Hypolipidemic and antihypertensive drugs for prevention of cardiovascular complications in patients with rheumatoid arthritis

2008 ◽  
Author(s):  
Barbora de Courten ◽  
Melissa N Barber ◽  
Renea V Johnston ◽  
Danny Liew ◽  
Maximilian de Courten ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Antihypertensive Drugs ◽  
Cardiovascular Complications

scholarly journals AB0163 ELECTROCARDIOGRAPHIC MANIFESTATIONS IN PATIENTS WITH SEROPOSITIVE RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1108.2-1108
Author(s):  
S. Spitsina ◽  
E. Mozgovaya ◽  
A. Trofimenko ◽  
S. Bedina ◽  
M. Mamus
Keyword(s):  
Rheumatoid Arthritis ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Heart Defects ◽  
Clinical Manifestations ◽  
Blood Chemistry ◽  
Cardiovascular Complications ◽  
Silent Myocardial Ischemia ◽  
Conduction Disorders ◽  
Artery Disease

Background:Cardiovascular disease in rheumatoid arthritis (RA) is more common than in general population. Particular attention should be paid to cardiac dysfunction, as their timely diagnosis strongly affects the general outcome.Objectives:To assess the prevalence of arrhythmias and conduction disorders in patients with seropositive RA without clinical manifestations of coronary artery disease, as well as to determine their relationship with activity and duration of RA.Methods:The research was carried out in agreement with the WMA Declaration of Helsinki principles. 48 patients with seropositive RA were included in the study. The exclusion criteria were: age over 60 years; obesity; congenital heart defects; coronary artery disease; peripheral atherosclerosis; thyroid disease; diabetes mellitus. All patients were assessed using general physical, laboratory and instrumental survey including CBC, blood chemistry panel, as well as ECG. RA diagnosis was verified using the 2010 ACR / EULAR classification criteria. Central tendencies were expressed as mean ±SD.Results:All the included persons were women. Their average age was 50.50 ± 7.22 years, and average duration of the disease was 8.13 ± 2.34 years. All patients had articular form (without systemic manifestations) of moderate and high activity. The patients were treated with basic and NSAIDs therapy; no glucocorticoids were applied at the time of the examination. Using 12-lead ECG arrhythmias and conduction disorders were revealed in 27 (56.25%) of RA patients. Sinus rhythm deviations had the highest (31.25%) prevalence for all arrhythmias, comprising sinus tachycardias (18.75%), sinus bradycardias (6.25%), and sinus arrhythmias (6.25%). Premature beats were registered in 12.5% cases, being supraventricular and ventricular ones in equal proportions. We have found left anterior bundle branch block in 6 (12.5%) of patients. Despite absence of any angina symptoms, 9 (18.75%) of patients had myocardial repolarization disturbances, either as ST depression deeper than 0.1 mV or as negative T wave appearance, which were quite similar to silent myocardial ischemia manifestations. All the patients with these two features had RA history of more than 10 years. There was no relationship between the prevalence of the manifestations and radiographic stage of RA.Conclusion:Arrhythmias and conduction disorders are quite frequent finding in seropositive RA (56.25% and 18.75%, respectively). Their incidence and severity do not coincide exactly with the radiographic progression in joints, while their prevalence generally increases with disease duration.These data highlight the importance of additional Holter ECG monitoring in RA for revelation and treatment of silent life-threatening cardiovascular complications.Disclosure of Interests:None declared

OBESITY: CLINICAL AND PATHOGENETIC JUSTIFICATION OF PREVENTION AND TREATMENT

2020 ◽  
pp. 5-10
Author(s):  
O. M. Korzh
Keyword(s):  
Metabolic Syndrome ◽  
Antihypertensive Drugs ◽  
Critical Role ◽  
Cardiovascular Complications ◽  
Excess Body Weight ◽  
Treatment And Prevention ◽  
Prevalence Of Obesity ◽  
Tissue Sensitivity ◽  
Genetic And Environmental Factors ◽  
Weight Correction

Obesity is one of the most common chronic diseases worldwide. Numerous studies in recent years have identified obesity as a key cause of type 2 diabetes, metabolic syndrome, and cardiovascular disease. Comprehensive medical and non−medical treatment of metabolic disorders, obesity and correction of excess body weight are the urgent tasks for both the patient and doctor. When defining the obesity as a chronic psychosomatic disease caused by the interaction of numerous genetic and environmental factors there is emphasized the complexity of the problem, including psychological, medical, social, physical and economic aspects. The widespread prevalence of obesity, which determines its comorbid nature, dictates the need to clarify the principles and options for treatment and prevention. In the process of active study, the multicomponent pathogenesis of obesity with the important role of different parts of the brain determines the relevance of a combination of pharmacotherapy and lifestyle intervention. In pharmacotherapy, the weight correction is an important component and reduces the risk of cardiovascular complications, improves quality of life and prognosis. The basis of weight correction measures is a change in lifestyle, increased physical activity and alteration in diet in order to achieve a balance between energy consumption and expenditure. Weight loss is accompanied with an increased tissue sensitivity to insulin, improved lipid metabolism, elimination of latent inflammation, lowering blood pressure and, accordingly, plays a critical role in prevention of the associated diseases and reducing the risk of complications. The fight against obesity is not only an improvement in the patient general condition, but also a great economic benefit, as the doses of drugs are reduced or the need for hypolipidemic, antidiabetic and antihypertensive drugs disappears. Key words: obesity, metabolic syndrome, diabetes mellitus, cardiometabolic risk, microbiota, insulin resistance, treatment, prevention.

scholarly journals Paraoxonase 1 Phenotype and Protein N-Homocysteinylation in Patients with Rheumatoid Arthritis: Implications for Cardiovascular Disease

Antioxidants ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 899
Author(s):  
Jolanta Parada-Turska ◽  
Grażyna Wójcicka ◽  
Jerzy Beltowski
Keyword(s):  
Rheumatoid Arthritis ◽  
Protein Concentration ◽  
Serum Proteins ◽  
Density Lipoprotein ◽  
Cardiovascular Complications ◽  
Paraoxonase 1 ◽  
Pon1 Activity ◽  
Phenyl Acetate ◽  
Control Subjects ◽  
Increased Risk

Paraoxonase 1 (PON1) is the high density lipoprotein-associated esterase which inhibits the development of atherosclerosis by metabolizing lipid peroxidation products as well as hydrolyzing proatherogenic metabolite of homocysteine (Hcy), Hcy thiolactone, which otherwise reacts with lysine groups of proteins, thus forming N-Hcy-protein in a process referred to as protein N-homocysteinylation. Rheumatoid arthritis (RA) is the chronic inflammatory autoimmune disease associated with increased risk of cardiovascular complications, but the underlying mechanisms are incompletely understood. We examined PON1 status and N-homocysteinylation of serum proteins in patients with RA. Blood was collected from 74 RA patients and 70 control subjects. PON1 activity was measured toward synthetic (paraoxon, phenyl acetate) and natural (Hcy thiolactone) substrates. PON1 protein concentration was measured by ELISA. Total Hcy as well as N-Hcy-protein were measured in serum as well. PON1 activity toward Hcy thiolactone was lower in RA patients than in control subjects which was accompanied by increased concentration of N-Hcy-protein despite normal total Hcy concentration. PON1 protein concentration was unchanged in the RA group, but the specific enzyme activity was reduced. When RA patients were categorized according to the DAS28-ESR score, PON1 concentration and enzymatic activity were lower whereas N-Hcy-protein was higher in those with high disease activity. PON1 activity and Hcy thiolactone were correlated with DAS28-ESR score and myeloperoxidase concentration. In conclusion, RA is associated with deficiency of PON1 activity and increased protein N-homocyseinylation which may contribute to accelerated development of cardiovascular diseases.

scholarly journals Interaction of antihypertensive drugs and rosuvastatin: focus on safety, efficiency and prospects

2017 ◽  
Vol 14 (3) ◽  
pp. 79-83
Author(s):  
E V Luchinina ◽  
O G Kompaniets ◽  
N V Kizhvatova
Keyword(s):  
Arterial Hypertension ◽  
Adverse Reactions ◽  
Antihypertensive Drugs ◽  
Cardiovascular Complications ◽  
Low Density Lipoproteins ◽  
Comorbid Condition ◽  
Primary And Secondary Prevention ◽  
Basic Drug ◽  
Require Dose ◽  
Require Dose Adjustment

Arterial hypertension and dyslipidemia is a very frequent comorbid condition. Arterial hypertension and dyslipidemia are combined in 40-70% of patients. The statins is the basic drug in primary and secondary prevention of cardiovascular disease and in the reduction of cardiovascular complications. We`ve attempted to summarize some data about the statins and interaction of antihypertensive drugs. Rosuvastatin is a medicine that provides an intensive reduction of low-density lipoproteins, does not require dose adjustment when applied in conjunction with antihypertensive drugs. The absence of inhibition and activation of rosuvastatin cytochrome P450 provides a low risk of negative interactions in the clinical situations of induced polypharmacy. Every clinician is to remember that it`s crucial to take into account some adverse reactions combining the statins with drugs of other pharmacological groups.

scholarly journals Vascular stiffness in patients with arterial hypertension: possible antihypertensive therapy

2016 ◽  
Vol 13 (2) ◽  
pp. 17-23
Author(s):  
O D Ostroumova ◽  
A I Kochetkov ◽  
M V Lopukhina
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Pulse Wave ◽  
Antihypertensive Drugs ◽  
Vascular Wall ◽  
Cardiovascular Complications ◽  
Increased Risk ◽  
Pharmacokinetic Properties ◽  
Complications And Mortality

The article discusses the factors that increase the arterial stiffness: the blood pressure, atherosclerosis, smoking, diabetes, age. Given evidence that pulse wave velocity and a number of other indicators that reflect the state of the vascular wall, are markers for increased risk of cardiovascular complications and mortality. The influence of antihypertensive drugs of different groups on the stiffness of the vascular wall, with particular attention paid to the effects of drugs from group of diuretics. We discuss possible mechanisms of the influence of indapamide retard on the elastic properties of vessels. It is emphasized that the influence on the stiffness of the arteries of different antigipertenzivny medicines, even belong to the same class, is different, due to differences in pharmacokinetic properties.

scholarly journals The hardness of the vessel wall in patients with arterial hypertension

2015 ◽  
Vol 12 (2) ◽  
pp. 43-48
Author(s):  
O D Ostroumova ◽  
A I Kochetkov ◽  
I I Kopchenov ◽  
T F Guseva ◽  
O V Bondarec
Keyword(s):  
Arterial Hypertension ◽  
Vessel Wall ◽  
Antihypertensive Drugs ◽  
Blood Pressure Level ◽  
Vascular Wall ◽  
Cardiovascular Complications ◽  
Increased Risk ◽  
The Status ◽  
The Difference

The article deals with the role of the hardness of the vessel wall in the pathogenesis of arterial hypertension and its complications and cardiovascular mortality. We discussed the factors increasing the hardness of the vessel wall, such as age, blood pressure level, atherosclerosis, smoking and diabetes mellitus. We showed the indicators reflecting the status of the vascular wall and which could play a role of markers of increased risk of cardiovascular complications. We reviewed the data concerning the improvement of the parameters of the hardness of the vessel wall under the influence of antihypertensive therapy using the angiotensin II type 1 receptor blocker - candesartan. We discussed the possible mechanisms of the candesartan influence on the elastic properties of the vessels. We stressed that the effect on the hardness of the arteries on using antihypertensive drugs, even within the same class, was different, which, apparently, was associated with the difference in the pharmacokinetic properties.

scholarly journals Endothelial function and its role in the formation of cardiovascular pathology in patients with rheumatoid arthritis

2019 ◽  
Vol 100 (3) ◽  
pp. 451-456
Author(s):  
A A Tulichev ◽  
N Yu Borovkova ◽  
N N Borovkov ◽  
A A Spassky ◽  
I V Polyakova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Diseases ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Unknown Origin ◽  
Vascular Wall ◽  
Cardiovascular Complications ◽  
Point Of View ◽  
Microvascular Changes ◽  
Initial Stage

Currently rheumatoid arthritis is considered as an immune inflammatory disease of unknown origin characterized by chronic erosive arthritis and systemic damage of internal organs, leading to early disability and reduced life expectancy. Cardiovascular diseases are most often mentioned as factors of poor prognosis in rheumatoid arthritis. Pathology of the cardiovascular system in rheumatoid arthritis is usually associated with the macro- and microvascular changes and rheumatoid lesions of the heart. The leading factor in the damage of the vascular wall in rheumatoid arthritis is systemic inflammation affecting its viscosity and elastic properties, increased rigidity, impaired endothelial function. Endothelial dysfunction is currently regarded to as an initial stage of morphogenesis of various vascular disorders. It is considered as a subclinical marker of cardiovascular diseases and the earliest predictor of cardiovascular complications. From this point of view study of endothelial dysfunction in patients with rheumatoid arthritis aimed at determining cardiovascular risk is a perspective direction. Only single and fragmentary information about certain endothelial functions in patients with rheumatoid arthritis and substances released in this. There is no clear analysis of relationship between them and dependence on the process activity. Not clear is their role in the pathology of the vascular wall in rheumatoid arthritis. This literature review discusses the problem of endothelial dysfunction in rheumatoid arthritis patients as well as its role in the development of cardiovascular diseases in these patients. The development mechanisms and the role of immune inflammation in its formation are considered. Also the association was found between chronic inflammatory activity indicators in rheumatoid arthritis and various biological markers and development of endothelial dysfunction. The effects of antirheumatic treatment on endothelial dysfunction in these patients were analyzed.

scholarly journals DEVELOPMENT AND METHODOLOGY FOR THE ESTIMATION OF ATENOLOL AND VALSARTAN IN PHARMACEUTICALS

2020 ◽  
pp. 30-33
Author(s):  
K. Ye. Peleshok ◽  
L. S. Logoyda ◽  
O. B. Poliak
Keyword(s):  
Simultaneous Determination ◽  
Antihypertensive Drugs ◽  
Cardiovascular Complications ◽  
Future Research ◽  
Eligibility Criteria ◽  
Mobile Phases ◽  
Urgent Task ◽  
Acetic Acid Water ◽  
Tlc Analysis

According to the appropriate protocols for the treatment of hypertension are often used antihypertensive drugs of the 5 main classes – first-line drugs, which when used in equivalent doses contribute to the reduction of blood pressure and significantly reduce the risk of cardiovascular complications. Quite often, doctors prescribe two/three medicines at a time. Therefore, the creation of fixed combinations antihypertensive action in the form of solid dosage forms is an urgent task of modern pharmacy. The aim of the study – to improve to more rapid, simple, selective, less expensive methods TLC analysis of simultaneous determination of atenolol and valsartan in pharmaceuticals. Methods. The present study assessed mobile phases of atenolol and valsartan for TLC. Results and Discussion. Method of simultaneous identification of atenolol and valsartan by TLC has been developed. We have established that the most optimal Rf observed using mobile phases for simultaneous determination of atenolol and valsartan: n-butanol-acetic acid-water (40:10:20). We have explored the validation characteristics – specificity and suitability of the chromatographic system that met, the eligibility criteria established by the SPU. Conclusion. We have developed chromatographic method for simultaneous determination of atenolol and valsartan. Prospects for future research will be aimed at developing analytical methods of analysis.

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