenova of the Ministry of Health of Russia, MD V.V. Zakharov. (Read more Read more).

Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. VLUSI FSBEI HPE RMANPO of the Ministry of Health of the Russian Federation, professor, MD O.D. Ostroumova made a report "Interdisciplinary consultation of a patient with arterial hypertension." (Read more Read more).

Senior Researcher of the Federal State Budgetary Institution "Scientific Center for Neurology", Ph.D. A.A. Zavrzhzhaev presented the report “The neurological characteristics of the patient with arterial hypertension. What should be paid to. " (Read more Read more).

Concluding the symposium, prof. O.D. Ostroumova noted that at present the possibilities of medical specialists in the correction of cognitive disorders are quite wide. Of course, research in this area will continue, since there are still many “white spots” in it. But even what is known now allows you to look with confidence in the future.

Place of publication:
therapy No. 9 (61) 2022

Summary:
Cognitive disorders (KN) - a widespread clinical syndrome, with which specialists of various profiles are often found in outpatient reception. Diagnosis of KN is a responsible task, the correct solution of which requires a comprehensive study of the anamnesis, the nature of the clinical picture, the results of a laboratory and instrumental examination. A common cause of KN is cerebrovascular diseases. The article discusses the issues of patients with KN of vascular genesis, in particular, the main aspects of correction of factors of cardiovascular risk, the choice of optimal drug therapy. Information is given about the possibility of using the drug Mexidol to treat this contingent of patients. The results of studies are analyzed by the study of the possibility of the use of Mexidol in chronic cerebrovascular circulation disorders with KN. Key words: chronic brain ischemia, chronic cerebrovascular diseases, a disease of small cerebral arteries, cognitive impairment, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 5

Summary:
Purpose of the study. To study the leading pathogenetic mechanisms that underlie the development of complications of diabetes (diabetes) of the 2nd type and optimize therapeutic approaches to the treatment of this category of patients. Material and methods. The results of treatment are presented 30 patients suffering from type 2 diabetes and its complications who received Mexidol in/in a drop of 500 mg/day for 14 days, with the subsequent transition to the oral reception of Mexol Fort 250 to 250 mg 3 times a day in the course of 60 days. The dynamics of the condition was evaluated by standardized neuropsychological scales. Clinical and biochemical studies are performed according to the protocol of patients with type 2 diabetes. Results. Mexidol therapy according to the presented scheme was accompanied by an improvement in cognitive functions, a decrease in signs of asthenia, anxiety and depression, normalization of sleep, improving biochemical blood indicators, and an increase in the quality of life. Conclusion. The appointment of Mexidol in the form of consistent prolonged therapy may be an effective approach, which allows you to improve the quality of life of patients with type 2 diabetes. Keywords: diabetes, hypoxia, oxidative stress, antioxidants, neurotransmitters, antihypoxants, Mexidol.

Place of publication:
New therapeutic journal Non Nocera, August 2021

Summary:
For centuries, every representative of the fair sex wanted to stay young and beautiful as long as possible. For this, for example, Queen Cleopatra or Queen of England Elizabeth I daily took baths with milk (cows, goats, donkeys, etc.). In the Victorian era, women for the sake of whiteness of skin applied creams containing lead, which definitely did not contribute to health and a long happy life, the duration of which began to increase only in the twentieth century against the backdrop of the rapid development of medical science. According to the World Health Organization, for the period from 2015 to 2050, the number of people 60+ will increase from 900 million to 2 billion (from 12 to 22% in the total population of the world), that is, each 5th person will be over 60 years old. But is it possible to slow down even more or completely stop the aging process, and what is needed for this?

Place of publication:
New therapeutic journal Non Nocera, December, 2020

Resume:
asthenia (Greek “powerlessness”, “lack of strength”)-a protective-compensator reaction of the body to any state that threatens the exhaustion of energy resources, and by definition in ICD-10-“a constant sensation and/or complaints about a sense of general weakness, increased fatigue (with any type of load), as well as a decrease in working capacity in combination with 2 or more of the following complaints: muscle pain; headaches of tension; dizziness; sleep disturbances; dyspepsia; inability to relax; irritability".

Clinical manifestations of asthenic syndrome (AS) can be divided into:

• physical (muscle weakness, fatigue, exhaustion);

• emotional-psychological (emotional lability, irritability, a sense of internal tension, lowered mood background, apathetic);

• cognitive (decrease in mental performance, memory, concentration of attention);

• Sleep disorders (insomnia, drowsiness).

Place of publication:
New therapeutic magazine "Non Nocera", November, 2020

Summary:
arterial hypertension (AH) is an important medical and social problem around the world. The disease is often called the "silent killer" (English Silent Killer, since most patients are quite difficult to suspect the earliest symptoms of the lesions of target organs mediated by AH. Moreover, in patients with systolic blood pressure (garden)> 130 mm RT. Art. In the middle age, the risk of dementia in old age increases by 34%. According to the current clinical recommendations, the manifestations of the brain damage to AH are considered to be the so-called dumb (asymptomatic) lacunar heart attacks, hyperinathery changes in the white substance of the brain and cerebral micro-power, which are detected by magnetic resonance tomography (MRI). The clinical manifestation of brain damage as a target organ is cognitive impairment (KN). The recommendations for the treatment of patients from AH 2018 emphasize that MRI is an enough examination method, which does not allow it to use it for routine screening. However, neuroizualization, that is, an MRI, is necessary for patients with clinical signs of cognitive disorders (KF). Consequently, a competent and timely detection of cognitive complaints, signs of KN and their correction in patients with AH is an extremely important task for a doctor of any specialty.

Place of publication:
therapy No. 6 (40) 2020

Summary:
the purpose of the study is to evaluate the effectiveness, safety and the possibility of correcting the neuropsychiatric manifestations of chronic brain ischemia (chemical) drugs Mexidol ^® and Mexidol ^® Forte 250 within the framework of consecutive therapy against the background of arterial hypertension, atherosclerosis (IBS), osteoarthritis or OA) or OA) or OA) rheumatoid arthritis (RA). Material and methods. 134 patients 45–75 years old with a neuroimulated chemical chemicized, combined with hypertension, coronary heart disease and articular pathology were examined. Group 1 (observations) included 79 patients - 30 patients with RA (subgroup 1A) and 49 with the ot of the knee joints (subgroup 1b), who received in the complex therapy Mexidol ^® and Mexidol ^® Fort 250. Group 2 (control) amounted to 55 patients - 25 patients with RA (subgroup 2A) and 30 - with OA (subgroup 2B), which used to use basic therapy without the addition of Mexidol. The dynamics of subjective and physical symptoms were evaluated, values ​​on the scales of CGI, Mosa, MFI 20, anxiety and depression of Hamilton, Tinnetti. Mexidol ^® was prescribed intravenously (500 mg per day) for 14 days with the subsequent oral administration of the drug Mexidol ^® Fort 250 at 250 mg 3 times/day another 60 days. Results. ^® and Mexidol ^® to the standard treatment of drugs in the framework of consistent therapy contributed to an increasing improvement in all studied indicators. In the control groups, the cognitive status did not change. The use of initiating intravenous therapy with Mexidol increased the adherence of patients to the prolonged use of the drug. Conclusion. Violations of the locomotor function in polymorbid patients are partially associated with chemicals. The additional purpose of the consistent infusion and tablet forms of Mexidol significantly improves cognitive functions with the correction of the stability of walking, asthenic manifestations, and increases the motivation for active life. Key words: chronic brain ischemia, Mexidol ^® , Mexidol ^® Fort 250, osteoarthritis, rheumatoid arthritis, arterial hypertension, coronary heart disease.

Target. The study of the features of biochemical and morphometric indicators in patients with diabetes (diabetes) of type 2 and cognitive disorders (KN).

Material and methods. The main group was 72 patients suffering from type 2 diabetes, 20 people were included in the control group without cognitive violations from type 2 diabetes. Used: Montreal cognitive scale, level 1.5-anglyucitol, continuous monitoring of glucose levels, magnetic resonance imaging of the brain.

Results. As a result of data processing, it was revealed that in patients with type 2 diabetes and KN, a high level of glycated hemoglobin was recorded, however, there was no statistically significant difference in the level of 1.5 anhydroglucitol between the presented groups. Patients with KN have registered a decrease in the surface area of ​​gray and white matter, as well as subcortical structures - hippocampus, a adjacent nucleus and shells on both sides, amygdaly and a pale ball on the right. The severity of KN correlated with the degree of polyneuropathy. In patients with a proliferative stage of retinopathy, a decrease in the volume of the tail nucleus, pale ball, shells and adjacent core is a decrease.

Conclusion. As a result of the study, it was revealed that patients with type 2 diabetes have the worst parameters of carbohydrate metabolism; They also found a decrease in cortical and subcortical structures of the brain. Key words: diabetes, cognitive disorders, variability, morphometry.