The authors give the results of their investigation dealing with citicoline therapy in patients with hypertension and cognitive impairments.Objective: to determine the efficiency of citicoline therapy on the level and variability of both systolic and diastolic blood pressures (BP) (SBP and DBP).Patients and methods. The investigation covered 60 patients with Stage II hypertension and a goal BP of < 140/90 mm Hg within ≥3 months before their inclusion. The patients were randomized into 2 groups: 30 patients in the study group were assigned to receive a cycle of 10 injections of citicoline in a daily dose of 1000 mg dropwise intravenously, then 1000 mg/day orally for as long as 3 months. 30 patients comprised the control group.Results and discussion. 24-hour BP monitoring indicated that during 4-week citicoline therapy there were significant (p<0.05) reductions in average nocturnal SBP (by 4.1±2.24 mm Hg), average daytime (-1.5±0.39 mm Hg) and average nighttime (-1.5±0.37 mm Hg) BP variabilities; such changes were not found in the control group. In the study group, normal daytime SBP variability at baseline (≤15 mm Hg) was seen in 15 (50%) patients; that after citicoline treatment was in 21 (70%); in the control group, this was in 15 (50% and 14 (46.7%) patients before and after 4-week therapy, respectively. In the study group, normal nocturnal SBP variability at baseline (≤ 15 mm Hg) was seen in 15 (50%) patients; that after citicoline treatment was in 23 (76.7%); in the control group, this was in 15 (50% and 16 (53.3%) patients, respectively.Twenty-one (70%) patients in each group had baseline normal daytime DBP variability (<14 mm Hg); following 4 weeks of treatment, the number of patients with normal daytime DBP variability remained unchanged in the control group and that increased by one patient (n = 22 (73.3%)) in the citicoline group. Normal nocturnal DBP variability at baseline (<12 mm Hg) was observed in 19 (63.3%) patients in each group; that after 4 weeks was in 20 (66.7%) patients in each group.Conclusion. Following 4-week citicoline treatment, there were significant decrease in average nocturnal SBP and average daytime and average nighttime SBP variabilities and an increase in the number of patients with normal average daytime and average nighttime BP variabilities.