THE COURSE OF DYSRIRCULATORY ENCEPHALOPATHY IN PATIENTS WITH HYPERTENSION AND CONCOMITANT ERYTHROCYTOSIS

Aim. To determine the clinical course features of dyscirculatory encephalopathy (DE) in patients with hypertension (HT) and concomitant erythrocytosis. Materials and methods. In a single-center cross-sectional study, clinical and instrumental data of 90 patients were consecutively included and analyzed. The patients were divided into the following groups: 1) Group I (n=30) – patients with DE on the background of HT (hypertensive DE [HDE]) combined with erythrocytosis (median age [Me, interquartile range (IQR)] 61 (55-63) years; 20 men (67%) and 10 women [33%]); 2) Group II (n=30) – patients with HDE who had a history of mild ischemic stroke (up to 4 points on the NIHSS scale) (62 (57-66) years; 19 men (64%) and 11 women [36%]); 3) Group III (n=30) – patients without cerebrovascular diseases who sought medical help for acute non-vascular conditions (49 (40-54) years; 13 men (43%) and 17 women [57%]). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) scale. The severity of anxiety and depression was assessed using the Hospital Anxiety and Depression Scale (HADS). Patients whose erythrocytosis was a manifestation of true polycythemia (JAK2-positive) were not included in the study. Results. The MMSE scale showed that the cognitive function score of patients with HDE and erythrocytosis was comparable to that of individuals who had suffered a mild stroke with neurological deficit on the background of HT. When evaluating the psycho-emotional state using the HADS scale, a higher level of anxiety was found in Group I patients (15 [12-18] points) compared to Groups II (12 [9-14] points; p˂0.05) and III (7 [5-9] points; p˂0.05). Approximately half (47%) of Group I patients demonstrated severe anxiety (16-21 points). Meanwhile, the level of depression in Group II patients, on average, corresponded to a moderate degree of severity (11-15 points) and was higher than that of Group III individuals ([mean±standard deviation] 13.5±5.34 versus 7.8±2.43 points, respectively; p˂0.05). Conclusions. The course of DE on the background of HT combined with erythrocytosis has its own characteristics. The anxiety state was more pronounced in patients with HDE and erythrocytosis compared to those who had experienced a mild ischemic stroke on the background of HT. On the contrary, among the study participants, manifestations of depression were most pronounced in patients who had suffered a stroke, corresponding, on average, to a moderate degree of severity.