Russian Journal of Geriatric Medicine · Sep 6, 2026

Arterial Hypertension and Cognitive Functions: Pathogenetic Mechanisms and Strategies for Prevention of Cognitive Impairment. Literature Review

By Dudchenko NG, Kotovskaya YV

Population aging and the increasing prevalence of arterial hypertension (AH) have led to an epidemic of cognitive impairment and dementia. AH is a key modifiable risk factor that triggers a cascade of pathophysiological changes: cerebrovascular remodeling, blood-brain barrier (BBB) dysfunction, and neuroinflammation. Analysis of current data demonstrates that angiotensin II receptor blockers (ARBs), particularly telmisartan, possess unique neuroprotective properties due to their high affinity for AT1R and their ability to activate PPARγ. This provides anti inflammatory and antioxidant effects, as well as improved cerebral blood flow. Calcium channel blockers (CCBs), such as amlodipine, complement this effect by improving regional perfusion and reducing oxidative stress. The combination of telmisartan and amlodipine ensures not only stable blood pressure control and reduced variability but also multi-channel protection of the neurovascular unit.

doi.org/10.37586/2686-8636-3-2026-355-362 Open access Interventions