Abstract
Cognitive impairment in elderly patients with arterial hypertension is an urgent medical and social problem. This is especially important given the high prevalence of arterial hypertension. In this regard, the mechanisms of cognitive impairment are of growing interest in order to find new preventive and therapeutic strategies. In general, the main mechanisms determining the association between hypertension and cognitive impairment include imbalances in cerebral blood flow perfusion, immune and metabolic disorders, blood-brain barrier dysfunction, and brain structure abnormalities. Metabolic disorders, including insulin resistance in the brain, are of growing interest as mechanisms of cognitive impairment. Comorbid diseases and target organ damage, which are common in arterial hypertension, also play an important role.