Cognitive impairment is one of the main medical and socio-economic problems in the world. Therapy of patients with cognitive impairment, in particular dementia, is a time-consuming and long-term process and, unfortunately, today it is unable to completely restore the patient. The most severe complication of dementia is the loss of everyday independence, a decrease in the quality of life of patients and their loved ones. The development of cognitive disorders is due to complex pathophysiological mechanisms that are debuting early in the period of the appearance of light or non-cognitive cognitive dysfunctions. The main role in the development of pathological changes in the brain is caused by microcirculation disorders, leading to metabolic disturbances that occur in the conditions of long-term arterial hypertension. The article considers the importance of early diagnosis of cognitive disorders from the point of view of vascular causes that result from arterial hypertension. Such identification is based on clinical manifestations and analysis of their relationship with various pathophysiological mechanisms due to arterial hypertension. The therapeutic effect on pathophysiological mechanisms with pathogenetically validated drugs can slow or stop the pathological process. The article describes the possibility of using a drug with vascular, metabolic, neuroprotective actions - alpha-adrenoblocker nicergoline in patients with arterial hypertension with the aim of preventing cognitive disorders in the early stages and with dementia, and also the risk factors for the development of non-cognitive disorders and dementia, in pathogenesis which are closely intertwined with vascular, metabolic and other mechanisms.

Non-alcoholic fatty liver disease is the most frequent liver pathology of non-viral etiology. The development of it is closely related to abdominal obesity and insulin resistance. Diagnosis of non-alcoholic fatty liver disease at an early stage is of great prognostic value, and, in view of the often asymptomatic course of the process, it is necessary to carry out a targeted diagnostic search for the disease in people who have diabetes mellitus and dyslipidemia. Lifestyle modification is the basis for treatment of non-alcoholic fatty liver disease in outpatient settingsneeds to be carried out taking into account the attendant factors of cardiovascular risk.

Improving the adherence of patients to treatment and risk factors' correction for cardiovascular disease is one of the most effective ways to address the high mortality rate of young and able-bodied people in our country. The use of a fixed combination of amlodipine / lisinopril / rosuvastatin allows to control the two most important risk factors for cardiovascular diseases and their complications - arterial hypertension and dyslipidemia effectively, greatly improving patients’ adherence to treatment.

Cachexia often develops with oncological diseases, and can also accompany other somatic pathologies. Cachexia affects the effectiveness of treatment and worsens the prognosis of the underlying disease. The article analyzes the etiopathogenesis of cachexia, classification and its clinical manifestations. We consider gastroenterological disorders and metabolic disorders that develop with cachexia and require complex treatment. Therapeutic measures for cachexia include diet therapy, drug therapy, the use of nutrient mixtures. The article proposes modern ways of introducing enteral nutritional mixtures, as well as an algorithm for selecting nutrient mixtures in various situations.

Obesity is one of the cardiovascular diseases risk factors. Being an active endocrine organ, fatty tissue can influence the regulation of blood pressure, the development of inflammatory reactions, the violation of lipid and carbohydrate metabolism. Prevention of cardiovascular disease is targeted at bodyweight reducing by diet therapy and drug treatment. Anorectic medicines, along with efficiency, possess side effects. The study of Reduxin in the obesity treatment revealed the efficiency and safety of the drug in use.

The problem of early detection of chronic heart failure, as well as preventing its decompensation, is among the most urgent in cardiology. The article gives classification of the disease, diagnostic criteria of chronic heart failure depending on the criteria of the ejection fraction, modern approaches to treatment are considered. The necessity of managing patients at the optimal doses of ACE inhibitors and beta-blockers is shown. The role of antagonists of mineralocorticoid receptors in the treatment of chronic heart failure is considered.

The article describes the syndrome of tokatsubo, etiology, diagnostic criteria. A clinical case of a patient with a current syndrome is presented. Specific features of clinical manifestations are described: pain syndrome, connection with psychoemotional stress, regression of clinical symptoms, Echo-CG and ECG data. A differential diagnosis with acute coronary syndrome, pericarditis, myocarditis is considered. The tactics of managing patients and the prognosis of the disease are described.