Ethylmethylhydroxypyridine succinate and evidence-based neuroprotection: trends and perspectives

Arterial hypertension (AH) is a leading risk factor for cardiovascular disease, including cerebrovascular events. Damage to the brain as a target organ of AH manifests itself in vascular cognitive impairment (VCI) of varying severity, as well as the development of associated conditions in the form of acute cerebrovascular disorders. In the absence of risk factor correction and rational neuroprotective therapy, VCI can progressively worsen, transforming into dementia, which completely disadapts the patient in all areas of life and creates the need for constant assistance from others. Moreover, VCI itself, even in its early stages, can negatively affect the patient’s adherence to treatment by impairing memory, thereby reducing its effectiveness and increasing the risk of adverse outcomes. In this regard, we review the clinical manifestations and diagnostic approaches to identifying brain damage as one of the highly sensitive target organs in AH. In Russian practice, the original russian drug Mexidol^® (ethylmethylhydroxypyridine succinate) is used alongside antihypertensive therapy for the treatment and prevention of cerebrovascular diseases with cognitive impairment. The article reviews the evidence base for the drug, with a particular focus on its effectiveness in protecting the brain in conditions of concomitant hypertension, and presents the multimodal mechanisms through which the drug exerts a complex neuroprotective effect, demonstrably improves cognitive status, and also alleviates the clinical symptoms associated with cerebrovascular damage and improves the quality of life of patients.

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