Comparison of Early Target Organ Damage Between Blacks and Whites with Mild Systemic Arterial Hypertension

The article substantiates the feasibility of combination antihypertensive therapy in patients with arterial hypertension without target organ damage and high cardiovascular risk. The authors consider a clinical case of the use of amlodipine and losartan in a fixed-dose combination (Lozap AM) as part of complex therapy in a patient with arterial hypertension, dyslipidemia and obesity. The clinical case showed the ability of the drug to both achieve a steady level of target blood pressure and improve its daily profile by transferring the Night-peaker type to the Non-dipper type.

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Cardiovascular risk profile in patients with arterial hypertension who first seek medical attention

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2018-5-5-10 ◽

2018 ◽

Vol 17 (5) ◽

pp. 5-10

Author(s):

D. V. Nebieridze ◽

T. V. Kamyshova ◽

A. A. Sarycheva ◽

A. S. Safaryan

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Arterial Hypertension ◽

Target Organ Damage ◽

Density Lipoprotein ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Medical Attention ◽

Cardiovascular Morbidity And Mortality

Aim.Objective assessment of cardiovascular risk (CVR) in patients with arterial hypertension (AH), who first contact with primary care setting.Material and methods. 300 patients (age 40-65 years) with sustained increase in arterial pressure and first seek medical attention were included in the study. All patients underwent medical examination, history taking to identify risk factors, blood pressure measurement and anthropometric research, biochemical blood assay to estimate levels of total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, glucose. Based on the specified parameters, the risk was determined by SCORE (Systematic Coronary Risk Evaluation). After the risk assessment, all patients underwent an echo-cardiography, duplex ultrasonography screening of the brachiocephalic arteries and determination of microalbuminuria to detect target organ damage. According to results of a complex survey, the risk was reclassified based on the presence of target organ damage.Results.The study showed that patients with sustained AH who first seek medical attention have a large number of risk factors and their combinations, among which the most common are dyslipidemia (89,3%), smoking (37,7%) and obesity (28,3%). Patients with AH who first seek medical attention without clinical signs of atherosclerosis often have various disorders of target organs, such as left ventricular hypertrophy — 67,3%, thickening of carotid intima-media complex — 46,3%, atherosclerotic plaques in carotid arteries — 34,7%, microalbuminuria — 25,3%, as well as different combinations thereof. After a complex examination, the CVR profile of patients changes increases. According to SCORE 60% of patients with low and mean risk is reclassified to high risk.Conclusion.One of the most important tasks of health care system in Russia is to increase the efficiency of the CVR stratification systems, as well as to develop a new standards of examination of patients with AH on an outpatient stage, in order to reduce cardiovascular morbidity and mortality.

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Influence of fixed-dose combination perindopril/amlodipine on target organ damage in patients with arterial hypertension with and without ischemic heart disease (results of EPHES trial)

Vascular Health and Risk Management ◽

10.2147/vhrm.s163608 ◽

2018 ◽

Vol Volume 14 ◽

pp. 265-278 ◽

Cited By ~ 2

Author(s):

Ganna Radchenko ◽

Liliya Mushtenko ◽

Yuriy Sirenko

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Arterial Hypertension ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Ischemic Heart ◽

Fixed Dose Combination ◽

Fixed Dose ◽

Dose Combination

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Clinical profile and drug therapy of outpatients with arterial hypertension

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2020-04-04 ◽

2020 ◽

Vol 16 (2) ◽

pp. 206-212

Author(s):

N. V. Izmozherova ◽

A. A. Popov ◽

V. M. Bakhtin ◽

M. A. Shambatov

Keyword(s):

Arterial Hypertension ◽

Antiplatelet Therapy ◽

Antihypertensive Therapy ◽

Antihypertensive Treatment ◽

Myocardial Hypertrophy ◽

Target Organ Damage ◽

Organ Damage ◽

Mean Value ◽

Target Organ ◽

Very High

Aim. To study clinical profile and antihypertensive treatment features in outpatients observed in ambulatory facilities.Material and methods. 140 arterial hypertension (AH) outpatients were examined, questioning and anthropometry were performed. Blood pressure (BP) was measured on both hands, then twice on the hand with larger value, the medium value was calculated. Tests results were obtained from outpatient cards.Results. The sampling included 100 (71.4%) females and 40 (28.6%) males. Median of systolic BP at first measurement was 140.0 mm Hg (130.0;150.0), mean value of three BP measurements was 138.0 mm Hg (127.0;150.0) (p<0.001); median diastolic BP at first measurement was 83.0 mm Hg (80.0;90.0), mean BP value was 82.0 mm Hg (78.0;88.0) (p<0.001). Grade 1 AH was identified in 11.4% of patients, Grade 2 – in 35.7%, Grade 3 in 52.9%. No target organ damage was found in 26.4% of AH patients, asymptomatic target organ damage was diagnosed in 26.4%, and 61.4% had associated clinical conditions. Cardiovascular event risk was assessed as moderate in 13.6%, high – in 24.3% and very high – in 62.1% of patients. Every third patient had myocardial hypertrophy signs; Cornell index was detected more often than Sokolov-Layon index (p=0.006). Chronic kidney disease was diagnosed in 65.1% of patients: 44.0% of them had stage C2, 13.8% – stage C3A, 6.5% – stage C3B, and 1.8% – stage C4. 97.9% of AH patients received antihypertensive treatment. Daily medication consumption was reported by 127 people, and 10 patients reported taking medication as needed. Monotherapy was prescribed in 14.3% of patients; combined treatment was performed in 83.6% people. BP target value was achieved in 59 patients (42.1%) at first measurement results and in 71 (50.7%) ones at calculated mean value (p=0.002). Indications for statin use were identified in 86.4% of patients. Statins were administered in 56.2% patients having indications and in 21.1% of subjects without indications (p=0.006). Indications for antiplatelet therapy use were identified in 56.4% of patients. Antiplatelet treatment was administered in 58.2% of patients with indications and in 23.0% of subjects without indications (p<0.001).Conclusion. Glomerular filtration rate and left ventricular myocardial hypertrophy amplitude criteria calculation allow to diagnose subclinical target organ damage in outpatients at physician visit without additional costs. Compliance with the current antihypertensive therapy guidelines allows to achieve target BP in current practice. Compliance with the BP measuring rules allows to adequately assess the effectiveness of antihypertensive therapy. A significant proportion of AH outpatients have a very high cardiovascular risk, which requires lipid-lowering and antiplatelet therapy.

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