scholarly journals Masked arterial hypertension: prevalence, pathophysiological determinants and clinical significance

2019 ◽  
pp. 92-98 ◽  
Author(s):  
В. I. Geltser ◽  
V. N. Kotelnikov ◽  
О. О. Vetrova ◽  
R. S. Karpov
Keyword(s):  
Arterial Hypertension ◽  
Cardiovascular Complications ◽  
Hypertension Prevalence ◽  
Rational Pharmacotherapy ◽  
Maximum Reduction ◽  
Target Organs ◽  
Rf Exposure ◽  
Increased Risk ◽  
Water Salt ◽  
Hemostatic Disorders

In most modern studies, masked arterial hypertension (MAH) is characterized as a poorly diagnosed, latent clinical condition predisposing to subclinical damage to target organs and an increased risk of cardiovascular complications. The prevalence of MAH among the population depends on gender, age, anthropometric and socioeconomic factors, profession, race and other characteristics. The most important risk factors (RF) of MAH and its pathophysiological determinants include genetic polymorphism, subclinical non-specific inflammation, hemostatic disorders, obesity, metabolic syndrome, water-salt imbalance, dyslipidemia, hyperuricemia. A defined value has latent dysfunction of the mechanisms that provide circulatory homeostasis, the detection of which is possible by the hemodynamic response to psycho-emotional, hypoxic, hypocapnic, orthostatic effects. Aggressiveness of RF exposure and the consequences of their implementation are evaluated by the rate of development of cardiovascular events and mortality, which indicate an unfavorable prognosis of “uncontrolled” MAH. The maximum reduction of the RF effects and rational pharmacotherapy can significantly improve its clinical prospects.

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 Worksite hypertension as a model of stress-induced arterial hypertension

2018 ◽  
Vol 90 (9) ◽  
pp. 123-132 ◽  
Author(s):  
O D Ostroumova ◽  
A I Kochetkov
Keyword(s):  
Risk Factor ◽  
Arterial Hypertension ◽  
Stress Reduction ◽  
Job Strain ◽  
Epidemiological Data ◽  
Cardiovascular Complications ◽  
Protective Properties ◽  
Increased Risk ◽  
Induced Hypertension ◽  
Β Blocker

The review presents a modern view on stress as a risk factor for the development of arterial hypertension (AH). A variety pathogenic mechanisms responsible for increase of blood pressure during stress exposure are described in detail. The importance of the sympathetic activation as a key link in the development of stress-induced AH and initiation of a cascade of pathophysiological reactions that realize their adverse effects at the level of the whole organism is underlined. Particular attention is paid to worksite AH as a variant of stress-induced hypertension due to its wide prevalence and association with an increased risk of cardiovascular complications, primarily myocardial infarction and stroke. Epidemiological data and results of recent metanalysis are presented, indicating the high significance of job strain as a risk factor for adverse cardiovascular events. The actual psychological stress reduction programs are described. Possibilities of using β-blockers in patients with stress-induced hypertension as drugs affecting the central pathogenetic trigger of this disease are considered. The advantages of using bisoprolol as a highly selective β-blocker are considered taking into account the available body of evidence for its effectiveness in patients with worksite AH, as well as its metabolic neutrality and target-organ protective properties.

The role of physical factors of the working environment in the formation of arterial hypertension

2020 ◽  
pp. 692-693
Author(s):  
A. V. Melentev ◽  
P. V. Serebryakov
Keyword(s):  
Arterial Hypertension ◽  
Working Conditions ◽  
Significant Contribution ◽  
Cardiovascular Complications ◽  
Working Environment ◽  
Physical Factors ◽  
Noise And Vibration ◽  
Increased Risk ◽  
Influence Of Noise

The influence of noise and vibration on the development of arterial hypertension in workers employed in adverse working conditions was studied. It is shown that these physical factors of the working environment make a significant contribution to the formation of an increased risk of cardiovascular complications

scholarly journals Risk of target organ damage in patients with arterial hypertension and various numbers of metabolic syndrome components

2014 ◽  
Vol 11 (1) ◽  
pp. 40-44
Author(s):  
Yu V Zhernakova ◽  
G Kh Sharipova ◽  
I E Chazova
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Clinical Medicine ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Cardiovascular Complications ◽  
Target Organ ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Metabolic Syndrome Components

The metabolic syndrome is one of most socially significant and strategic problems of clinical medicine. It is known that metabolic syndrome promotes earlier and more expressed target organ damage in patients with arterial hypertension. However, correlation of the number of metabolic syndrome components with target organ damage, selection of metabolic syndrome components, influencing expressiveness on target organ damage, are studied insufficiently. In this study it is determined that with the elevating number of the metabolic syndrome components, the frequency and expressiveness of heart, kidney and vessel damage, accompanied by the increased risk of development of cardiovascular complications, increase in patients with the maximum number of the metabolic syndrome components. Moreover, it is revealed that the relative risk of simultaneous damage of heart, kidneys and vessels in patients with arterial hypertension and metabolic syndrome, apart from high blood pressure and abdominal obesity is associated with the increase of fasting glucose level.

The Role of Revascularisation in Patients Undergoing Non-cardiac Surgery

2010 ◽  
Vol 5 (1) ◽  
pp. 104
Author(s):  
Daniel S Menees ◽  
Eric R Bates ◽  
◽  
Keyword(s):  
Cardiac Surgery ◽  
Prediction Models ◽  
Cardiovascular Complications ◽  
Weight Of Evidence ◽  
Beta Blockade ◽  
Cardiac Morbidity ◽  
Increased Risk ◽  
Reduction Strategies ◽  
Artery Disease ◽  
Risk Reduction Strategies

Coronary artery disease (CAD) affects millions of US citizens. As the population ages, an increasing number of people with CAD are undergoing non-cardiac surgery and face significant peri-operative cardiac morbidity and mortality. Risk-prediction models can be used to help identify those patients at increased risk of peri-operative cardiovascular complications. Risk-reduction strategies utilising pharmacotherapy with beta blockade and statins have shown the most promise. Importantly, the benefit of prophylactic coronary revascularisation has not been demonstrated. The weight of evidence suggests reserving either percutaneous or surgical revascularisation in the pre-operative setting for those patients who would otherwise meet independent revascularisation criteria.

Vascular endothelial growth factor as a potential marker of subclinical organ damage mediated by arterial hypertension

2019 ◽  
Vol 34 (3) ◽  
pp. 40-44
Author(s):  
E. Yu. Gubareva ◽  
I. V. Gubareva
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Essential Hypertension ◽  
Growth Factor ◽  
Arterial Hypertension ◽  
Organ Damage ◽  
Cardiovascular Complications ◽  
Vascular Endothelial ◽  
Potential Marker ◽  
Endothelial Growth Factor

The authors’ report presents a brief review of the key studies, providing the reason for the use of vascular endothelial growth factor as a marker for stratification of the risk of cardiovascular complications in patients with essential hypertension.

CLINICAL CHALLENGES FOR ANESTHESIOLOGIST FACING PATIENT WITH ACROMEGALY. CASE REPORT

2020 ◽  
Vol 30 (3) ◽  
pp. 56-59
Author(s):  
Jūratė Gudaitytė ◽  
Justina Jermolajevaitė ◽  
Martynas Judickas
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
General Population ◽  
Metabolic Disorders ◽  
Upper Airway ◽  
Cardiovascular Complications ◽  
Case Presentation ◽  
Increased Risk ◽  
Fluid Regulation ◽  
Class Iv

Background and objectives: Acromegaly is endocri­nal disorder which results in changes involving ge­neral appearance as well as upper airway abnorma­lities, cardiovascular and metabolic disorders which can aggravate the anesthesia and can lead to compli­cations. We aim to discuss the challenges for anesthe­siologist that occurs facing patient with acromegaly and are necessary to investigate before performing any kind of intervention. Case Presentation: 79 years old male patient presen­ted the hospital with recently diagnosed acromegaly for rectal prolapse surgery. From anamnesis he had NYHAIII with cardiomyopathy, atrial fibrillation and arterial hypertension, also multiple old compressive fractures Th10 – L5. He was graded with Mallam­pati score IV and ASA class IV. The complemen­tary examinations were made to assess the possible complications. In induction of general anesthesia the intubation was performed using fibro- bronchoscope and anesthesia went without complications except hypotension which was managed. After surgery the patient was leaded to the postoperative room for furt­her monitoring. Discussion and Conclusion: Acromegalic patients have an increased risk of difficulty during anesthe­sia compared to general population due to difficult intubation, cardiovascular complications , OSA , alte­ration in intraoperative glucose intolerance and fluid regulation. Therefore profound investigation and as­sessment are necessary to predict and prepare for possible difficulties in the surgery room.

Cardiovascular Complications in Patients with Klinefelter’s Syndrome

2020 ◽  
Vol 26 (43) ◽  
pp. 5556-5563
Author(s):  
Franz Sesti ◽  
Riccardo Pofi ◽  
Carlotta Pozza ◽  
Marianna Minnetti ◽  
Daniele Gianfrilli ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Klinefelter Syndrome ◽  
Subclinical Atherosclerosis ◽  
Cardiovascular Complications ◽  
High Risk Population ◽  
Metabolic Disturbances ◽  
Future Studies ◽  
Increased Risk ◽  
Chromosome Disorder

More than 70 years have passed since the first description of Klinefelter Syndrome (KS), the most frequent chromosome disorder causing male infertility and hypogonadism. KS is associated with increased cardiovascular (CV) mortality due to several comorbidities, including hypogonadism, as well as metabolic syndrome and type 2 diabetes, which are highly prevalent in these patients. Aside from metabolic disturbances, patients with KS suffer from both acquired and congenital CV abnormalities, cerebrovascular thromboembolic disease, subclinical atherosclerosis and endothelial dysfunction, which may all contribute to increased CV mortality. The mechanisms involved in this increased risk of CV morbidity and mortality are not entirely understood. More research is needed to better characterise the CV manifestations, elucidate the pathophysiological mechanisms and define the contribution of testosterone replacement to restoring CV health in KS patients. This review explores the complex association between KS, metabolic syndrome and CV risk in order to plan future studies and improve strategies to reduce mortality in this high-risk population.

Cardiovascular Complications of Sleep Disorders: A Better Night’s Sleep for a Healthier Heart / From Bench to Bedside

2020 ◽  
Vol 19 (2) ◽  
pp. 210-232 ◽  
Author(s):  
Theodora A. Manolis ◽  
Antonis A. Manolis ◽  
Evdoxia J. Apostolopoulos ◽  
Helen Melita ◽  
Antonis S. Manolis
Keyword(s):  
Sleep Disorders ◽  
Disease Risk ◽  
Behavioral Therapy ◽  
Benzodiazepine Receptor ◽  
Cardiovascular Complications ◽  
Gamma Aminobutyric Acid ◽  
Acid Type ◽  
Increased Risk ◽  
Cv Disease ◽  
Meta Analyses

: Sleep is essential to and an integral part of life and when lacking or disrupted, a multitude of mental and physical pathologies ensue, including cardiovascular (CV) disease, which increases health care costs. Several prospective studies and meta-analyses show that insomnia, short (<7h) or long (>9h) sleep and other sleep disorders are associated with an increased risk of hypertension, metabolic syndrome, myocardial infarction, heart failure, arrhythmias, CV disease risk and/or mortality. The mechanisms by which insomnia and other sleep disorders lead to increased CV risk may encompass inflammatory, immunological, neuro-autonomic, endocrinological, genetic and microbiome perturbations. Guidelines are emerging that recommend a target of >7 h of sleep for all adults >18 years for optimal CV health. Treatment of sleep disorders includes cognitive-behavioral therapy considered the mainstay of non-pharmacologic management of chronic insomnia, and drug treatment with benzodiazepine receptor agonists binding to gamma aminobutyric acid type A (benzodiazepine and non-benzodiazepine agents) and some antidepressants. However, observational studies and meta-analyses indicate an increased mortality risk of anxiolytics and hypnotics, although bias may be involved due to confounding and high heterogeneity in these studies. Nevertheless, it seems that the risk incurred by the non-benzodiazepine hypnotic agents (Z drugs) may be relatively less than the risk of anxiolytics, with evidence indicating that at least one of these agents, zolpidem, may even confer a lower risk of mortality in adjusted models. All these issues are herein reviewed.

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