nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2014-2S-56-61nnp-425Research ArticleREVIEWSОБЗОРЫArterial hypertension and stroke: cardiac and neurological aspects of secondary preventionАртериальная гипертензия и инсульт: кардионеврологические аспекты вторичной профилактикиГераскинаЛ.А.GeraskinaL.A.neurocor@mail.ruФГБУ «Научный центр неврологии» РАМН, МоскваРоссияNeurology Research Center, Russian Academy of Medical Sciences, Moscow, RussiaRussian Federation20140410201462SSpecial issue "Stroke"5661Copyright © Geraskina L., 20142014Гераскина Л.Geraskina L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/425

This article considers the pathogenetic mechanisms of stroke in arterial hypertension (AH) with special emphasis on comorbid neurological and cardiac disorders. It presents the cardiac and neurological aspects of the current strategy of medical therapy within the secondary prevention of poststroke cardiovascular events. The secondary prevention of cardiovascular events in patients who have sustained ischemic stroke in the presence of AH involves the use of not only antihypertensive drugs, but also adequate antiplatelet therapy and statins. The most important part is assigned to the prevention and treatment of cognitive impairments, which also promotes increased patient treatment adherence and improved poststroke prognosis, including longer survival and better quality of life.

В статье рассматриваются патогенетические механизмы развития инсульта при артериальной гипертензии (АГ), особое внимание уделяется коморбидности неврологических и кардиальных нарушений. Представлены кардионеврологические аспекты современной стратегии медикаментозной терапии в рамках вторичной профилактики сердечно-сосудистых осложнений после перенесенного инсульта. Вторичная профилактика сердечно-сосудистых осложнений у больных, перенесших ишемический инсульт на фоне АГ, включает применение не только антигипертензивных средств, но и адекватной антитромботической терапии, статинов. Важнейшая роль отводится предупреждению и лечению когнитивных нарушений, что также способствует повышению приверженности больных лечению и улучшению постинсультного прогноза, в том числе увеличению продолжительности и улучшению качества жизни.

артериальная гипертензияинсультвторичная профилактика.arterial hypertensionstrokesecondary preventionReferencesDzau V, Braunwald E. Resolved and unresolved issues in the prevention and treatment of coronary artery disease: a workshop consensus statement. Am Heart J. 1991;121 (4 Pt 1):1244–63.Dzau V, Braunwald E. Resolved and unresolved issues in the prevention and treatment of coronary artery disease: a workshop consensus statement. Am Heart J. 1991;121 (4 Pt 1):1244–63.Nys GM, van Zandvoort MJ, de Kort PL, et al. The prognostic value of domain-specific cognitive abilities in acute first-ever stroke. Neurol. 2005;64(5):821–7.Nys GM, van Zandvoort MJ, de Kort PL, et al. The prognostic value of domain-specific cognitive abilities in acute first-ever stroke. Neurol. 2005;64(5):821–7.Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). Москва; 2010. [Diagnostika i lechenie arterial'noi gipertenzii. Rossiiskie rekomendatsii (chetvertyi peresmotr) [Diagnostics and treatment of arterial hypertension. Russian recommendations (the fourth revision)]. Moscow; 2010.]Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). Москва; 2010. [Diagnostika i lechenie arterial'noi gipertenzii. Rossiiskie rekomendatsii (chetvertyi peresmotr) [Diagnostics and treatment of arterial hypertension. Russian recommendations (the fourth revision)]. Moscow; 2010.]Суслина ЗА, Гераскина ЛА, Фонякин АВ. Артериальная гипертония и инсульт: связь и перспективы профилактики. Атмосфера. Кардиология. 2001;(1):5–7. [Suslina ZA, Geraskina LA, Fonyakin AV. Arterial hypertension and stroke: communication and prevention prospects. Atmosfera. Kardiologiya. 2001;(1):5–7. (In Russ.)]Суслина ЗА, Гераскина ЛА, Фонякин АВ. Артериальная гипертония и инсульт: связь и перспективы профилактики. Атмосфера. Кардиология. 2001;(1):5–7. [Suslina ZA, Geraskina LA, Fonyakin AV. Arterial hypertension and stroke: communication and prevention prospects. Atmosfera. Kardiologiya. 2001;(1):5–7. (In Russ.)]Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialist's Collaboration. Lancet. 2000;355(9246):1955–64.Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialist's Collaboration. Lancet. 2000;355(9246):1955–64.Верещагин НВ, Моргунов ВС, Гулевская ТС. Патология головного мозга при атеросклерозе и артериальной гипертонии. Москва: Медицина; 1997. 228 с. [Vereshchagin NV, Morgunov VS, Gulevskaya TS. Patologiya golovnogo mozga pri ateroskleroze i arterial'noi gipertonii [Brain pathology at atherosclerosis and an arterial hypertension]. Moscow: Meditsina; 1997. 228 p.]Верещагин НВ, Моргунов ВС, Гулевская ТС. Патология головного мозга при атеросклерозе и артериальной гипертонии. Москва: Медицина; 1997. 228 с. [Vereshchagin NV, Morgunov VS, Gulevskaya TS. Patologiya golovnogo mozga pri ateroskleroze i arterial'noi gipertonii [Brain pathology at atherosclerosis and an arterial hypertension]. Moscow: Meditsina; 1997. 228 p.]Попов СВ, Антонченко ИВ. Значение электрофизиологии сердца в выборе тактики лечения фибрилляции предсердий. Практикующий врач. 2001;2(20):14–8. [Popov SV, Antonchenko IV. Value of electrophysiology of heart in a choice of tactics of treatment of fibrillation of auricles. Praktikuyushchii vrach. 2001;2(20):14–8. (In Russ.)]Попов СВ, Антонченко ИВ. Значение электрофизиологии сердца в выборе тактики лечения фибрилляции предсердий. Практикующий врач. 2001;2(20):14–8. [Popov SV, Antonchenko IV. Value of electrophysiology of heart in a choice of tactics of treatment of fibrillation of auricles. Praktikuyushchii vrach. 2001;2(20):14–8. (In Russ.)]Фонякин АВ, Гераскина ЛА, Суслина ЗА. Сравнительная оценка постоянной и пароксизмальной фибрилляции предсердий в патогенезе кардиоцеребральной эмболии. Кардиология. 2002;42(7):4–6. [Fonyakin AV, Geraskina LA, Suslina ZA. Comparative assessment of continuous and paroksizmalny fibrillation of auricles in patogenes a cardiocerebral embolism. Kardiologiya. 2002;42(7):4–6.Фонякин АВ, Гераскина ЛА, Суслина ЗА. Сравнительная оценка постоянной и пароксизмальной фибрилляции предсердий в патогенезе кардиоцеребральной эмболии. Кардиология. 2002;42(7):4–6. [Fonyakin AV, Geraskina LA, Suslina ZA. Comparative assessment of continuous and paroksizmalny fibrillation of auricles in patogenes a cardiocerebral embolism. Kardiologiya. 2002;42(7):4–6.(In Russ.)](In Russ.)]Суслина ЗА, Фонякин АВ, Петрова ЕА, Кистенев БА, Гераскина ЛА. Значение холтеровского мониторирования ЭКГ у больных в остром периоде ишемического инсульта. Терапевтический архив. 1997;69(4):24–6. [Suslina ZA, Fonyakin AV,Petrova EA, Kistenev BA, Geraskina LA. ValueСуслина ЗА, Фонякин АВ, Петрова ЕА, Кистенев БА, Гераскина ЛА. Значение холтеровского мониторирования ЭКГ у больных в остром периоде ишемического инсульта. Терапевтический архив. 1997;69(4):24–6. [Suslina ZA, Fonyakin AV,Petrova EA, Kistenev BA, Geraskina LA. Valueof holterovsky monitoring of an electrocardiogram at patients in the sharp period of an ischemic stroke. Terapevticheskii arkhiv. 1997;69(4):24–6. (In Russ.)]of holterovsky monitoring of an electrocardiogram at patients in the sharp period of an ischemic stroke. Terapevticheskii arkhiv. 1997;69(4):24–6. (In Russ.)]Bladin ChF, Chambers BR. Frequency and pathogenesis of hemodynamic stroke. Stroke. 1994;25(11):2179–82.Bladin ChF, Chambers BR. Frequency and pathogenesis of hemodynamic stroke. Stroke. 1994;25(11):2179–82.Cуслина ЗА, Пирадов МА, редакторы. Инсульт: диагностика, лечение, профилактика. Москва: МЕДпресс-информ; 2009. 288 с. [Suslina ZA, Piradov MA, editors. Insul't: diagnostika, lechenie, profilaktika [Stroke: diagnostics, treatment, prevention]. Moscow: MEDpress-inform; 2009. 288 p.]Cуслина ЗА, Пирадов МА, редакторы. Инсульт: диагностика, лечение, профилактика. Москва: МЕДпресс-информ; 2009. 288 с. [Suslina ZA, Piradov MA, editors. Insul't: diagnostika, lechenie, profilaktika [Stroke: diagnostics, treatment, prevention]. Moscow: MEDpress-inform; 2009. 288 p.]Sacco RL, Shi T, Zamanillo MC, Kargman DE. Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan Stroke Study. Neurology. 1994;44(4):626–34. DOI: http://dx.doi.org/10.1212/WNL.44.4.626.Sacco RL, Shi T, Zamanillo MC, Kargman DE. Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan Stroke Study. Neurology. 1994;44(4):626–34. DOI: http://dx.doi.org/10.1212/WNL.44.4.626.The European Stroke Organization (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attacks 2008. Cerebrovasc Dis. 2008;25(5):457–507. DOI: 10.1159/000131083. Epub 2008 May 6.The European Stroke Organization (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attacks 2008. Cerebrovasc Dis. 2008;25(5):457–507. DOI: 10.1159/000131083. Epub 2008 May 6.Фонякин АВ, Гераскина ЛА. Ключевые направления консервативной терапии при ишемическом инсульте. Неврология, нейропсихиатрия, психосоматика. 2013;2:64–9. [Fonyakin AV, Geraskina LA. The key areas of medical therapy for ischemic stroke. Nevrologiya, neiropsikhiatriya, psikhosomatikaФонякин АВ, Гераскина ЛА. Ключевые направления консервативной терапии при ишемическом инсульте. Неврология, нейропсихиатрия, психосоматика. 2013;2:64–9. [Fonyakin AV, Geraskina LA. The key areas of medical therapy for ischemic stroke. Nevrologiya, neiropsikhiatriya, psikhosomatika= Neurology, Neuropsychiatry, Psychosomatics. 2013;2:64–9. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2013-2416.= Neurology, Neuropsychiatry, Psychosomatics. 2013;2:64–9. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2013-2416.Rashid R, Leonardi-Bee J, Bath Ph. Blood pressure reduction and secondary prevention of stroke and other vascular events. A systematic review. Stroke. 2003;34(11):2741–9. DOI: http://dx.doi.org/10.1161/01.STR.0000092488.40085.15. Epub 2003 Oct 23.Rashid R, Leonardi-Bee J, Bath Ph. Blood pressure reduction and secondary prevention of stroke and other vascular events. A systematic review. Stroke. 2003;34(11):2741–9. DOI: http://dx.doi.org/10.1161/01.STR.0000092488.40085.15. Epub 2003 Oct 23.Bangalore S, Gong Y, Cooper-DeHoff RM, et al. 2014 Eighth Joint National Committee Panel recommendations for blood pressure targets revisited: Results from the INVEST study. J Am Coll Cardiol. 2014;(64):784–93. DOI: http://dx.doi.org/10.1016/j.jacc.2014.05.044.Bangalore S, Gong Y, Cooper-DeHoff RM, et al. 2014 Eighth Joint National Committee Panel recommendations for blood pressure targets revisited: Results from the INVEST study. J Am Coll Cardiol. 2014;(64):784–93. DOI: http://dx.doi.org/10.1016/j.jacc.2014.05.044.Gradman AH. Optimal blood pressure targets in older adults. How low is low enough? J Am Coll Cardiol. 2014;(64):794–6. DOI: http://dx.doi.org/10.1016/j.jacc.2014.06.1153.Gradman AH. Optimal blood pressure targets in older adults. How low is low enough? J Am Coll Cardiol. 2014;(64):794–6. DOI: http://dx.doi.org/10.1016/j.jacc.2014.06.1153.Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack. a guideline for healthcare professionals from the American HeartKernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack. a guideline for healthcare professionals from the American HeartAssociation/American Stroke Association. Stroke. 2014;45(7):2160–236. DOI: 10.1161/STR.0000000000000024. Epub 2014 May 1.Association/American Stroke Association. Stroke. 2014;45(7):2160–236. DOI: 10.1161/STR.0000000000000024. Epub 2014 May 1.Furie KL, Goldstein LB, Albers GW, et al. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation: a science advisory for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(12):3442–53. DOI: 10.1161/STR.0b013e318266722a. Epub 2012 Aug 2.Furie KL, Goldstein LB, Albers GW, et al. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation: a science advisory for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(12):3442–53. DOI: 10.1161/STR.0b013e318266722a. Epub 2012 Aug 2.Amarenco P, Bogousslavsky J, Callahan A. 3rd, et al.; SPARCL investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355(6):549–59. DOI: http://dx.doi.org/10.1056/NEJMoa061894.Amarenco P, Bogousslavsky J, Callahan A. 3rd, et al.; SPARCL investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355(6):549–59. DOI: http://dx.doi.org/10.1056/NEJMoa061894.Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Клинические рекомендации ВНОК. Кардиоваскулярная терапия и профилактика. Приложение 3. 2009;8(6). [Diagnostics and correction of violations of a lipidic exchange with the purpose of prevention and atherosclerosis treatment. Clinical recommendations of VNOK. Klinicheskie rekomendatsii VNOK. Kardiovaskulyarnaya terapiya i profilaktika. Prilozhenie 3. 2009;8(6). (In Russ.)]Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Клинические рекомендации ВНОК. Кардиоваскулярная терапия и профилактика. Приложение 3. 2009;8(6). [Diagnostics and correction of violations of a lipidic exchange with the purpose of prevention and atherosclerosis treatment. Clinical recommendations of VNOK. Klinicheskie rekomendatsii VNOK. Kardiovaskulyarnaya terapiya i profilaktika. Prilozhenie 3. 2009;8(6). (In Russ.)]Яхно НН. Когнитивные нарушения при инсульте. Москва: Антидор; 2006. 214 с. [Yakhno NN. Kognitivnye narusheniya pri insul'te [Cognitive violations at a stroke]. Moscow: Antidor; 2006. 214 p.]Яхно НН. Когнитивные нарушения при инсульте. Москва: Антидор; 2006. 214 с. [Yakhno NN. Kognitivnye narusheniya pri insul'te [Cognitive violations at a stroke]. Moscow: Antidor; 2006. 214 p.]Чердак МА, Парфенов ВА. Когнитивные расстройства у пациентов, перенесших ишемический инсульт. Неврологический журнал. 2011;16(6):37–44. [Cherdak MA, Parfenov VA. The cognitive impairments in patients after ischemic stroke. Nevrologicheskii zhurnal. 2011;16(6):37–44. (In Russ.)]Чердак МА, Парфенов ВА. Когнитивные расстройства у пациентов, перенесших ишемический инсульт. Неврологический журнал. 2011;16(6):37–44. [Cherdak MA, Parfenov VA. The cognitive impairments in patients after ischemic stroke. Nevrologicheskii zhurnal. 2011;16(6):37–44. (In Russ.)]Leys D, Henon H, Mackowiak-Cordoliani MA, Pasquier F. Poststroke dementia. Lancet Neurol. 2005;4(11):752–9. DOI: http://dx.doi.org/10.1016/S1474-4422(05)70221-0.Leys D, Henon H, Mackowiak-Cordoliani MA, Pasquier F. Poststroke dementia. Lancet Neurol. 2005;4(11):752–9. DOI: http://dx.doi.org/10.1016/S1474-4422(05)70221-0.Ballard C, Rowan E, Stephens S, et al. Prospective follow-up study between 3 and 15 months after stroke: Improvements and decline in cognitive function among dementia-free stroke survivors >75 years of age. Stroke. 2003;34(10):2440–4. DOI: http://dx.doi.org/10.1161/01.STR.0000089923.29724.CE. Epub 2003 Sep 25.Ballard C, Rowan E, Stephens S, et al. Prospective follow-up study between 3 and 15 months after stroke: Improvements and decline in cognitive function among dementia-free stroke survivors >75 years of age. Stroke. 2003;34(10):2440–4. DOI: http://dx.doi.org/10.1161/01.STR.0000089923.29724.CE. Epub 2003 Sep 25.Roman GS. Stroke, cognitive decline and vascular dementia the silent epidemic of 21st century. Neuroepidemiol. 2003;22(3):161–4. DOI: http://dx.doi.org/10.1159/000069885.Roman GS. Stroke, cognitive decline and vascular dementia the silent epidemic of 21st century. Neuroepidemiol. 2003;22(3):161–4. DOI: http://dx.doi.org/10.1159/000069885.PROGRESS Collaborative Group. Randomized trial of a perindopril-based bloodpressurelowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001;358(9287):1033–41. DOI: http://dx.doi.org/10.1016/S0140-6736(01)06178-5.PROGRESS Collaborative Group. Randomized trial of a perindopril-based bloodpressurelowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001;358(9287):1033–41. DOI: http://dx.doi.org/10.1016/S0140-6736(01)06178-5.Schrader JS, Luders S, Kulschewski A, et al. Morbidity and mortality after stroke, eprosartan compared with nitrendipine for secondary prevention principal results of a prospective randomizedSchrader JS, Luders S, Kulschewski A, et al. Morbidity and mortality after stroke, eprosartan compared with nitrendipine for secondary prevention principal results of a prospective randomizedcontrolled study (MOSES). Stroke. 2005;36(6):1218–26. DOI:http://dx.doi.org/10.1161/01.STR.0000166048.35740.a9. Epub 2005 May 5.controlled study (MOSES). Stroke. 2005;36(6):1218–26. DOI:http://dx.doi.org/10.1161/01.STR.0000166048.35740.a9. Epub 2005 May 5.Nilsson SE, Johansson B, Takkinen S, et al. Does aspirin protect against Alzheimer's dementia? A study in a Swedish populationbased sample aged > or = 80 years. Eur J Clin Pharmacol. 2003;59(4):313–9. DOI:Nilsson SE, Johansson B, Takkinen S, et al. Does aspirin protect against Alzheimer's dementia? A study in a Swedish populationbased sample aged > or = 80 years. Eur J Clin Pharmacol. 2003;59(4):313–9. DOI:http://dx.doi.org/10.1007/s00228-003-0618-y. Epub 2003 Jun 25.http://dx.doi.org/10.1007/s00228-003-0618-y. Epub 2003 Jun 25.Kang JH, Cook N, Manson J, et al. Low dose aspirin and cognitive function in the Women's Health Study cognitive cohort. BMJ. 2007;334(7601):987. DOI:http://dx.doi.org/10.1136/bmj.39166.597836.B E. Epub 2007 Apr 27.Kang JH, Cook N, Manson J, et al. Low dose aspirin and cognitive function in the Women's Health Study cognitive cohort. BMJ. 2007;334(7601):987. DOI:http://dx.doi.org/10.1136/bmj.39166.597836.B E. Epub 2007 Apr 27.Knecht S, Oelschlager Ch, Duning Th, et al. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. Eur Heart J. 2008;29(17):2125–32. DOI: 10.1093/eurheartj/ehn341. Epub 2008 Jul 29.Knecht S, Oelschlager Ch, Duning Th, et al. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. Eur Heart J. 2008;29(17):2125–32. DOI: 10.1093/eurheartj/ehn341. Epub 2008 Jul 29.Nyenhuis DL, Gorelick PB, Geenen EJ, et al. The pattern of neuropsychological deficits in vascular cognitive impairment – no dementia (vascular CIND). Clin Neuropsychol. 2004;18(1):41–9. DOI: http://dx.doi.org/10.1080/13854040490507145.Nyenhuis DL, Gorelick PB, Geenen EJ, et al. The pattern of neuropsychological deficits in vascular cognitive impairment – no dementia (vascular CIND). Clin Neuropsychol. 2004;18(1):41–9. DOI: http://dx.doi.org/10.1080/13854040490507145.Gorelick PhB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672–713. DOI: 10.1161/STR.0b013e3182299496. Epub 2011 Jul 21.Gorelick PhB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672–713. DOI: 10.1161/STR.0b013e3182299496. Epub 2011 Jul 21.Захаров ВВ, Яхно ВВ. Нарушения памяти. Москва: ГЭОТАР-Медиа; 2003. 160 с. [Zakharov VV, Yakhno VV. Narusheniya pamyati [Memory violations]. Moscow: GEOTAR-Media; 2003. 160 p.]Захаров ВВ, Яхно ВВ. Нарушения памяти. Москва: ГЭОТАР-Медиа; 2003. 160 с. [Zakharov VV, Yakhno VV. Narusheniya pamyati [Memory violations]. Moscow: GEOTAR-Media; 2003. 160 p.]Kavirajan H, Schneider LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vacular dementia: a meta-analysis of randomized controlled trials. Lancet Neurol. 2007;6(9):782–92. DOI: http://dx.doi.org/10.1016/S1474-4422(07)70195-3.Kavirajan H, Schneider LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vacular dementia: a meta-analysis of randomized controlled trials. Lancet Neurol. 2007;6(9):782–92. DOI: http://dx.doi.org/10.1016/S1474-4422(07)70195-3.Парфенов ВА. Цитиколин при ишемическом инсульте: исследование ICTUS. Неврология, нейропсихиатрия, психосоматика. 2012;(4):71–6. [Parfenov VA. Citicoline for ischemic stroke: ICTUS trial. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(4):71–6. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2012-426.Парфенов ВА. Цитиколин при ишемическом инсульте: исследование ICTUS. Неврология, нейропсихиатрия, психосоматика. 2012;(4):71–6. [Parfenov VA. Citicoline for ischemic stroke: ICTUS trial. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(4):71–6. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2012-426.Davalos A, Castillo J, Alvarez-Sabin J, et al. Oral citicoline in acute ischemic stroke: anDavalos A, Castillo J, Alvarez-Sabin J, et al. Oral citicoline in acute ischemic stroke: anindividual patient data pooling analysis of clinical trials. Stroke. 2002;33(12):2850–7. DOI: http://dx.doi.org/10.1161/01.STR.0000038691.03334.71.individual patient data pooling analysis of clinical trials. Stroke. 2002;33(12):2850–7. DOI: http://dx.doi.org/10.1161/01.STR.0000038691.03334.71.Saver JL, Wilterdink J. Choline precursors in acute and subacute human stroke: a metaanalysis.Saver JL, Wilterdink J. Choline precursors in acute and subacute human stroke: a metaanalysis.Stroke. 2002;(33):353.Stroke. 2002;(33):353.Davalos A, Alvarez-Sabin J, Castillo J, et al. Citicoline in the treatment of acute ischaemic stroke: an international, randomized, multicentre, placebo-controlled study (ICTUS trial). Lancet. 2012;380(9839):349–57. DOI: 10.1016/S0140-6736(12)60813-7. Epub 2012 Jun 11.Davalos A, Alvarez-Sabin J, Castillo J, et al. Citicoline in the treatment of acute ischaemic stroke: an international, randomized, multicentre, placebo-controlled study (ICTUS trial). Lancet. 2012;380(9839):349–57. DOI: 10.1016/S0140-6736(12)60813-7. Epub 2012 Jun 11.Hankey GJ. How effective is citicoline for acute ischaemic stroke? Lancet. 2012;380(9839):318–20. DOI: 10.1016/S0140-6736(12)60912-X. Epub 2012 Jun 11.Hankey GJ. How effective is citicoline for acute ischaemic stroke? Lancet. 2012;380(9839):318–20. DOI: 10.1016/S0140-6736(12)60912-X. Epub 2012 Jun 11.Lozano Fernandez R. Efficacy and safety of oral CDP-choline. Drug surveillance study in 2817 cases. Arzneimittelforsch. 1983;33(7A):1073–80.Lozano Fernandez R. Efficacy and safety of oral CDP-choline. Drug surveillance study in 2817 cases. Arzneimittelforsch. 1983;33(7A):1073–80.

The authors declare that there are no conflicts of interest present.