scholarly journals Combined pharmacotherapy for arterial hypertension in patients with type 2 diabetes mellitus

2004 ◽  
Vol 10 (2) ◽  
pp. 118-121
Author(s):  
A. S. Ametov ◽  
T. Yu. Demidova ◽  
L. V. Smagina
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Night Time ◽  
Two Phase ◽  
Corrective Effect ◽  
Negative Effect ◽  
Term Basis ◽  
Dose Combination

The antihypertensive effects and tolerance of a fixed low-dose combination of the angiotensin-converting enzyme (ACE) inhibitor perindopril, 2 mg, and the diuretic indapamide, 0.025 mg (noliprel), were studied in patients with mild and moderate arterial hypertension associated with diabetes mellitus. The patients' mean age was 51.36 ± 6.11 years, Hblc was 7.86 ± 1.73 %. The antihypertensive effects were evaluated from the results of daily blood pressure monitoring following 16 weeks of therapy. It was found that noliprel exerted a multidirectional corrective effect on the daily blood pressure (BP): it provided a significant optimal BP lowering during a clay on a long-term basis; significantly normalized the pressure load index in day- and night-time; significantly diminished the baseline increased systolic and diastolic BP variabilities during a day. normalized the impaired two-phase BD profile. The efficiency of treatment was 100 %, as evidenced by clinical BP and diurnal BP profile; the achievement of targeted BP was 88 % by the end of therapy. During therapy with the agent, stable glycemia control preserved and there was no negative effect on the lipid spectrum, which permits the use of the drug in patients with arterial hypertension concurrent with metabolic disorders.

scholarly journals Dynamics of blood pressure indicators in patients with diabetes mellitus after planned percutaneous coronary intervention

2021 ◽  
Vol 17 (1) ◽  
pp. 12-20
Author(s):  
A. M. Kochergina ◽  
O. L. Barbarash
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Effective Control ◽  
Pressure Monitoring ◽  
Night Time ◽  
Percutaneous Coronary ◽  
History Of ◽  
Pressure Indicators

Arterial hypertension (AH) is a common modifiable cardiovascular risk factor. Despite the wide choice of antihypertensive drugs, according to epidemiological studies, just over 20% of patients demonstrate effective control of hypertension. Failure to achieve the target values of blood pressure (BP) determines a high probability of developing cardiovascular events, which is also true for patients undergoing percutaneous coronary interventions (PCI). However, there is evidence that individuals who have undergone PCI show a higher percentage of achieving the target blood pressure levels. Aim of the study was to evaluate the dynamics of blood pressure indicators in patients with stable coronary artery disease (CAD) and diabetes mellitus, depending on the fact of performing PCI.Material and methods. The study was conducted at federal state budgetary scientific institution research institute of complex issues of cardiovascular diseases as a prospective, open, not comparative. The study included 75 patients with stable CAD and type 2 diabetes who regularly received therapy for at least 1 month prior to the start of participation in this study. The majority of patients 45 (60%) are represented by males. The median age was 52.64±6.96 years. 44 patients (58.81%) had a history of myocardial infarction, and 46 patients (61.33%) had previously undergone myocardial revascularization, history of stroke had 5 patients (6.66%). All patients according to the daily blood pressure monitoring at the 1st visit had average daily blood pressure values above 130/80 mmHg. Participants were divided into 2 groups: 43 patients had indications for routine PCI at the time of inclusion in the study, 32 patients had no indications for revascularization. The groups did not have significant differences in clinical and anamnestic characteristics, and regular significant differences were noted in relation to previously undergone revascularization (46.51 and 81.25%, respectively, p=0.0022) and the SYNTAX Score (14.39±9.20 and 6.13±8.28, respectively, p=0.0001). During 4 visits (1 visit, 1 month, 3 months, 6 months), ambulatory blood pressure monitoring (ABPM) was performed using the BiPiLAB system.Results. Initially according ABPM parameters group without the alleged PCI had greater variability in systolic blood pressure (SBP) in the daytime, higher values of mean diastolic blood pressure (DBP) at night, more time index of hypertension DBP at night. After 1 month of follow — up (for the group with PCI 1 month after the procedure), there were significant differences in the average daily SBP and DBP, the index of the time of hypertension DBP in the daytime, and the average daily SBP. Patients who underwent revascularization had lower ABPM values. The previously described differences in the night time DBP and the index of hypertension time at night were preserved. After 3 months of follow-up, significant differences were observed only in the indicators of night time SAD and DBP. At the end of the study (6 months of follow-up), the groups had differences only in the indicators of mean diastolic pressure at night.Conclusion. Patients who underwent PCI for 1 month after the procedure have a significant tendency to normalize (compared to the group without revascularization) blood pressure indicators. However, over time, the effect «escapes». Most likely, the short-term improvement in blood pressure is due to a temporary improvement in treatment adherence after an invasive procedure.

scholarly journals Biochemical and Chemical Lipid Profile and Blood Pressure Assessment in Arterial Hypertension with Chronic Kidney Disease

2020 ◽  
Vol 71 (7) ◽  
pp. 425-435
Author(s):  
Teim Baaj ◽  
Ahmed Abu-Awwad ◽  
Mircea Botoca ◽  
Octavian Marius Cretu ◽  
Elena Ardeleanu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Lipid Profile ◽  
Blood Pressure Monitoring ◽  
Hdl Cholesterol ◽  
Night Time ◽  
Hypertensive Patients ◽  
Lipid Disorders

Accelerated atherosclerosis and cardiovascular diseases are frequent complications in hypertensive patients with chronic kidney disease (CKD), being mainly driven by cardiovascular risk factors as lipid disorders and an unfavorable blood pressure profile. The objectives of the study were to evaluate the lipid profile and to assess the characteristics of blood pressure (BP) in patients with primary arterial hypertension associating chronic kidney disease (CKD) in a primary care population in Timis County, Romania. Lipid disorders were highly prevalent in hypertensive patients with CKD, consisting in hyper LDL-cholesterolemia in 50.3%, hypertriglyceridemia in 52%, low HDL-cholesterol levels in 35.8%. More than 2 lipid abnormalities were present in 68.8% of CKD hypertensive. CKD hypertensive patients, compared with those without CKD, presented a BP profile with higher systolic and diastolic office BP. On ambulatory blood pressure monitoring they also registred higher systolic and diastolic BP, the systolic BP (SBP), both for 24 h SBP, day-time and night-time SBP being statistically significant higher than in hypertensive patients without CKD. The circadian 24 h BP profile demonstrated in the CKD hypertensive population an unfavourable nocturnal profile in 67%, consisting of a high prevalence of the non-dipping profile and of nocturnal riser pattern.

scholarly journals Daily blood pressure variations in patients with type 1 diabetes mellitus and nephropathy

2003 ◽  
Vol 49 (5) ◽  
pp. 5-10
Author(s):  
I. A. Bondar ◽  
V. V. Klimontov ◽  
Ye. A. Korolyova ◽  
L. I. Zheltova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Arterial Hypertension ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Blood Pressure Monitoring ◽  
Inpatient Setting ◽  
Systemic Hemodynamic

То study a relationship between systemic hemodynamic parameters, albuminuria, and autonomic dysfunction in patients with type 1 diabetes mellitus (DM-1) without obvious nephropathy, the authors examined 55 patients in the inpatient setting. Twenty-nine patients had a normal urinary albumin excretion (CAE), 26 patients had microalbuminuria. 24-hour blood pressure monitoring (24-h BPM) was occillometrically made. The average daily, average diurnal and nocturnal values of systolic and diastolic blood pressure (BP) were significantly higher in DM-1 patients with microalbuniuria than in those with normal UAE. Routine autonomic cardiovascular tests showed that the incidence and severity of autonomic neuropathy were also higher in patients with microalbuminuria. Arterial hypertension (AH) diagnosed in compliance with the 24-h BPM criteria was detected. in 17.2%) of the DM-1 patients with normal UAE and in 42.3%) of the patients with microalbuminuria. According to the data of 24-h BPM, the incidence of arterial hypertension was 1.7 times as high as that evidenced by single BP measurements. The specific feature of circadian hemodynamic variations in patients with DM-1 was a low nocturnal BP decrease. 37.9%) of the patients with normoalbuminuria and 61.5%) of the patients with microalbuminuria had no normal (>10%)) nocturnal BP lowering. Stepwise regression analysis has ascertained that in patients with DM-1 without obvious nephropathy, systemic hemodynamic disorders are associated with albuminuria, autonomic dysfunction, and glycemic monitoring quality.

scholarly journals An approach to antihypertensive therapy in sleep deprivation conditions

2012 ◽  
Vol 18 (3) ◽  
pp. 199-205
Author(s):  
A. Z. Tsfasman ◽  
D. V. Alpaev ◽  
V. D. Gorokhov
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Sleep Deprivation ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Night Shift ◽  
Pressure Profile ◽  
Diurnal Rhythms ◽  
Corrective Effect ◽  
Design And Methods

Objective. To assess the effects of several antihypertensive drugs on diurnal rhythms of blood pressure (BP) in sleep deprivation. Design and methods. The research included 58 patients with initial stages and levels of arterial hypertension (AH) divided into four groups (no medication, lisinopril, metoprolol, anaprilin before night with sleep deprivation). All patients underwent 24-hour blood pressure monitoring during the day with and without sleep deprivation. Results. Sleep deprivation was found to cause either inversion of daily blood pressure profile (DBPP) with higher night BP values, or at least reduction of night BP dipping. Among all mentioned medications only Anaprilin had some corrective effect on DBPP in sleep deprivation, and it can be recommended for night workers with arterial hypertension immediately before a night shift.

scholarly journals VARIABILITY OF ARTERIAL BLOOD PRESSURE IN CHILDREN WITH DIABETES MELLITUS AND OBESITY

2019 ◽  
Vol 7 ◽  
pp. 778-782
Author(s):  
Yuriy Nechitaylo ◽  
Oleksandr Buriak ◽  
Olesya Pidmurniak ◽  
Nataliya Kovtyuk ◽  
Tatiana Fomina
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Diabetic Patients ◽  
Pressure Monitoring ◽  
Diabetes And Obesity ◽  
Healthy Persons

INTRODUCTION: The activity of the cardiovascular system has a clear to the circadian rhythms of a child's body. Daily fluctuations in blood pressure in normal conditions and in pathology is a physiological phenomenon which can play a significant role in developing arterial hypertension and even in the occurrence of fatal cardiovascular states such as heart attacks, strokes, and sudden cardiac arrest activities. Ambulatory blood pressure monitoring is recognized as a necessary instrumental investigation for diagnosis and management of patients with arterial hypertension and especially in children from high risk groups such as diabetics and obesity it may be even more important for hypertension diagnostics than in adults. AIM: The objective of the study was to analyze the features of circadian oscillations of blood pressure and heart rate variability in children with diabetes mellitus and hypothalamic syndrome with obesity. METHODS: Research included 76 children aged 10 to 18 years: 52 children with endocrine pathology (diabetes and obesity) and 24 clinically healthy persons. The peculiarities of nutrition, sleep, and the definition of the chronotype using the Horn-Ostberg questionnaire were carried out. The functional state of the cardiovascular systems was determined by single office measurement and by ambulatory blood pressure monitoring. FINDINGS AND RESULTS: Ambulatory blood pressure monitoring revealed a number of differences between the groups of children. In diabetic patients, daytime systolic blood pressure was higher with increased variability, while the night blood pressure was significantly lower and with significantly less variability, compared to other groups. Attention is drawn to the higher level of diastolic blood pressure and lower variability at night in obese children. CONCLUSIONS: Daily fluctuations of arterial pressure in children with diabetes and obesity differ from healthy persons depending on the type of disease and could be regarded as result of circadian biorhythms disruption. In obese persons it appears in the form of nocturnal SBP and DBP elevation but with index of variability compared to the control group. In diabetic children the circadian BP rhythms deviations appear in form of SBP elevation during the day with higher index of its variability. Their BP changes were associated with the presence of diabetic nephropathy and proteinuria.

Ambulatory blood pressure monitoring-based definition of true arterial hypertension

2020 ◽  
Vol 111 (6) ◽  
Author(s):  
Ramón C. Hermida ◽  
Artemio Mojón ◽  
José R. Fernández ◽  
Alfonso Otero ◽  
Juan J. Crespo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Definition Of

scholarly journals High prevalence of non-dipping patterns among Black Africans with uncontrolled hypertension: a secondary analysis of the CREOLE trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Prossie Merab Ingabire ◽  
◽  
Dike B. Ojji ◽  
Brian Rayner ◽  
Elijah Ogola ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Secondary Analysis ◽  
Uncontrolled Hypertension ◽  
African Countries ◽  
Night Time ◽  
Black Africans ◽  
Long Term Outcome ◽  
Black African ◽  
High Prevalence

Abstract Background Dipping of blood pressure (BP) at night is a normal physiological phenomenon. However, a non-dipping pattern is associated with hypertension mediated organ damage, secondary forms of hypertension and poorer long-term outcome. Identifying a non-dipping pattern may be useful in assessing risk, aiding the decision to investigate for secondary causes, initiating treatment, assisting decisions on choice and timing of antihypertensive therapy, and intensifying salt restriction. Objectives To estimate the prevalence and factors associated with non-dipping pattern and determine the effect of 6 months of three antihypertensive regimens on the dipping pattern among Black African hypertensive patients. Methods This was a secondary analysis of the CREOLE Study which was a randomized, single blind, three-group trial conducted in 10 sites in 6 Sub-Saharan African countries. The participants were 721 Black African patients, aged between 30 and 79 years, with uncontrolled hypertension and a baseline 24-h ambulatory blood pressure monitoring (ABPM). Dipping was calculated from the average day and average night systolic blood pressure measures. Results The prevalence of non-dipping pattern was 78% (564 of 721). Factors that were independently associated with non-dipping were: serum sodium > 140 mmol/l (OR = 1.72, 95% CI 1.17–2.51, p-value 0.005), a higher office systolic BP (OR = 1.03, 95% CI 1.01–1.05, p-value 0.003) and a lower office diastolic BP (OR = 0.97, 95% CI 0.95–0.99, p-value 0.03). Treatment allocation did not change dipping status at 6 months (McNemar’s Chi2 0.71, p-value 0.40). Conclusion There was a high prevalence of non-dipping among Black Africans with uncontrolled hypertension. ABPM should be considered more routinely in Black Africans with uncontrolled hypertension, if resources permit, to help personalise therapy. Further research is needed to understand the mechanisms and causes of non-dipping pattern and if targeting night-time BP improves clinical outcomes. Trial registration ClinicalTrials.gov (NCT02742467).

ABPM Comparison of the Anti-Hypertensive Profiles of Telmisartan and Enalapril in Patients with Mild-to-Moderate Essential Hypertension

2002 ◽  
Vol 30 (6) ◽  
pp. 543-552 ◽  
Author(s):  
J Amerena ◽  
S Pappas ◽  
J-P Ouellet ◽  
L Williams ◽  
D O'Shaughnessy
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Monitoring ◽  
Study Drug ◽  
Pressure Control ◽  
Moderate Essential Hypertension ◽  
Open Label ◽  
Night Time ◽  
Once Daily

In this multicentre, prospective, randomized, open-label, blinded-endpoint (PROBE) study, the efficacy of 12 weeks' treatment with once-daily telmisartan 40–80 mg and enalapril 10–20 mg was evaluated using ambulatory blood pressure monitoring (ABPM) in 522 patients with mild-to-moderate essential hypertension. Patients were titrated to the higher dose of study drug at week 6 if mean seated diastolic blood pressure (DBP) was ≥ 90 mmHg. The primary endpoint was the change from baseline in ambulatory DBP in the last 6 h of the 24-h dosing interval after 12 weeks' treatment. Telmisartan and enalapril produced similar reductions from baseline in DBP and systolic blood pressure (SBP) over all ABPM periods evaluated (last 6 h, 24-h, daytime and night-time). Telmisartan produced a significantly greater reduction in mean seated trough DBP, measured unblinded with an automated ABPM device in the clinic, amounting to a difference of −2.02 mmHg ( P < 0.01). A significantly greater proportion of patients achieved a seated diastolic response with telmisartan than enalapril (59% versus 50%; P < 0.05), also measured with the same ABPM device. Both treatments were well tolerated. Compared with telmisartan, enalapril was associated with a higher incidence of cough (8.9% versus 0.8%) and hypotension (3.9% versus 1.1%). Therefore, telmisartan may provide better long-term compliance and, consequently, better blood pressure control than enalapril.

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