scholarly journals Approaches to the treatment of uncontrolled hypertension. Place of the Physiotens®

2021 ◽  
Vol 26 (6) ◽  
pp. 4535
Author(s):  
S. N. Tereshchenko ◽  
V. V. Ruksin ◽  
N. I. Gaponova ◽  
O. N. Tkacheva ◽  
D. V. Duplyakov ◽  
...  
Keyword(s):  
Antihypertensive Therapy ◽  
Target Organ Damage ◽  
Hypertensive Crisis ◽  
Organ Damage ◽  
International Classification Of Diseases ◽  
Target Organ ◽  
Uncontrolled Hypertension ◽  
Russian Society ◽  
Classification Of Diseases ◽  
Icd 10

The paper discusses the issues of managing uncontrolled hypertension. It is noted that in the International Classification of Diseases, 10th revision (ICD-10), there is no diagnosis “hypertensive crisis”, which complicates the epidemiological estimates. In the new Russian Society of Cardiology guidelines, instead of using the term “uncomplicated hypertensive crisis”, the term “sudden pronounced individually relevant blood pressure (BP) increase” was proposed to describe pronounced BP increase without target organ damage. Since the term “uncomplicated hypertensive crisis” is not recommended for use, but this condition is often diagnosed in practice, it is advisable to replace this term with “sharp BP increase not accompanied by target organ damage” or “sudden pronounced individually relevant BP increase”. At the same time, there is no evidence that in patients with uncomplicated hypertensive crisis, a more rapid BP decrease is more effective over the standard antihypertensive therapy in relation to the risk of complications. The drug Physiotens® lowers BP smoothly and without sudden falls, while having favorable pharmacokinetics. The issues of revising the current approaches to antihypertensive therapy in patients with frequent BP increases, as well as the use of original drugs and generics are considered.

scholarly journals Hypertensive Crisis in the Elderly Patients

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 128-135
Author(s):  
O. N. Tkacheva ◽  
Yu. V. Kotovskaya ◽  
K. A. Eruslanova
Keyword(s):  
Elderly Patients ◽  
Clinical Symptoms ◽  
Target Organ Damage ◽  
Hypertensive Crisis ◽  
The Elderly ◽  
Organ Damage ◽  
Target Organ ◽  
Sudden Increase ◽  
Chronic Therapy ◽  
High Level

A hypertensive crisis is a sudden increase in blood pressure (BP) to an individually high level associated with clinical symptoms and target organ damage, in which BP must be reduced immediately. Since 2018 in Europe and since 2020 in Russia, an uncomplicated hypertensive crisis is recommended to be considered as a part of malignant (uncontrolled) arterial hypertension. The clinical picture of increased BP in elderly patients is characterized by nonspecific symptoms even in target organ damage. Management of this group of patients requires a physician to know the patient’s comorbidities and the drugs taken on a regular basis to minimize development of side effects of the administered drugs and their undesirable interaction with the chronic therapy.

scholarly journals A descriptive study on the hypertensive crisis in Visakhapatnam, Andhra Pradesh, India

2020 ◽  
Vol 8 (6) ◽  
pp. 386-391
Author(s):  
Dr. Salla Surya Prakasa Rao ◽  
◽  
Dr. Salla Sweta Ramani ◽  
Dr. Pudi Venkat Sai Kiran ◽  
Dr. Siddanati Kiran Prasad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Andhra Pradesh ◽  
Adverse Outcome ◽  
Target Organ Damage ◽  
Hypertensive Crisis ◽  
Descriptive Study ◽  
Organ Damage ◽  
Target Organ ◽  
Elevated Blood ◽  
Presenting Symptoms

Objective: The objective of the present study, A Descriptive study on Hypertensive Crisis inVisakhapatnam, India was to evaluate the modes of presentations, clinical profile, and spectrum oftarget organ damage in patients with hypertensive emergencies. Material and Methods: The studypopulation included patients admitted in this hospital with severely elevated blood pressure withclinical or laboratory evidence of acute target organ damage. Result: The clinical and laboratoryprofile of 50 of these patients were evaluated. Males had higher chances of developing ahypertensive emergency compared to females. The commonest presenting symptoms were chestpain, dyspnoea, and neurological deficit. The majority of the patients have known hypertensives.Higher levels of blood pressure at presentation were associated with an adverse outcome. Acute LVFwas the commonest target organ damage observed. In-hospital mortality of 14% was observed inthe present study. Conclusion: Known hypertensives are at a higher risk of presenting with acutetarget organ damage associated with chest pain. Acute LVF is the commonest form of target organdamage encountered in the present study.

scholarly journals Clinical profile and drug therapy of outpatients with arterial hypertension

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.

scholarly journals Antihypertensive Pharmacotherapy in Correcting the Indicators of Innate Immunity in Patients with Essential Arterial Hypertension

2020 ◽  
Vol 6 (4) ◽  
pp. 13-18
Author(s):  
Evgeniia V. Gavriliouk ◽  
IrinaIrina V. Evsegneeva ◽  
Vadim P. Mikhin
Keyword(s):  
Innate Immunity ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Vascular Lesions ◽  
Left Ventricular Myocardium ◽  
Essential Arterial Hypertension

Introduction: The study of indicators of innate immunity in patients with arterial hypertension in clinical trials makes it necessary to correct them in order to reduce vascular inflammation in arterial hypertension to prevent damage to target organs and development of cardiovascular complications. The aim of the study was to assess the effectiveness of antihypertensive therapy to correct indicators of innate immunity in patients with essential arterial hypertension. Materials and methods: Patients with essential arterial hypertension (EAH) (II stage, 3rd degree) were divided into 3 groups: the 1st group included the patients with hypertrophy of the left ventricular myocardium; the 2nd group included the patients with atherosclerotic vascular lesions; the 3rd group included the patients with chronic kidney disease. As an initial antihypertensive pharmacotherapy, all the patients with essential arterial hypertension were prescribed perindopril (5–10 mg/day) and amlodipine (5–10 mg/day). Results and discussion: Changes in innate immunity indices in patients with essential arterial hypertension (II stage, 3rd degree) are differentiated depending on the affected target organ. The antihypertensive pharmacotherapy with perindopril and amlodipine in patients with essential arterial hypertension has various corrective effects on impaired innate immunity, depending on the nature of target organ damage. Regardless of target organ damage, ноу antihypertensive therapy with perindopril and amlodipine does not affect the reduced functional and increased metabolic activities of peripheral blood neutrophils. Conclusion: The results obtained dictate the need for further clinical studies of other classes of antihypertensive drugs and their combinations in the correction of innate immunity indices in order to effectively prevent the progression of target organ damage. Graphical abstract

scholarly journals Uric Acid Is Not Associated With Blood Pressure Phenotypes and Target Organ Damage According to Blood Pressure Phenotypes

2020 ◽  
Author(s):  
Anping Cai ◽  
Lin Liu ◽  
Mohammed Siddiqui ◽  
Dan Zhou ◽  
Jiyan Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Uric Acid ◽  
Arterial Stiffness ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Uncontrolled Hypertension ◽  
Hypertensive Patients

Abstract BACKGROUND Hypertensive patients with increased serum uric acid (SUA) are at increased cardiovascular (CV) risks. Both the European and American hypertension guidelines endorse the utilization of 24 h-ambulatory blood pressure monitoring (24 h-ABPM) for hypertensive patients with increased CV risk. While there is difference in identifying uric acid as a CV risk factor between the European and American guidelines. Therefore, it is unknown whether 24 h-ABPM should be used routinely in hypertensive patients with increased SUA. METHODS To address this knowledge gap, we investigated (i) the correlation between SUA and 24 h-ABP; (ii) the association between SUA and blood pressure (BP) phenotypes (controlled hypertension [CH], white-coat uncontrolled hypertension [WCUH], masked uncontrolled hypertension [MUCH], and sustained uncontrolled hypertension [SUCH]); (iii) the association between SUA and target organ damage (TOD: microalbuminuria, left ventricular hypertrophy [LVH], and arterial stiffness) according to BP phenotypes. RESULTS In 1,336 treated hypertensive patients (mean age 61.2 and female 55.4%), we found (i) there was no correlation between SUA and 24 h, daytime, and nighttime systolic blood pressure/diastolic blood pressure, respectively; (ii) in reference to CH, SUA increase was not associated WCUH (odds ratio [OR] 0.968, P = 0.609), MUCH (OR 1.026, P = 0.545), and SUCH (OR 1.003, P = 0.943); (iii) the overall prevalence of microalbuminuria, LVH, and arterial stiffness was 2.3%, 16.7%, and 23.2%, respectively. After adjustment for covariates, including age, sex, smoking, body mass index, diabetes mellitus, and estimated glomerular filtration rate, there was no association between SUA and TOD in all BP phenotypes. CONCLUSIONS These preliminary findings did not support routine use of 24 h-ABPM in treated hypertensive patients with increased SUA.

scholarly journals Homocysteine predicts vascular target organ damage in hypertension and may serve as guidance for first‐line antihypertensive therapy

2021 ◽  
Author(s):  
Revathy Carnagarin ◽  
Janis M. Nolde ◽  
Natalie C. Ward ◽  
Leslie Marisol Lugo‐Gavidia ◽  
Justine Chan ◽  
...  
Keyword(s):  
Antihypertensive Therapy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
First Line

White coat effect and masked uncontrolled hypertension in treated hypertensive-diabetic patients: Prevalence and target organ damage

2015 ◽  
Vol 7 (5) ◽  
pp. 699-707 ◽  
Author(s):  
Liana F. Leiria ◽  
Mateus D. Severo ◽  
Priscila S. Ledur ◽  
Alexandre D. Becker ◽  
Fernanda M. Aguiar ◽  
...  
Keyword(s):  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
White Coat ◽  
Uncontrolled Hypertension ◽  
Diabetic Patients ◽  
White Coat Effect

MODERN EMERGENCY CARE STRATEGY FOR HYPERTONIC CRISIS

2021 ◽  
Vol Special issue (2) ◽  
pp. 9-18
Author(s):  
Nizomiddin Xalilov ◽  
◽  
Temur Jurakulov ◽  
Gyosiddin Xursandov ◽  
Xumoyun Nematov ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Hypertensive Crisis ◽  
Organ Damage ◽  
Target Organ ◽  
Medical Associations ◽  
Clinical Hypertension ◽  
Reflex Tachycardia ◽  
Wide Range ◽  
Skin Redness

The article is devoted to discussing modern approaches todiagnosis andtreatment in complicated anduncomplicated hypertensive crises.The options for antihypertensive drugs are considereddepending on thenature of target organ damage ina hypertensive crisis.The data on themost frequently prescribed drugs for complicated anduncomplicated hypertensive crisis increases the volumetric velocity of coronary andcerebral blood flowand reduces the pressure inthe pulmonary artery system.It is usually used to relieve the mild uncomplicated hypertensive crisis. Still, a wide range of side effects, including reflex tachycardia, periorbital andperipheral edema, skin redness, pruritus,limits its use.Keywords: cerebral blood flow, routine clinical, hypertension, medical associations, hypertensive crisis

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