scholarly journals Clinical-hemodynamic efficiency of fixed combined hypotensin therapy for patients with heavy arterial hypertension

2019 ◽  
Vol 21 (2) ◽  
pp. 48-51
Author(s):  
N R Gizi Azayeva
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Diastolic Pressure ◽  
Blood Pressure Monitoring ◽  
Systolic Pressure ◽  
Clinical Manifestations ◽  
Pressure Profile ◽  
Left Ventricular ◽  
Combination Drug ◽  
Efficacy Of Treatment

The efficacy of treatment was evaluated by the fixed combination drug «Exforge-H» in 40 patients suffering from grade 3 arterial hypertension. All patients underwent general clinical and laboratory and instrumental examination (electrocardiography, echocardiography, 24-hour blood pressure monitoring) before and after 6 months of treatment. It was established that treatment with «Exforge-H» statistically reliably reduces the level of blood pressure, normalizes the variability and daily blood pressure profile. So, two weeks after the start of treatment, the systolic and diastolic pressure levels during clinical measurement decreased by 32,1±2,7 and 30,4±1,9 mm Hg. Art. respectively. After 3 months of treatment, 60% of patients showed achievement of the target level of blood pressure, and after 6 months - 96%. High hypotensive efficacy of treatment was also demonstrated during the daily monitoring of blood pressure in all its indicators. A significant decrease in systolic and diastolic pressure was observed during the day and night hours. The amplitudes of systolic and diastolic pressure variability have also been improved. At the same time, the variability of systolic pressure during the day was reduced by 46%, diastolic - by 49%, and at night by 59,3 and 52,8%, respectively, indicating a normalization of blood pressure during the day. All this was also accompanied by a decrease in the clinical manifestations of the disease. So, after 6 months of treatment, 84% of patients had positive clinical dynamics: a decrease in cardiac and cerebral symptoms, as well as emotional lability, which positively correlated with a decrease in the level of clinical blood pressure. The cardioprotective effect of the drug is expressed in the form of regression of left ventricular hypertrophy. In general, the use of the three-component fixed drug «Exforge-H» (valsartan - 80 mg, amlodipine - 5 mg and hydrochlorothiazide - 12,5 mg) is manifested by an increased antihypertensive effect due to the influence of its constituents side effects and the development of metabolic changes.

scholarly journals Blood pressure profile, structural and functional cardiac parameters, renal function and metabolic status in hypertensive patients with chronic secondary pyelonephritis

2010 ◽  
Vol 16 (3) ◽  
pp. 256-260 ◽  
Author(s):  
M. E. Statsenko ◽  
M. V. Derevjanchenko
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Close Relation ◽  
Pressure Profile ◽  
Upper Urinary Tract ◽  
Chronic Pyelonephritis ◽  
Metabolic Status ◽  
Hypertensive Patients

Objective. To study the blood pressure variability, morphofunctional parameters of the heart, kidney and metabolic status in hypertensive patients with secondary chronic pyelonephritis. Design and methods. The study included 110 patients: 55 patients with arterial hypertension and secondary chronic pyelonephritis, who underwent surgery for upper urinary tract, and 55 patients with essential arterial hypertension. All patients underwent 24-hour blood pressure monitoring, echocardiography; relative urine density in the morning urine portion, microalbuminuria, blood creatinine were assessed, glomerular fi ltration rate was calculated using MDRD formula. Results. Patients with arterial hypertension and chronic pyelonephritis have signifi cant changes of the blood pressure profi le, and hypertrophy and diastolic left ventricle dysfunction are more frequently observed in this group. A close relation between renal function and the state of the cardiovascular system is established. We also found higher numbers of total cholesterol, the most atherogenic fractions of cholesterol and triglycerides in this group compared to patients with essential hypertension.

Increased cardiac contractility in acute uremia: interrelationships with hypertension

1975 ◽  
Vol 229 (2) ◽  
pp. 501-505 ◽  
Author(s):  
T Nivatpumin ◽  
T Yipintsoi ◽  
S Penpargkul ◽  
J Scheuer
Keyword(s):  
Blood Pressure ◽  
Systolic Hypertension ◽  
Diastolic Pressure ◽  
Cardiac Contractility ◽  
Systolic Pressure ◽  
Pressure Rise ◽  
Left Ventricular ◽  
Ventricular Systolic Pressure ◽  
Inotropic State ◽  
Left Ventricular Systolic Pressure

To study the effects of acute uremia on the inotropic state of the rat heart, we subjected rats to bilateral nephrectomy and studied their hearts in the open chest 24 h later. Uremic rats had significantly higher systolic blood pressure than sham-operated animals. Left ventricular systolic pressure and maximum dP/dt, both during ejection and isovolumic contrations, were higher for any given end-diastolic pressure in hearts of uremic rats than in sham-operated animals. This difference in performance charcteristics was not abolished by doses of propranolol that blocked the heart rate response to isoproterenol. The administration of phenoxybenzamine during the 24 h of uremia abolished the blood pressure rise in uremic rats, but the increased contractile state persisted. Treatment of sham-operated animals with methoxamine to produce the same course of blood pressure as observed in uremic rats was also associated with an increased inotropic state. These results indicate that in the rat, acute uremia is associated with an increased inotropic state that is not mediated by beta-adrenergic mechanisms. The systolic hypertension of acute uremia is not the major cause of the increased contractility, although systolic hypertension without uremia can mimic the performance characteristics found in hearts of uremic rats.

scholarly journals Prevalence of Arterial Hypertension and Characteristics of Nocturnal Blood Pressure Profile of Asthma Patients According to Therapy and Severity of the Disease: The BADA Study

2020 ◽  
Vol 17 (18) ◽  
pp. 6925
Author(s):  
Domenico Di Raimondo ◽  
Gaia Musiari ◽  
Alida Benfante ◽  
Salvatore Battaglia ◽  
Giuliana Rizzo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Pressure Profile ◽  
Control Group ◽  
Cardiovascular Comorbidities ◽  
Cardiovascular Damage ◽  
Increased Risk ◽  
Asthma Patients ◽  
Severity Of The Disease

Background: several studies report an increased risk for asthmatic subjects to develop arterial hypertension and the relationship between these two diseases, frequently co-existing, still has some unclear aspects. Methods: The BADA (blood pressure levels, clinical features and markers of subclinical cardiovascular damage of asthma patients) study is aimed to evaluate the prevalence of the cardiovascular comorbidities of asthma and their impact on the clinical outcome. The main exclusion criteria were the presence of other respiratory diseases, current smoking, any contraindication to ambulatory blood pressure monitoring (ABPM). Results: The overall percentage of asthmatics having also hypertension was 75% (30 patients) vs. 45% (18 patients) of the control group (p: 0.012). Reduced level of FEV1 (but not inhaled steroid therapy) was associated to newly-diagnosed hypertension (p: 0.0002), higher day SBP levels (p: 0.003), higher day DBP levels (p: 0.03), higher 24 h-SBP levels (p: 0.005) and higher 24h-DBP levels (p: 0.03). The regression analysis performed taking into account sex, age, diabetes, fasting glucose, and body mass index confirms the independent role played by asthma: odds ratio (OR): 3.66 (CI: 1.29–11.1). Conclusions: hypertension is highly prevalent in asthma; the use of ABPM has allowed the detection of a considerable number of unrecognized hypertensives.

scholarly journals Diagnostics and treatment of arterial hypertension in children and adolescents, overview of new clinical guidelines of the American Academy of Pediatrics

2019 ◽  
Vol 64 (4) ◽  
pp. 114-127 ◽  
Author(s):  
L. I. Agapitov ◽  
I. V. Cherepnina
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Children And Adolescents ◽  
Clinical Guidelines ◽  
Blood Pressure Monitoring ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
New Guidelines ◽  
Hypertension In Children

The article analyzes clinical guidelines oftheAmericanAcademy ofPediatrics dd 2017 “ClinicalPractice Guideline forScreening andManagement of High Blood Pressure in Children and Adolescents”. This document contains new values of blood pressure in children, replaces the term “prehypertension” with the term “elevated blood pressure”, provides a simplified classification of arterial hypertension in adolescents over 13 years and revisesthe guidelinesfor daily blood pressure monitoring and echocardiography. The documentspecifiesthe criteria for diagnosing increased body weight of the left ventricular myocardium, changesthe target blood pressure levels. This new guidelines helps to optimize the diagnostics and treatment of hypertension in children. At the same time there is need for further comprehensive analysis of clinicalrecommendations and assessment of their practicalsignificance for pediatrics.

scholarly journals The problem of concomitant diseases with a focus on the cardiovascular system condition in patients with arterial hypertension and acid-related diseases

2013 ◽  
Vol 94 (1) ◽  
pp. 80-85 ◽  
Author(s):  
O V Khlynova ◽  
A V Tuev ◽  
L N Beresneva ◽  
A V Agafonov
Keyword(s):  
Blood Pressure ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Arterial Hypertension ◽  
Reflux Disease ◽  
Medical Science ◽  
Clinical Manifestations ◽  
Pressure Profile ◽  
Arterial Blood ◽  
Blood Pressure Profile

At present, the problem of concomitant diseases still remains very important for medical science as well as for medical practice. Arterial hypertension is one of the most actual global healthcare problems, holding the leading place among cardiovascular diseases. Acid-related diseases, including gastroesophageal reflux disease and duodenal ulcer are also widely-spread with the tendency of prevalence growth, and are having the leading place among gastrointestinal diseases. The combination of arterial hypertension and acid-related diseases is a new state of an organism regulation. Their synchronism is not accidental, as both diseases share links of the general etiology and pathogenesis. The daily arterial pressure profile and heart rhythm variability has a number of distinctive features when the diseases collide. The presence and progression of esophageal and duodenal mucous membranes inflammation in these patients promotes the certain arterial blood pressure profile formation. The data concerning the prevalence, common etiology and pathogenesis, features of hemodynamics and clinical manifestations in patients with arterial hypertension associated with peptic ulcer disease and gastroesophageal reflux disease are reviewed. Data of autonomic regulation features, 24-hour blood pressure profile and central hemodynamics condition in patients the combination with the mentioned diseases are also covered.

Severe preeclampsia is associated with postpartum diastolic dysfunction and non-dipping blood pressure profile pattern

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Abdel Ghany ◽  
M Rashed ◽  
A Abbas ◽  
A.M.R Youssef ◽  
M Sayed
Keyword(s):  
Blood Pressure ◽  
Diastolic Dysfunction ◽  
Blood Pressure Monitoring ◽  
Previous History ◽  
Pressure Profile ◽  
Left Ventricular ◽  
Severe Preeclampsia ◽  
University Hospital ◽  
Funding Source ◽  
History Of

Abstract Background Left ventricular diastolic dysfunction and non-dipping profile, detected by ambulatory blood pressure monitoring (ABPM), are two features recorded to be associated with sustained hypertension. Both are predictors of an increased cardiovascular morbidity later in life. Complete normalization of blood pressure (BP) in preeclampsia is detected over a variable period of time. Methods A prospective cohort study was conducted in a tertiary university hospital including normotensive women with a history of preeclampsia in the current pregnancy enrolled within the first week postpartum. All cases were subjected to 24 h-ABPM and 2D trans-thoracic echocardiography three months post postpartum concomitantly with a clinical evaluation. Chi2-test was used to compare the qualitative data while student t-test was used to compare the quantitative data. Multivariate regression analysis was used for prediction of non-dippers and diastolic dysfunction in our cohort. Results Hundred twenty eight women were included in the study. Their mean age was 28.6±5.1 years and the mean basal BP was 123.1±6.4/74.6±5.9 mm Hg. Out of the studied women, 90 (70.3%) women were dippers and 38 (29.7%) women were non-dippers. It was noticed that diastolic dysfunction was presented in 28 (73.7%) of non-dippers while none of dippers had diastolic dysfunction. Women with severe preeclampsia had higher frequency of non-dipper (35.5% vs. 24.2%; P=0.02) and diastolic dysfunction (29% vs. 15%; P=0.01) in comparison to those women with mild preeclampsia. Severe preeclampsia and previous history of preeclampsia were significant predictors for non-dipping status (OR=1.1, 95% CI: 0.05–10.56 and 1.4, 95% CI: 0.30–4.26 respectively, R2 = 0.7; P<0.001). They were also predictors for diastolic dysfunction in our studied population (OR = 1.6, 95% CI: 1.1–2.2 and 1.3, 95% CI: 1.2–2.2 respectively, R2 = 0.6; P<0.05). Conclusion Women with a history of preeclampsia have the risk for developing cardiovascular events later in life. The severity and recurrence of preeclampsia were significant predictors for both non-dipping profile and diastolic dysfunction. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Orman Heart Hospital-Assiut University; Women Health Hospital-Assiut University

scholarly journals Significance/role of family medicine physicians in early detection of secondary hypertension

2021 ◽  
Vol 26 (83) ◽  
pp. 71-82
Author(s):  
Marijana Jandrić-Kočič ◽  
Snežana Knežević
Keyword(s):  
Blood Pressure ◽  
Early Detection ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Left Kidney ◽  
Secondary Hypertension ◽  
Left Ventricular ◽  
Levothyroxine Sodium ◽  
Thyroid Peroxidase ◽  
Dietary Regimen

SUMMARY - Introduction: Secondary arterial hypertension has an identifiable underlying cause. Routine screening is not indicated given the low prevalence of the disease (5-10% arterial hypertension), longterm and costly diagnostic evaluation. Case report: An outpatient family medication presents a 34-year-old patient due to worsening, by then stable, arterial hypertension. She was found 12 months ago when reported to a private healthcare facility where she was allowed perindopril / amlodipine 4/5 mg, 1x1 tablet. So far healthy, it negates diseases of relevance to inheritance. Smoker. 24hour outpatient blood pressure monitoring checks for elevated diastolic blood pressure levels in 59,3% of measurements during the day and 59,2% of measurements during the night. Thyroid ultrasound checks for inhomogeneous structure, right flap 40x15x16 mm, left flap 42x15x16 mm. Abdominal ultrasound reduces left kidney, bilateral thinning cortex, left ventricular moderate hydronephrosis. The laboratory contains large amounts of tyrosimulating hormone as well as antibodies to thyroid peroxidase, decreased levels of free thyroxine and a slight increase in albumin in 24 hours of urine. The patient is referred for a consultative examination by a nephrologist and a nuclear medicine specialist. Same indicative hygiene dietary regimen and introduction of levothyroxine sodium tablets 100 mcg 1x 1 ¼ tablets (125 mcg). Antihypertensive therapy was discontinued at most months later, while levothyroxine sodium replacement therapy was reduced to 1 x 100 mcg. Conclusion: The work of a selected family physician in accordance with good clinical practice guidelines allows for the early detection, normalization or increase in the number of secondary hypertension, the reduction of the possibility of accommodation of irreversible changes in blood vessels, and coexisting essential hypertension.

Abstract 284: A Pilot Study Comparing Two Ambulatory Blood Pressure Monitors Worn at the Same Time

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Radhakrishna R Kallem ◽  
Kevin Meyers ◽  
Deirdre Sawinski ◽  
Raymond R Townsend
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Diastolic Pressure ◽  
Blood Pressure Monitoring ◽  
Demographic Data ◽  
Systolic Pressure ◽  
University Of Pennsylvania ◽  
Public Health Importance ◽  
Blood Pressures ◽  
The University

Introduction Ambulatory blood pressure monitoring (ABPM) has been proposed as the most effective way to characterize a person’s BP profile. However, there are very limited data in the literature comparing two simultaneously worn ABPM devices. Therefore, we compared an eight hour daytime simultaneous ABPM using two monitors (Mobil-O-Graph [I.E.M., Stolberg, Germany] and Spacelabs 90207 [Spacelabs Medical, Issequah, WA]). Methods Simultaneous BP and heart rate data were measured on 13 adult volunteers at the University of Pennsylvania using the two monitors over an 8 hour period. Other demographic data were also collected. Standard seated BPs were obtained in triplicate at the beginning and end of the 8 hour monitoring period using an Accutor (Datascope, Mahwah, NJ) device. Three blood pressures were obtained at 1 minute intervals, recorded and averaged for each arm using the Accutor device. Results The data show high concordance of measured mean arterial pressures (Mobil-O-Graph 101.4 [SEM-2.0] mmHg, Spacelabs 100.6 [SEM-2.4] mmHg) and heart rates (Mobil-O-Graph measuring 82.4 [ SEM- 4.1] beats/minute, Spacelabs 81.7 [4.0] beats/minute) between the monitors. Spacelabs measured a 10 mmHg higher systolic pressure (p=0.0016) and a non-statistically significant, but numerically higher (2.8 mmHg) diastolic pressure (Figure 1). Conclusion The systolic BP difference between the two devices has public health importance. These differences if confirmed in larger cohorts, ABPM manufacturers should consider developing a normative database to help practitioners interpret ABPM data obtained with their device.

INDIRECT ESTIMATION OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURE IN THE NEWBORN

PEDIATRICS ◽  
1972 ◽  
Vol 50 (3) ◽  
pp. 387-394
Author(s):  
Colin H. M. Walker ◽  
Phillip J. West ◽  
Sanford L. Simons ◽  
Anthony R. Whytock
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Blood Pressure Monitoring ◽  
Systolic Pressure ◽  
Correlation Coefficients ◽  
Mean Value ◽  
Arithmetic Mean ◽  
Pressure Monitoring ◽  
Blood Pressures ◽  
The Mean

An impedance plethysmographic method for measuring systolic and diastolic blood pressures in small infants using standard electro-cardiogram recorders has been studied. The overall 95% confidence limit of the mean of five estimations was found to be ±3.74 mm Hg for the systolic and ±3.72 mm Hg for the diastolic value. Comparing this method with intra-arterial measurements gave correlation coefficients (r) of 0.95 (bias 10.09 mm Hg) for systolic pressure and 0.89 (Bias 10.09 mm Hg) for diastolic pressure. Values for the comparison with auscultation were 0.98 (bias 19.29 mm Hg) systolic and 0.86 (bias 10.17 mm Hg) diastolic, and for the comparison of the arithmetic mean value with the flush method 0.84 (bias 30.17 mm Hg). These results reveal a good correlation with the intra-arterial measurements and indicate that this technique can be used for the periodic or continuous blood pressure monitoring of infants.

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