Introduction. Hypertension (HT) is a significant and independent risk factor for the development of cerebrovascular disease, which is a leading cause of death and disability and is one of the most common cardiovascular diseases in most countries of the world. In Ukraine, the percentage of patients with arterial hypertension is between 30 and 41%, which is more than 12 million patients. the aim of our research-to improve the diagnostic approaches of cerebrovascular disorders in patients with hypertensive encephalopathy (HE) by clarifying the development of pathogenetic mechanisms, based on a comprehensive clinical and paraclinical study. Materials and methods. Clinical and neurological examination; neuropsychological examination; instrumental examination (chronobiotic structure of blood pressure (ВР) according to daily blood pressure monitoring; heart rate variability (HRV); single photon emission computed tomography (SPECT); laboratory testing (determining homocysteine levels). results. The normal level of homocysteine (GC) has been registered among 64.7% of patients with HE, moderate increase of GC has been noticed in 5.9% of cases, and a significant degree of increasment-only among 2.9% of patients. The spectral analysis of HRV has shown a decrease in the values of indicators of the overall variability of the heart rate, accompanied by a weakening of the parasympathetic and increased sympathetic effects on the cardiovascular system. conclusions. It has been established that vascular lesions of the retina, signs of left ventricular hypertrophy and hypercholesterolemia were more commonly observed among patients with HE II stage than among patients HE stage I. According to the results of daily blood pressure monitoring, changes in the parameters among patients with HE І stage, were characterized by an increase in pulse pressure (especially at night) in conjunction with an increase in the rate of morning blood pressure. High pulse pressure is accompanied by a decreasement of brain perfusion (according to the SPECT) and this is an independent risk factor for the development of HE.

This article describes the definition of the state of the autonomic nervous system in patients with chronic cerebral ischemia and chronic heart failure. It has been established that in patients with a reduced left ventricular ejection fraction was recorded the prevalence of the sympathetic link of the autonomic nervous system. Since the activation of the sympathetic nervous system is often a predictor of the development of diseases of the cardiovascular system, the detection of an increase in the activity of the sympathetic department of the autonomic nervous system in the early stages is one of the key moments in preventing the progression of diseases of the cardiovascular system.

In this article discusses the study of the drug Olatropil on the dynamics of the functional state of the brain in patients with chronic stroke against the background of cardiovascular disease. It has been proved the impact of dysfunction autonomic nervous system on the emergence of cognitive and psycho-emotional disorders that can serve as an early diagnostic criterion to identify these disorders Application of of combined nootropic medicinal drugs Olatropil in a complex treatment has a reliable positive impact on the dynamics of the functional state of the brain, gives true opportunity to decline and progression in patients with worsening opportunities switch to different activities, reducing the need for activity and communicating with increasing sensitivity to setbacks and high self-control. It has been shown that using of Olatropil in treatment of these patients improves treatment efficacy as a whole by restoring 1) vegetative lability, 2) improving cognitive function, and 3) reducing anxiety.

The number of scientific studies which proving that the cause of many chronic diseases is the autonomic nervous system dysfunction has increased. The changes in the autonomic nervous system can be detected before the appearance of clinical symptoms. This is the basis of prevention. Reducing the influence of the parasympathetic nervous system and activating the sympathetic nervous system are predictors of arterial hypertension, cardiovascular diseases, diabetes and others. There are no clear mechanisms for the emergence of hyperactivity of the sympathetic nervous system in cardiovascular pathology. That is why it needs to be studied. And that is why the study of the influence of the autonomic nervous system in chronic conditions is relevant.

Chronic heart failure relates to the priorities of national health systems in most countries due to the high prevalence, steady increase in the number of new cases in all countries, frequent repeated hospitalizations, poor quality of treatment, high levels of disability and mortality, and increased treatment costs. An important multidisciplinary task is to study the state of the brain in the background of chronic cardiac pathology, which is associated with a violation of the pumping function of the heart and central hemodynamics. The purpose of the study was to investigate the state of the cognitive and psychoemotional sphere in patients with chronic cerebral ischemia and chronic heart failure with a preserved and reduced release fraction. In a comparative analysis in patients with chronic cerebral ischemia and chronic heart failure with a preserved and reduced emission fraction, a statistically significant difference was not found. Direct correlation dependence with complaints of memory impairment (r = 0.34), anxiety manifestations (r = 0.44), depression (r = 0.42). According to the study, cognitive impairment was observed in 95.3% of patients in group 1 and in 71.1% of patients in group 2. Dementia of light severity was found in patients with 1 group in 18.6% and in patients with 2 groups in 11.1%. Data from a neuropsychological study showed cognitive safety in 4.6% of patients in group I and 28.8% in group 2, which were characterized by mild modal-nonspecific mantle disorders. Premedicinal cognitive disorders were observed in group 1 in 33 (76.7%) patients and in 27 (60%) patients in group 2 (Table 1). There was a statistically significant difference between the groups p = 0.009 (p <0.05) and the direct correlation between MMSE and age (r = 0.63), quality of life (r = 0.31), complaints when considering deterioration of memory (r = 0.39).