Study of the effectiveness of the drug Elcarnitine in the correction of increased variability of arterial pressure in patients with hypertensive disease and cognitive dysfunction

Increased blood pressure variability (BPV) in patients with hypertension negatively affects their prognosis and is also a factor for the development and/or progression of cognitive dysfunction. L-carnitine can affect the functions of the autonomic nervous system and may be effective in correcting increased BPV. Objective. To assess the efficacy of L-carnitine for the treatment of increased blood pressure variability in patients with hypertension. Materials and methods. A simple, double-blind, placebo-controlled study was conducted involving 116 patients with hypertension, including 30 patients with increased daily blood pressure variability and moderate cognitive impairment, aged between 50 and 70 years. Participants were randomly assigned (randomization 2:1 using a random number table generated in Excel) into two groups. Patients in the experimental group (n=70) received levocarnitine at a dose of 1000 mg intravenously once a day for 10 days. Patients in the control group (n=34) received an intravenous drip solution containing 0.9% sodium chloride 200.0 ml, 4% potassium chloride 10.0 ml, and 25% magnesium sulfate 10.0 ml daily. During Visit 1 (screening) and Visit 2 (final visit), all study participants underwent electrocardiography, 24-hour blood pressure monitoring, and cognitive function assessments using Wechsler subtests 5 and 7, the Bourdon proofreading test, and the assessment of the asthenia vegetative index using the MFI-20 scale. A multifactorial analysis of variance (ANOVA) was performed using Statistica 10.0 software. Results. Patients in the test group, compared to those in the control group, had significantly reduced variability in systolic and diastolic blood pressure over both day and night. The observed effect of L-carnitine on BPV may be due to its effect on the autonomic nervous system. Conclusion. L-carnitine may be effective in the treatment of increased blood pressure variability in patients with hypertension.