Affiliation:
1. Pirogov Russian National Research Medical University
Abstract
According to a WHO report, the number of patients with arterial hypertension in the world has increased from 650 million to 1.3 billion over a relatively short period of about 10 years. In neurological practice, fluctuations in blood pressure are associated with acute cerebrovascular accidents, chronic cerebral ischemia, cognitive impairment, and dementia. At the same time, low blood pressure also causes irreversible changes in the cerebral cortex, especially in elderly patients, and is associated with a risk of developing cardiovascular diseases and neurodegeneration, therefore, in foreign literature, fluctuations in blood pressure are considered a global neurological problem. The versatility of pathological changes in a number of risk factors for the development of hypertension requires early prescription of cerebroprotectors – drugs that affect all parts of the neurovascular unit. One of the modern treatment strategies is the use of polypills, which are a combination of 2 or 3 medicinal substances in one tablet. The polypill strategy is reflected in new treatment regimens for neurological diseases. Complexes of non-steroidal anti-inflammatory drugs with vitamins or muscle relaxants, several antioxidants, and two neuroprotectors have proven themselves to be effective. Fixed combinations are the basis for multifactorial cerebroprotection without increasing the pharmacological load, a way to increase compliance. The fixed combination of Picamilon + Ginkgo Biloba extract is an example of optimal synergism as pharmacodynamic (potentiation and summation of the vasoprotective and antioxidant effects of Picamilon on the one hand, enhancing the neurotransmitter effect of Ginkgo Biloba extract on the other) and pharmacokinetic (the complex does not require dose adjustment depending on the age of the patients, since the composition was selected according to long-term clinical trials in optimal dosages) action.