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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.

Presidium of the Council of Experts:

Martynov A.I., MD, professor, academician of the Russian Academy of Sciences, professor of the Department of Hospital therapy No. 1 of the Federal State Budgetary Institution “Moscow State Medical and Dental University named after A.I. Evdokimova "of the Ministry of Health of Russia, President of the Russian Scientific Medical Society of therapists (RNDMO), Moscow

Tanashian M.M., MD, professor, corresponding member of the Russian Academy of Sciences, deputy. Director for scientific work of the FGBN “Scientific Center of Neurology”, Moscow

Malyavin A.G., MD, professor at the Department of Testions and Pulmonology Faculty of Faculty of Faculty of FSBEI in the Moscow State Medical and Dental University named after A.I. Evdokimova ”of the Ministry of Health of Russia, chief freelance pulmonologist of the Ministry of Health of Russia for the Central Federal District, General Secretary of the RND, Moscow

Participants in the Council of Experts:

Bogolepova A.N. D.M.N., head of the cognitive violations department of the Federal Center for Brain and Neurotechnology, FMBA of Russia, professor of the Department of Neurology, Neurosurgery and Medical Genetics of Faculty of Faculty of Faculty of Medicine in the Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of Russia, Moscow

Borovkova N.Yu., MD, the first deputy. Director of the Institute of Therapy, Professor of the Department of Hospital Therapy and General Medical Practice of the Volga Research Medical University of the Ministry of Health of Russia, Nizhny Novgorod.

Eliseeva L.N., MD, professor, head. Department of Faculty of Faculty of FSBENSI and Kuban State Medical University of the Ministry of Health of Russia, Chairman of the Krasnodar Regional Branch of the RND, Krasnodar

Zhuravleva M.V., MD, professor, professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases of the FGAOU in the First Moscow State Medical University named after THEM. Sechenova "of the Ministry of Health of Russia (Sechenov University), the main freelance specialist - a clinical pharmacologist of the Department of Health of the city of Moscow, Moscow

Zakharov V.V., MD, professor at the Department of Nervous Diseases and Neurosurgery of the FGAOU in "First Moscow State Medical University named after THEM. Sechenova "of the Ministry of Health of Russia (Sechenov University), Moscow

Koryagina N.A., MD, professor at the Department of Clinical therapy of FSBEI in Perm State Medical University named after Academician E.A. Wagner ”of the Ministry of Health of Russia, Vice-President of the Association of Doctors of the therapeutic Profile of the Perm Territory, Chairman of the Perm Regional Department of the RND, Chief Forest Transportist of the Ministry of Health of the Perm Territory, Perm Perm

Mikhin V.P., MD, professor, head. Department of Internal Diseases No. 2 of the FSBEI in “Kursk State Medical University” of the Ministry of Health of Russia, Kursk

Osipova I.V., MD, professor, head. Department of Faculty Therapy and Professional Diseases of the FSBEI in Altai State Medical University of the Ministry of Health of Russia, Barnaul

Ostroumova O.D., MD, professor, head. Department of Therapy and Polymorbid Pathology of the Federal State Budgetary Institution of the DPO “Russian Medical Academy of Continuing Professional Education” of the Ministry of Health of Russia, Moscow

Poznyak A.O., MD, professor, head. The Department of Therapy, Geriatrics and the General Practice of the Kazan State Medical Academy - a branch of the Federal State Budgetary Institution of the DPO “Russian Medical Academy of Continuing Professional Education” of the Ministry of Health of Russia, Kazan Kazan

Portnyagina U.S., Ph.D., Associate Professor of the Department of Internal Diseases and General Personnel Practice (Family Medicine) of the FGOU FGAOU in North-East Federal University named after M.K. Ammosova ”, the main freelance specialist in therapy and general medical practice of the Ministry of Health of the Republic of Sakha (Yakutia), Yakutsk

Statsenko M.E., MD, professor, head. Department of Internal Diseases of the FSBEI in Volgograd State Medical University of the Ministry of Health of Russia, Volgograd

Tyrenko V.V., MD, professor, head of the department and clinic of the faculty therapy of the Federal State Budgetary Institution “Military Medical Academy named after S.M. Kirov »of the Ministry of Defense of the Russian Federation, chief cardiologist of the Ministry of Defense of the Russian Federation, St. Petersburg St.

Chesnikova A.I., MD, professor, head. Department of Internal Diseases No. 1 of the Federal State Budgetary Institution “Rostov State Medical University” of the Ministry of Health of Russia, the main freelance specialist in therapy of the Southern Federal District, Rostov-on-Don

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:
cardiology and cardiovascular surgery, 2023, T. 16, No. 4

Summary:
Purpose of the study. Assessment of the effect of Mexidol, as part of the complex therapy of heart failure for 10 weeks on cognitive status, quality parameters, asthenic syndrome and anxiety level in patients with XN II-III functional class (according to NYHA classification). Material and methods. An open randomized study included 60 comorbide patients with coronary heart disease (coronary heart disease) and stable chronic heart failure (COL) with cognitive disorders (KN) ≤24 points on the Montreal scale for evaluating cognitive functions (MOCA). The average age of patients was 73.4 ± 8.6 years, 53% - male, the average release fraction of 43.5 ± 10.6%. 30 patients were included in the standard therapy group with the additional purpose of Mexidol (500 mg intravenously dropped 1 time per day for 14 days, then 250 mg 3 times a day 8 weeks) and 30 patients in a standard therapy group. Initially and at the end of the study, an assessment of the effect of therapy on the cognitive status of patients on the Montreal scale of assessment of cognitive functions (Mosa), anxiety level on the Bek scale, the degree of severity and the dynamics of asthenic syndrome on the subjective scale of astheny assessment (MFI-20), and health profiles according to the questionnaire was carried out EQ-5D-5L and quality parameters based on the results of the Essence on the Minnesotsky (MlHFQ), Kansas (Kansas City CardiOMYOPATHY QUESTIONNAIRA, KCCQ) and the SF36 questionnaire “Evaluation of the quality of life”. Results. In patients who received Mexidol, in addition to standard therapy, a reliable improvement of cognitive function by 21%was revealed, a decrease in anxiety-by 38%and the severity of asthenic syndrome-by 12%, improve the overall health of the EQ-5D-5L questionnaire-by 25%by 25% , as well as the qualities of life according to the Minnesotsky questionnaire - by 48%, according to the Kansas questionnaire - by 39%. Conclusion. Mexidol, when adding to standard therapy of patients with XN II-III, functional class, reliably improves cognitive status, quality parameters, reduces the severity of asthenic syndrome and anxiety level. Key words: heart failure, cognitive status, quality of life, Mexidol.

¹ FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University);
² FSBEI of DPO “Russian Medical Academy of Continuing Professional Education” of the Ministry of Health of Russia, Moscow;
³ FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow

Place of publication:
therapy No. 1 (63) 2023

Summary:
Annotation. Chronic brain ischemia (Khim) is one of the most common in the clinical practice of neurological pathological conditions. The goal is to evaluate the effectiveness and safety of sequential therapy with Mexidol ^® intravenously and Mexidol ^® Fort 250 oral in groups of patients with arterial hypertension (AH) and without the aspect of the drug on cognitive functioning, as well as the severity of asthenic, anxiety, autonomic and motor disorders, and Quality of life in a chemical conditions. Material and method. Within the framework of subanalysis, patients with chemicals were divided into 4 subgroups: 1st-patients with AH who received drugs Mexidol ^® and Mexidol ^® Forter 250 (n = 144); 2nd-patients with AG who received placebo (n = 146); 3rd-patients without hypertension receiving Mexidol ^® and Mexol ^® Fort 250 (n = 15); 4th-patients without hypertension receiving placebo (n = 12). Results. At the end of the observation period, statistically significant differences in the dynamics of the Mosa scale between groups of patients receiving Mexidol ^® and placebo (p = 0,000), indicating the superior effectiveness of the use of Mexidol in the subgroup of patients with AH, were identified. Against the background of therapy with Mexidol ^® , unlike placebo, the median value of the point on the Mosa scale at the end of the observation period reached the level of norm in all patients. When assessing the secondary endpoints of effectiveness, the statistically significant advantage of Mexidol over the placebo in the population of patients with AH at the final visit was achieved by the following parameters: a test of digital characters, an asthenication scale MFI-20, a Bek anxiety scale, a tinetti scale, and a psychological component of health according to the questionnaire according to the questionnaire SF-36. The comparable nature of the safety profile of Mexidol and placebo is established. Conclusion. The results give reason to recommend the long-term consistent use of the drug Mexidol ^® in the complex treatment of patients with hypertension as an instrument for protecting the brain as an organ-canal and means of pathogenetically substantiated therapy of cognitive, emotional, asthenic, vegetative and motor disorders. Keywords: chronic brain ischemia, arterial hypertension, cognitive disorders, ethylmethydroxypirinate, Mexidol ^® , Mexidol ^® Fort 250.

Place of publication:
cardiology and cardiovascular surgery, 2022, T. 15, No. 6

Summary:
The development of preventive measures to reduce the risk of developing cognitive deficiency is named after the main priorities of medicine. Cardiovascular diseases and cognitive disorders, on the one hand, have similar risk factors, such as obesity, smoking, dyslipidemia, insufficient physical activity, low level of education, and, on the other hand, the presence of atrial fibrillation (FP), arterial hypertension (hypertension (hypertension ), heart failure (CH), chronic kidney disease, diabetes contributes to the progression of cognitive impairment. In the era of patient-oriented medicine, choosing the optimal treatment regimen of hypertension, FP, SN, it is necessary to take into account the potential possibilities of certain regimes of therapy in the prevention of cognitive impairment. This article is devoted to the review of existing therapeutic strategies to prevent the development of cognitive deficiency in patients with a cardiological profile. Keywords: cognitive disorders, dementia, arterial hypertension, atrial fibrillation, heart failure, Mexidol.

Place of publication:
cardiology and cardiovascular surgery, 2020, T. 13, No. 5

Summary:
Purpose of the study. To study the effects of Mexidol on the level of n-cowline sodium sodium hormone (NT-PROBNP), the severity of oxidative stress, inflammatory reaction and endothelial dysfunction in patients with II-II-III functional class (FC) in the classification of NYHA during consistent intravenous and oral introduction Mexidol for 13 weeks against the background of standard basic therapy. Material and methods. The study included 44 patients with chemical and heart failure of the II -III functional class according to NYHA, a release fraction of less than 50%. The average age was 65.5 ± 11.8 years, 75% were male patients. 21 patients were included in the basic therapy group with the additional purpose of Mexidol (1000 mg intravenously dropped 1 time per day for 7 days, then 250 mg 3 times a day 12 weeks) and 23 patients in the basic therapy group. 34 patients completely completed the study. 10 patients were made in the form of a phone call in connection with an epidemic environment. Initially, on the 7th day and at the 13th week, an assessment of the level of the N-Container's sodium sodium hormone (NT-PROBNP), oxidative stress (the amount of low-minor dyalldehyde (MDA) and the activity of superoxidsmutase (SOD)), an assessment of the level of n-cow cerebral hormone was held. an inflammatory reaction (level of C-reactive protein (CRB), factor of necrosis of tumors α (FNOα)), as well as the content of homocysteine ​​and level of cystatin C. Results. In patients who received Mexidol in addition to basic therapy, a reliably more pronounced decrease in the level of NT-PROBNP, a decrease in the concentration of MDA, a decrease in the level of SRB and FNOα and an increase in the activity of SOD on the 7th day, and after 13 weeks of therapy compared to the group that received therapy was revealed Only basic therapy. Conclusion. When adding to the basic therapy of patients with chemical and heart failure II-III, the NT-PROBNP level has a reliable antioxidant activity, reduces the severity of the inflammatory reaction, slows down the increase in homocysteine, and does not affect the kidney function (cystatin C). Keywords: chronic brain ischemia, heart failure, oxidative stress, antioxidants, N-connection propeptide of cerebral hormone (NT-PROBNP), mild dialdehyde, superoxidsmutase, SRB, ethylmethylhydroxypirinidine sequicine, mexed.

Place of publication:
Journal of Neurology and Psychiatry, 9, 2018

Summary:
The article presents a review of domestic and foreign literature on the influence of arterial hypertension (AH) on the risk of cognitive impairment. The data of major studies are considered, indicating the relationship of blood pressure and risk of developing vascular dementia and Alzheimer's disease in elderly and senile people, as well as the role of antihypertensive therapy. Evidence of the negative impact of the presence of hypertension in the middle age on the state of cognitive functions in the elderly is presented. The importance of interdisciplinary approach to the treatment of cognitive impairment with cardiologists and/or therapists together with neurologists, as well as comprehensive treatment regimens, including correction of risk factors and neuroprotective therapy, is emphasized. Keywords: arterial hypertension, cognitive disorders, vascular dementia, Alzheimer disease, antihypertensive therapy.

Place of publication:
cardio, issue No. 11 (25), 2017

Summary:
cardiovascular diseases (SSZ) are a global problem for all of mankind. With the growth of socio-economic well-being in developed countries since the middle of the last century, heart disease and blood vessels have become the main cause of disability and mortality. In the structure of the fatal outcomes of Russians from blood circulation diseases, coronary heart disease (coronary heart disease) is only slightly inferior to the vascular pathology of the brain, including stroke.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, No. 1, 2013

Summary:
an assessment of the quality of life and anxiety was carried out in 130 patients with coronary heart disease and stable angina pectoris of the II functional class (FC) in the conditions of the City Clinical Hospital No. 4 BuzOO. Clinical and functional indicators in patients with stable angina pectoris, the effect of the disease on their quality of life were studied. The clinical efficiency of the drug 2-ETIL-6-methyl-3-hydroxypyridine serpicinate (Mexidol) in the complex treatment of patients with stable angina pectoris II FC is evaluated. A differentiated approach to pharmacotherapy has been developed taking into account the level of personality alarm in patients with angina pectoris II FC.