Factors associated with levels of interleukins -18, -8, and -6 in hypertensive patients at high and very high cardiovascular risk

Kardiologiia ◽  
2017 ◽  
Vol 17 (S3) ◽  
pp. 69-75 ◽  
Author(s):  
G. P. Arutyunov ◽  
◽  
D. O. Dragunov ◽  
A. V. Sokolova ◽  
V. M. Mitrokhin ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
Very High

scholarly journals Antihypertensive Efficacy of Fixed Combination of Amlodipine and Ramipril in Patients with Arterial Hypertension and Very High Cardiovascular Risk

2019 ◽  
Vol 14 (6) ◽  
pp. 840-845
Author(s):  
O. Yu. Korennova ◽  
S. P. Podolnaya ◽  
E. P. Prihodko ◽  
E. A. Turusheva ◽  
S. N. Starinskaya ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Antihypertensive Efficacy ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Coronary Artery Stenting ◽  
History Of ◽  
Very High

Aim. To evaluate the antihypertensive efficacy and tolerability of a fixed combination of amlodipine and ramipril in hypertensive patients with very high cardiovascular risk. Material and methods. A retrospective cohort study of real clinical practice of prescribing antihypertensive drugs according to 255 medical records of outpatient hypertensive patients with a history of acute coronary syndrome (ACS) and coronary artery stenting was performed in the first part. An open observational study was performed in the second part. 69 people older than 18 years with a history of ACS and coronary artery stenting, without reaching the target blood pressure (BP) level while using free combinations of antihypertensive drugs and with indications for a fixed combination of ramipril and amlodipine were included into the study. Analysis of self-monitoring of BP, office BP, daily BP monitoring (ABPM) and patients’ adherence to treatment (Morisky-Green test) initially, after 4 and after 12 weeks of taking the fixed combination of ramipril and amlodipine was performed to assess the clinical efficacy of the studied drug. Results. It was found that 42.0% of patients did not follow the recommendations for regular intake of antihypertensive drugs. So, hypertension of all patients regarded as false-refractory, which was the basis for the prescription of the fixed combination of ramipril and amlodipine in accordance with clinical guidelines for the diagnosis and treatment of hypertension. After 4 weeks of therapy, there was significant decrease in office BP with the achievement and preservation of the target level by the 12th week, normalization to the 12th week of day and night BP variability in 54.9% of patients. 78.0% of patients followed medical recommendations for regular administration of antihypertensive drugs, none of the patients had adverse events. Conclusion. The use of fixed combinations of drugs, in particular, amlodipine and ramipril as a part of multicomponent therapy in hypertensive patients with very high cardiovascular risk, led to the achievement of target BP by the 4th week of therapy and stable preservation of antihypertensive effect in 12 weeks of treatment as well as gradual normalization of day and night BP variability in more than half of patients. Fixed combination of ramipril and amlodipine allowed to improve adherence of patients to cardiovascular diseases.

scholarly journals Drug Correction of Vascular Remodeling in Patients with Hypertension: Results of 52-Week Prospective Study ARTERIA-AG

2020 ◽  
Vol 16 (2) ◽  
pp. 213-220
Author(s):  
O. V. Fedorishina ◽  
K. V. Protasov ◽  
A. M. Torunova
Keyword(s):  
Cardiovascular Risk ◽  
Vascular Remodeling ◽  
Fixed Combination ◽  
Augmentation Index ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density Lipoprotein Cholesterol ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Very High

Aim. To study the long-term dynamics of vascular remodeling in patients with hypertension and high and very high cardiovascular risk when statin is added to antihypertensive therapy with a fixed combination of calcium antagonist and angiotensin converting enzyme (ACE) inhibitor.Material and methods. Hypertensive patients (n=75) with high and very high cardiovascular risk (age 51.5 [44;58] years) were included in the study. Patients were randomized into two groups. The first group (n=36) received a fixed combination of amlodipine and lisinopril in starting dose of 5/10 mg/day. The second group (n=39) received the same antihypertensive therapy and additionally rosuvastatin (20 mg/day). The follow-up period was 52 weeks. The effect of therapy on the following parameters was evaluated: level of office and average daily blood pressure (BP), central BP in the aorta, augmentation index (AIx), pulse wave velocity (PWV), endothelium-dependent brachial artery vasodilation, carotid intima-media complex thickness, carotid arteries plaque height, and blood lipid profile indicators.Results. A significant decrease in office and average daily BP was found in both groups: from 171.5 (152;194)/104.5 (97;112) to 140.0 (129;154)/87.0 (83;95) mm Hg and from 142.1 (135;153)/86.7 (83;97) to 124.6 (119;133)/76.5 (73;80) mm Hg, respectively, in the 1st group; from 169.5 (160;190)/103.5 (95;109) to 135.0 (125;141)/83.0 (77;88) mm Hg and from 139.9 (136;152)/86.2 (80;92) to 125.1 (118;134)/74.0 (70;81) mm Hg, respectively, in the 2nd group (p<0.001 for all changes). The frequency of reaching the target office BP level was higher in the 2nd group (p=0.031). Significant decrease in total cholesterol by 33.1% and low-density lipoprotein cholesterol by 50.0% was observed in the group 2. Central BP in the aorta decreased in both groups; the degree of central BP reduction did not differ significantly. AIx decreased from 36.5 (24;41)% to 25.0 (15;36)% (p=0.04) in the 1st group and from 36.0 (30;41)% to 24.0 (20;32)% in the 2nd group (p<0.0001) with a more pronounced decrease in AIx after 24 weeks of therapy (-4.8% and -9.4%, respectively, p=0.036). This trend continued at the end of the observation (-6.4% and -10.8%, respectively, p=0.08). Carotid-femoral and carotid-radial PWV decreased only in the 2nd group from 9.5 (8.2;10.7) to 8.3 (7.6;8.9) m/s (p=0.003) and from 9,6 (8.5;10.6) to 8.4 (7.9;9.3) m/s (p=0.01), respectively. A significant decrease in the thickness of the intima-media from 1.08 (1.0;1.2) to 1.02 (0.9;1.1) cm (p<0.0001) and the height of the plaque from 2.2 (2,2;1.7) to 2.1 (2.1;1.7) mm (p=0.001) was found in the 2nd group.Conclusion. Addition of rosuvastatin to the fixed combination of amlodipine and lisinopril in treatment of hypertensive patients with high and very high cardiovascular risk was accompanied by a more frequent (compared with amlodipine and lisinopril only) achievement of the target office BP level and more pronounced reduction in the following indicators: augmentation index, carotid-femoral and carotid-radial PWV, intima-media thickness, plaque height, total cholesterol and low density lipoprotein cholesterol blood levels.

scholarly journals The major arteries and skin microcirculatory vessels status and antihypertensive therapy effect on them in hypertensive patients with high and very high cardiovascular risk

2016 ◽  
Vol 13 (2) ◽  
pp. 11-16
Author(s):  
E V Mordvinova ◽  
E V Oshchepkova ◽  
A A Fedorovich ◽  
A R Zairova ◽  
O A Pogorelova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Antihypertensive Therapy ◽  
The State ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Local Stiffness ◽  
Very High ◽  
Large Vessels

Aim: to assess the state of the large blood vessels and skin microcirculatory vessels and the effects of angiotensin II receptor blockers (ARB) on them in hypertensive patients with high and very high cardiovascular risk (CVR). Subjects and methods. We examined 59 hypertensive patients aged 35-60 years, of which 29 high CVR subjects and 30 very high CVR (without antihypertensive therapy within 2 weeks prior to the study). In all subjects the evaluation of target organ damage, laser Doppler flowmetry (LDF) with initial perfusion parameters registration and amplitude-frequency spectrum of LDF-grams analysis, registration of central blood pressure, local stiffness parameters and photoplethysmography (PTMG) were performed. The second study was carried out after 2 weeks of antihypertensive treatment with ARB. Results. A significant increase in endothelial rhythm amplitude and coefficient of variation in very high risk hypertensive patients in comparison with a group of high-risk patients was found. In the group of very high-risk hypertensive patients central arterial pressure, augmentation index and local stiffness values were higher (n/a), the rate of carotid arteries extensibility was significantly reduced. There was a significant large vessels impairment in very high risk group according PTMG data. Target blood pressure level achieved in up to 80% of patients after 2 weeks treatment. During the re-examination a statistically significant improvement in the large arteries was found, LDF parameters also improved, but significant values was not reached. Conclusion. The findings suggest that with increasing degree of CVR in patients with hypertension there is a progressive deterioration of both large vessels and microcirculation state. After short-term antihypertensive therapy the function of large vessels improve in very high risk hypertensive patients, but the state of the microvasculature not changes significantly.

Risk Factors for Cardiovascular Disease in Patients Undergoing Peritoneal Dialysis

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 205-209 ◽  
Author(s):  
Elvia García–López ◽  
Juan J. Carrero ◽  
Mohamed E. Suliman ◽  
Bengt Lindholm ◽  
Peter Stenvinkel
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Pressure Control ◽  
High Cardiovascular Risk ◽  
Cardiovascular Research ◽  
Factors Associated ◽  
Glycation End Products ◽  
Anemia Management ◽  
Altered Lipid

Patients on peritoneal dialysis (PD) are at high cardiovascular risk. Although some risk factors are unmodifiable (for example, age, sex, genetics), others are exacerbated in the unfriendly uremic milieu (inflammation, oxidative stress, mineral disturbances) or contribute per se to kidney disease and cardiovascular progression (diabetes mellitus, hypertension). Moreover, several factors associated with PD therapy may both increase (by altered lipid profile, hyperinsulinemia, and formation of advanced glycation end-products) and decrease (by better blood pressure control and anemia management) cardiovascular risk. The present review discusses recent findings and therapy trends in cardiovascular research on the PD population, with emphasis on the roles of inflammation, insulin resistance, homocysteinemia, dyslipidemia, vascular calcification, and genetics/epigenetics.

scholarly journals Clinical profiles and quality of care of subjects with type 2 diabetes according to their cardiovascular risk: an observational, retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Basilio Pintaudi ◽  
Alessia Scatena ◽  
Gabriella Piscitelli ◽  
Vera Frison ◽  
Salvatore Corrao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Risk Factors ◽  
High Cardiovascular Risk ◽  
Very High

Abstract Background The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. Methods The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. Results Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased. Conclusions A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.

scholarly journals Large auto-hemoinfusion versus rectal insufflation in patients with metabolic syndrome

Ozone Therapy ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
Francesco Vaiano ◽  
Fortunato Loprete
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Clinical Situation ◽  
Gas Mixture ◽  
High Cardiovascular Risk ◽  
Factors Associated ◽  
The Metabolic Syndrome ◽  
Alternative Method

The metabolic syndrome is a clinical situation including a series of factors at high cardiovascular risk; the treatment with an oxygenozone gas mixture can influence all factors associated with this syndrome. The objective of the study has been to verify if the rectal insufflation could replace the large auto-hemoinfusion when treating the metabolic syndrome in those patients who, for various reasons cannot use the auto-hemoinfusion. Twenty-four individuals aged between 34 and 68 were recruited and included in the group treated with ozonated auto-hemoinfusion and other 24 individuals aged between 35 and 67 were recruited and included in the group treated with rectal insufflation of the oxygen-ozone gas mixture. According to the results obtained by means of oxygen-ozone mixture rectal insufflation, which are almost equivalent to the results obtained with the large ozonated auto-hemoinfusion, authors could conclude that the ozonated rectal insufflation can be taken into consideration as alternative method to the large auto-hemoinfusion, while treating the metabolic syndrome, in those patients difficult to manage due to the previously described reasons.

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