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Introduction Arterial hypertension is a major risk factor of stroke. Does cognitive decline exist before stroke? It is necessary to analyze hypertonic syndrome in the context of normal and pathological aging. A.R. Luria syndrome analysis allows identification of cognitive decline even in case of mild and moderate dysfunction. Objective To study characteristics of cognitive functions in elderly patients with arterial hypertension with the use of A.R. Luria syndrome analysis. Aims To compare analysis of neuropsychological syndrome in healthy people (previous work) and elderly people with arterial hypertension Methods 100 patients aged 58-80 (65.9±8.9) with untreated or ineffectively treated arterial hypertension (1-2 WHO grade) were included. All the patients underwent A.R. Luria neuropsychological assessment (praxis, gnosis, reading, calculation, attention, memory, reasoning, visuospatial and executive functions). Results Three impaired domains were revealed (% of patients with abnormalities): - Intellectual sphere: 80%. Types of errors: decrease in generalization, difficulties in analysis of the task details. - Visuospatial functions: 82%. Types of errors: metric and topological. - Executive functions: 75%. Types of errors: impulsivity, decrease in control, difficulties in programming and shifting. Energetic deficit, memory and attention impairments were presented only in mild form and less then in half of patients. Conclusions - Impairments in executive and visuospatial functions were more common in patients with arterial hypertension comparing to norm. - Difference in energetic and neurodynamical maintenance of cognitive functions (memory, attention etc.) were less pronounced. Some cognitive declines exist before stroke in elderly patients with arterial hypertension.