POSTOPERATIVE COGNITIVE DYSFUNCTION IN PATIENTS WITH HYPERTENSION
Keywords:
рostoperative cognitive dysfunction, hypertension, neuroinflammation, general anesthesia, cerebral perfusion, cognitive assessment.Abstract
Postoperative cognitive dysfunction (POCD) is a frequent and clinically significant complication observed particularly in elderly patients following major surgical interventions. It manifests as a decline in various cognitive domains, including attention, memory, processing speed, and executive function, and can persist from days to months postoperatively. Chronic hypertension induces structural and functional alterations in cerebral vasculature, such as arterial stiffness, endothelial dysfunction, and microvascular remodeling, leading to impaired cerebral autoregulation and reduced perfusion reserve. These changes make the brain more vulnerable to intraoperative hemodynamic fluctuations, hypoperfusion, and inflammatory responses triggered by anesthesia and surgical stress. Therefore, in hypertensive patients, comprehensive perioperative strategies-including preoperative cognitive assessment, individualized anesthetic plans, strict intraoperative blood pressure control, and postoperative neurocognitive monitoring—are essential to mitigate the risk and impact of POCD and to improve long-term neurological outcomes.
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