P6374Effectively treated hypertension: secrets of blood rheology

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O Svirida ◽  
F T Ageev ◽  
N V Fgeeva ◽  
M D Smirnova ◽  
Z N Blankova ◽  
...  
Keyword(s):  
Blood Viscosity ◽  
Independent Predictor ◽  
Beta Blockers ◽  
Blood Rheology ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Plasma Viscosity ◽  
Angiotensin Ii Receptor ◽  
Rotational Viscometer ◽  
Converting Enzyme Inhibitors ◽  
Hypertensive Patients

Abstract Background The contributions of the effectively treated hypertension on blood viscosity remain unclear, as well as impact of clinical and demographic parameters, biochemical variables, level of anxiety. Aim Aim of the study is to research viscosity state in patients with effectively treated hypertension and to reveal factors affecting blood viscosity. Materials 58 treated hypertensive patients (36 females and 24 males aged 62,9±9,7 years) with achievement of target blood pressure (BP) level (systolic BP was 130,9 (126,6; 135,4), diastolic BP - 81,4 (79,7; 83,1) mmHg. 71.7% of patients were treated with beta-blockers, 46.7% - angiotensin converting enzyme inhibitors (ACE inhibitors), 31.7% - angiotensin II receptor blockers, 38.3% - calcium channel antagonists, 18.3% - diuretics, 71.3% - statins, 60% - acetylsalicylic acid. Coronary heart disease (CHD) were presented in 24 (40%). The average cholesterol level was 5.11 (4.76; 5.46) mmol/l, creatinine 71.83±12.6 mmol/l, sodium 143.4 (143.0; 143.9) mmol/l. The level of anxiety disorders determined on Sheehan's Patient-Rated Anxiety Scale (SPRAS) was 33.7 (23.1; 39.2) points. Methods Whole blood viscosity at high (η1) and low (η2) shear rates, plasma viscosity (ηpl) were measured by a rotational viscometer. Aggregation of erythrocytes (η2/ η1) was studied also. The statistical analysis was carried out by nonparametric method of Spearman and multivariate regression analysis with STATISTICA 6. Results Hemorheological profile was as follows: η1 4,7 (4,7; 5,0) sec–1, η 2 24,6 (23,5; 26,5) sec–1, η2/η 1 5,4 (4,9; 5,3), η pl 1,52 (1,51; 1,55) sec–1. Blood viscosity in men was higher than in women in all indices studied: η1 5,4 (5,1; 5,7) sec–1 in men vs 4,6 (4,6; 5,0) sec–1 in women (p<0,001), η 2 28,6 (26,0; 31,9) sec–1 vs 23,0 (21,6; 25,8) sec–1 (p=0,004), η2/η1 - 5,3 (5,1; 5,6) vs 4,9 (4,7; 5,2) (p=0,03) respectively. It was revealed η1 correlation with patient growth (r=0,468, p=0,001), η2 –with creatinine (r=0,551, p=0,001) and sodium (r=0,488, p<0,001) level. η2 /η1 positively correlated with the level of creatinine (r=0,383, p 0,04), sodium (r=0,543, p=0,0001), and with the level of anxiety as well (r=0,374, p=0,01). The level of anxiety is defined as an independent predictor of η2/η1 in the model including gender, age, creatinine, sodium, anxiety level. In patients treated with an ACE inhibitor η2/η1 was higher compared to patients who were not prescribed: 5,3 (4,6; 5,2) vs 5,0 (5,0; 5,5), (p=0,04). However, a multivariate analysis showed a loss of the prognostic value of antyhypertesive treatment (in model included gender, age, height, creatinine, sodium). Blood viscosity does not depend on the level of total cholesterol, the presence of CHD. Conclusion In effectively treated hypertensive patients the level of anxiety, indirectly reflected the activity of the sympatho-adrenal system, proved to be an independent predictor of a higher value of η2/η1.

Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on pulmonary function in hypertensive patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Azza S. Jabbar ◽  
Nadheera F. Neamah ◽  
Ahmed H. Al-Darraji
Keyword(s):  
Angiotensin Ii ◽  
Adverse Effects ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Hypertensive Patients ◽  
Receptor Blockers

Abstract Objectives Hypertension is a very common cardiovascular disease. Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are widely used to treat hypertension. Many patients with hypertension are vulnerable to the antihypertensive adverse effects, which potentially reduces the adherence rate. Therefore, we conducted this study in order to evaluate the safety profile of both classes (ACEi and ARBs) on respiratory functions. Methods Two main groups of subjects were studied: first group is healthy control subjects and the second group is hypertensive patients, which was subdivided into subgroups in order to investigate the effect of all tested medications (captopril, enalapril, lisinopril, losartan, and valsartan). Respiratory efficiency was evaluated by measuring pulmonary function tests: FEV1, FVC, and FEV1%. Measurements were done using micromedical spirometer. Results We found that ARBs do not impair normal respiratory functions as measured by FEV1, FEV1%, and FVC in hypertensive patients. While ACEi treatments significantly reduced FEV1, FEV1%, and FVC compared to the other groups. Conclusions ARBs are not associated with any harmful effects on respiratory functions in hypertensive patients, unlike ACEi. As such, they could represent a first-choice treatment for hypertensive patients who are at high risk to the respiratory adverse effects.

scholarly journals Medical therapy in patients with thoracic aortic aneurism

2018 ◽  
Vol 24 (3) ◽  
pp. 264-271
Author(s):  
E. B. Luneva ◽  
E. G. Malev ◽  
I. A. Pankova ◽  
E. V. Zemtsovsky
Keyword(s):  
Thoracic Aorta ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Medication Therapy ◽  
First Line Therapy ◽  
Receptor Blockers ◽  
Aorta Diameter

Aneurysm of the thoracic aorta of any origin is traditionally considered a pathology for surgical correction. Traditionally the patients are referred for the surgery (prosthetics or endovascular treatment) when thoracic aorta diameter achieves 50–55 mm. However, the management strategy and conservative treatment in case of the smaller aorta dilations are not well elucidated in еру guidelines. The medication therapy aims at the decrease of the hemodynamic stress in the aortic wall, as well as at the correction of risk factors and accompanying diseases, including coronary heart disease, diabetes mellitus, hypertension, etc. Since drug therapy of this pathology is not sufficiently developed, its choice is difficult for physicians. The paper reviews the main groups of drugs and their effectiveness in patients with thoracic aorta aneurism resulted from different causes, including atherosclerosis, genetic pathology (Marfan syndrome, Loeys-Dietz syndrome, etc.). Currently, no drugs are considered as first line therapy. The evidence suggests the use of beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers only in genetic pathology.

Abstract 11815: Effects of Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers and Beta-Blockers on the Prevention of Atrial Fibrillation in Patients With Heart Failure With Preserved Ejection Fraction: A Prospective Study of Four-Years Follow-Up

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Masanori Kawasaki ◽  
Ryuhei Tanaka ◽  
Shingo Minatoguchi ◽  
Takatomo Watanabe ◽  
Maki Saeki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Significant Difference ◽  
New Onset

Background: The incidence of new-onset atrial fibrillation (AF) is increasing with the prevalence of diastolic dysfunction. Diastolic dysfunction is thought to be responsible for heart failure with preserved ejection fraction (HFPEF). Effective medication for the treatment of HFPEF has been controversial, although angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs) and beta-blockers (BBs) have been proven to be effective in heart failure with reduced EF. We recently reported that pulmonary capillary wedge pressure (ePCWP) estimated by the combination of left atrial (LA) volume (V) and emptying function (EF) evaluated by speckle tracking echocardiography (STE) had a strong correlation with PCWP measured by cardiac catheterization (r=0.86-0.92). Methods: We screened 663 elderly (>65 years old) patients and identified 228 who had no AF history and met the criteria for diastolic dysfunction according to the Echocardiography Association of the European Society of Cardiology. These patients were prospectively followed for 4 years to identify new-onset AF. We measured echocardiographic parameters such as left ventricular (LV) mass index, LV ejection fraction, E/A, E/e’ and ePCWP at baseline. Concomitant medication was left to the discretion of the physicians in charge. Results: During a mean follow-up of 43 months, 63 elderly patients (age 73±6, 39 men) developed electrocardiographically-confirmed AF. There was no significant difference in the development of new-onset AF between the groups treated with and without BBs (hazard ratio (HR): 0.615, p=0.15). There was also no significant difference in new-onset AF between the groups with and without ACEIs or ARBs (HR: 0.796, p=0.46). However, in multivariate analysis that included ePCWP, LVM index, E/e’ and E/A, ePCWP at baseline independently predicted the risk of new-onset AF (HR: 1.42, 95% confidence interval: 1.29-1.57, p<0.001). Conclusions: ACEIs, ARBs or BBs had no beneficial effects on the prevention of new-onset AF as a marker of diastolic dysfunction in the patients with HFPEF. Estimation of ePCWP by STE had incremental value for the risk stratification of new-onset AF.

Heart failure

2012 ◽  
Keyword(s):  
Heart Failure ◽  
Angiotensin Ii ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Signs And Symptoms ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Angiotensin Ii Receptor Antagonists ◽  
Converting Enzyme Inhibitors

Introduction 368Forms of heart failure 370Causes and precipitants 372Signs and symptoms 374Investigations 378Management of heart failure 382Diuretics in heart failure 386Angiotensin-converting enzyme inhibitors for heart failure 390Angiotensin II receptor antagonists for heart failure 392Beta-blockers for heart failure ...

Effect of antihypertensive treatment on small artery remodeling in hypertension

2003 ◽  
Vol 81 (2) ◽  
pp. 168-176 ◽  
Author(s):  
Ernesto L Schiffrin
Keyword(s):  
Smooth Muscle ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Converting Enzyme ◽  
Small Artery ◽  
Converting Enzyme Inhibitors ◽  
Hypertensive Patients ◽  
Small Arteries

Blood vessels are remodeled in hypertension both structurally and functionally. The changes that occur in their structure, mechanical properties, and function contribute to blood pressure elevation and to complications of hypertension. We studied the remodeling of small arteries in experimental animals and humans. Smooth muscle cells of small arteries are restructured around a smaller lumen, with significant remodeling of the extracellular matrix and collagen and fibronectin deposition. Interestingly, there is no evidence of net growth of the vascular wall (which results in so-called eutrophic remodeling), particularly in the milder forms of human essential hypertension. Hypertrophic remodeling and increased small artery stiffness may be found in more severe forms of hypertension. Almost all hypertensive patients have vascular structural remodeling. However, only some exhibit endothelial dysfunction. This is particularly true in mild hypertension, in which endothelial dysfunction is less common. A 1-year treatment of hypertensive patients with angiotensin converting enzyme inhibitors, angiotensin AT1 receptor antagonists, and long acting calcium channel blockers corrected small artery structure and, to variable degrees depending on the agents used, impaired endothelial function. In contrast, beta blockers did not improve structure, function, or mechanics of vessels. When beta-blocker-treated patients were switched to an AT1 receptor antagonist, small artery structure and impaired endothelial function were corrected. The vascular protective action of some antihypertensive agents may contribute to improve outcome for hypertensive patients, although this is presently unproven.Key words: resistance arteries, smooth muscle, hypertrophy, endothelium, angiotensin converting enzyme inhibitors, AT1 receptor antagonists, calcium channel blockers, beta blockers.

Epidemiology of gout

2016 ◽  
Author(s):  
Samantha Hider ◽  
Edward Roddy
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Epidemiological Studies ◽  
Dietary Factors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Increased Risk

Gout is the most prevalent inflammatory arthritis in men. Data from epidemiological studies conducted in several countries suggest that the prevalence and incidence of gout have risen over the last few decades, although incidence may have stabilized recently. Dietary factors (animal purines, alcohol, and fructose), co-morbid medical conditions (obesity, metabolic syndrome, hypertension, and chronic kidney disease), and medications (diuretics, aspirin, beta blockers, angiotensin converting-enzyme inhibitors, and non-losartan angiotensin II receptor blockers) have been confirmed to be risk factors for both hyperuricaemia and gout. In contrast, low-fat dairy products, coffee, vitamin C, calcium channel antagonists, and losartan appear to reduce the risk of developing gout. People with gout are themselves at increased risk of developing cardiovascular disease and chronic kidney disease, independent of traditional risk factors for these conditions.

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