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 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.

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 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 Radiofrequency denervation of the renal arteries in patients with resistant arterial hypertension: 3 years of observation experience

2019 ◽  
Vol 16 (4) ◽  
pp. 65-69
Author(s):  
Nina Yu Savelyeva ◽  
Anna Yu Zherzhova ◽  
Ekaterina V Mikova ◽  
Liudmila I Gapon ◽  
Grigorii V Kolunin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Secondary Hypertension ◽  
Renal Arteries ◽  
Radiofrequency Denervation ◽  
Intact Kidney ◽  
Resistant Arterial Hypertension

Objective. To evaluate the efficiency of radiofrequency denervation of the renal arteries in patients with resi-stant arterial hypertension during a three-year follow-up. Materials and methods. The study involved 40 patients with resistant arterial hypertension aged 27 to 70 years (mean age 54.91±9.77 years) while receiving three or more antihypertensive drugs (including diuretic) in optimal doses. The conditions for inclusion in the study were considered resistant arterial hypertension with blood pressure (BP)>160/100 mm Hg, intact kidney function - glomerular filtration rate (MDRD)>45 ml/min - and the absence of secondary hypertension. All patients had sympatic radiofrequency denervation of renal arteries; its efficiency later was estimated according to the clinical measurement and ambulatory blood pressure monitoring (ABPM). Results. The level of office BP reliably differed initially and after 3 years: DSBP -34.48±6.44 mm Hg (p=0.001), DDBP - 22.29 mm Hg (p=0.001). According to ABPM results, reliable dynamics of systolic blood pressure was not observed. The data of DBP at night were significantly lower after 36 months; DDBP was -5.37±9.77 mm Hg. Conclusions. A marked decrease in the data of office SBP and DBP was observed, which proves the long-term efficiency of radiofrequency denervation of the renal arteries in patients with resistant hypertension. Accor-ding to ABPM results after 36 months, a significant decrease was registered among the DBP indicators at night and daytime.

scholarly journals Parameters of 24-hour blood pressure monitoring in young men at initial stage of hypertension

2011 ◽  
Vol 17 (5) ◽  
pp. 460-466 ◽  
Author(s):  
B. L. Multanovsky ◽  
S. A. Lenig
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Young Men ◽  
Initial Stage ◽  
Number Of Patients ◽  
Group 3 ◽  
Group 2 ◽  
Design And Methods ◽  
Group 1

Objective. To compare parameters of 24-hour blood pressure (BP) monitoring in young men with normal, high normal BP and arterial hypertension 1 degree. Design and methods. 102 men (group 1 — 32 subjects with optimal and normal BP, group 2 — 34 subjects with high normal BP, group 3 — 36 men with 1 degree hypertension) underwent 24-hour BP monitoring, and parameters of BP loading and BP changes during the day night were assessed. Results. To a considerable extent subjects with high normal BP demonstrated hypertension at 24-hour BP monitoring, and are characterized by higher «loading pressure» and higher morning BP elevation compared to those with normal and optimal BP; in the group with higher BP the number of patients with normal night profile of BP decreases. Conclusions. Our data confirm that 24-hour BP monitoring should be performed in all patients with high normal BP, and the latest should be considered a group of a higher cardiovascular risk. The disorders of daily BP profile become more profound as arterial hypertension develops.

scholarly journals Comparison of circadian blood pressure profile in Stage 2-3 arterial hypertension patients receiving different antihypertensive combinations

2011 ◽  
Vol 10 (6) ◽  
pp. 30-34
Author(s):  
S. D. Mayanskaya ◽  
E. V. Malysheva ◽  
M. V. Potapova ◽  
E. B. Frolova ◽  
O. Yu. Mikhoparova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Antihypertensive Agents ◽  
Pressure Profile ◽  
Circadian Blood Pressure ◽  
Blood Pressure Profile ◽  
Group I ◽  
First Choice ◽  
Circadian Blood Pressure Profile

Aim. To compare the dynamics of various parameters of circadian blood pressure profile (BP CP) and to assess the selection criteria for two combinations of the first-choice antihypertensive agents (AHA): angiotensin-converting enzyme (ACE) inhibitor plus thiazide diuretic (TD) or angiotensin II receptor antagonist (ARA) and calcium antagonist (CA) in patients with moderate to severe arterial hypertension (AH). Material and methods. This randomised study included 66 men aged 35-60 years with Stage 2-3 AH. Group I (n=37) received the combination of enalapril and hydrochlorothiazide (ENP + HCT; 20/12,5 mg/d), while Group II (n=29) was administered the combination of valsartan and S-amlodipine (VAL + S-AMD; 160/5 mg/d). All medications were taken daily, once a day. At baseline and after 12 weeks of the treatment, all participants underwent 24-hour blood pressure monitoring (BPM). The analysed parameters included: mean values and variability of systolic and diastolic BP (SBP, DBP), time index and pressure load index for SBP and DBP over 24 hours, dayand night-time, magnitude and velocity of SBP and DBP morning surge (MS), and diurnal/nocturnal BP ratio. Results. Twelve-week therapy with combinations significantly reduced mean SBP and DBP levels in patients with moderate to severe AH, regardless of the time of the day/night. It was also associated with reduced BP variability, mostly during the day-time. The ENP+HCT combination was more effective in terms of SBP MS reduction, while the VAL+S-AMD combination effect was more pronounced for DBP MS prevention. The VAL+S-AMD combination significantly improved diurnal/nocturnal BP ratio. Conclusion. The results obtained should be considered in the design of the antihypertensive combination therapy for Stage 2-3 AH patients with “non-dipper”, “night-peaker”, and “over-dipper” types of the two-phase BP CP.

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 The comparative effects of different fixed combinations of antihypertensive drugs in patients with arterial hypertension and hypothyroidism

2020 ◽  
Vol 27 (4) ◽  
pp. 35-44
Author(s):  
V. I. Tseluyko ◽  
D. A. Korchagina
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Myocardial Mass ◽  
Pressure Monitoring ◽  
Heart Remodeling ◽  
Group 2

The aim – to assess the effects of different fixed double combinations of antihypertensive drugs and analyze their impact on heart remodeling in patients with arterial hypertension and hypothyroidism. Materials and methods. The study included 50 patients with hypertension and hypertension, which were divided into 2 groups by the method of blind envelopes of 25 people each. Patients in group 1 were assigned a fixed combination of perindopril with indapamide, patients in group 2 were assigned a fixed combination of perindopril with amlodipine. The groups were statistically compared by age, duration of hormonal substitution therapy, duration of hypertension, level of office SBP, DBP at inclusion in the study. In terms of body mass index, the study groups were comparable, but the number of obese patients was higher in group 2 (p=0.05). Observation of patients lasted 12 months.Results and discussion. The studied fixed combinations of antihypertensive drugs, namely perindopril with indapamide and perindopril with amlodipine provide a reduction in blood pressure in patients with hypertension with concomitant hypothyroidism according to the results of ambulatory blood pressure monitoring. Control of blood pressure in patients with arterial hypertension and concomitant hypothyroidism during a year of antihypertensive therapy provides a reduction in the severity of heart remodeling, the nature and extent of which depends on both the presence of obesity and the choice of a fixed combination of antihypertensive drugs.Conclusions. The results showed that in patients with AН and hypothyroidism achievement of euthyroid state contributes to BP reduction, but requires further administration of antihypertensive therapy. We studied fixed combinations of antihypertensive drugs, namely perindopril with indapamide and perindopril with amlodipine in patients with AG and associated hypothyroidism provide reliable blood pressure reduction according to the results of outpatient blood pressure monitoring (р<0.05). The fixed combination of perindopril with amlodipine compared with the fixed combination of perindopril with indapamide provides a significantly more significant effect on the regression of left ventricular myocardial hypertrophy, namely, a decrease in myocardial mass index by a degree of 2.7 in patients with obesity (р<0,01) myocardial mass index by body surface area in patients without obesity (p=0.06).

scholarly journals Effect of antihypertensive therapy on cognitive function in hypertensive patients with obesity

2012 ◽  
Vol 18 (4) ◽  
pp. 325-333 ◽  
Author(s):  
I. B. Zueva ◽  
K. I. Vanaeva ◽  
E. L. Sanez ◽  
N. V. Moroshkina
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Cognitive Function ◽  
Arterial Hypertension ◽  
Evoked Potential ◽  
Blood Pressure Monitoring ◽  
Neuropsychological Testing ◽  
Pressure Monitoring ◽  
Hypertensive Patients ◽  
Design And Methods

Objective. To assess and compare efficacy of perindopril, eprosartan and amlodipine according to their effects on cognitive function in patients with arterial hypertension and obesity. Design and methods. This open clinical trial included 78 patients (mean age — 46,8 ± 5,5 years), 26 of them received perindopril, 26 — eprosartan, and 26 — amlodipine. Monotherapy has lasted for 12 months. At baseline and 12 months later, all participants underwent 24-hour blood pressure monitoring, neuropsychological testing and cognitive evoked potential (P300) to assess cognitive function. Results. Twelve-month monotherapy with eprosartan and amlodipine significantly improved cognitive function (neuropsychological testing and P300) in patients with obesity and arterial hypertension.

scholarly journals Comparison of the effect of treatment with the main groups of antihypertensive drugs on the quality of life in patients with stable arterial hypertension

2017 ◽  
Vol 8 (2) ◽  
pp. 5-10
Author(s):  
G. F Andreeva ◽  
V. M Gorbunov ◽  
O. V Molchanova ◽  
A. D Deev
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Converting Enzyme Inhibitors ◽  
Effect Of Treatment

When appointing antihypertensive drugs to patients with stable mild to moderate arterial hypertension (AH) it is necessary to take into account the effect of treatment on the quality of life (QoL) of these patients. The aim of the study was to compare the effect of prolonged use of antihypertensive drugs from the main treatment groups on QoL of patients with stable AH in 5 controlled trials. The results of monotherapy efficacy were assessed by 24-hour blood pressure monitoring and QoL patients were studied before and after long-term monotherapy according to the results of a database analysis of 5 studies performed in our center for the last 4 years. After the period of withdrawal of antihypertensive therapy, patients underwent 24-hour blood pressure monitoring, QoL was evaluated. According to 24-hour blood pressure monitoring, diltiazem had an antihypertensive effect, comparable to the effect of enalapril. Both drugs had no effect on the circadian rhythm of arterial pressure and the outpatient heart rate. Long-term use of none of the antihypertensive drugs (diltiazem, amlodipine, enalapril, metoprolol, telmisartan) did not worsen QoL. The greatest impact on QoL was provided by the group of angiotensin-converting enzyme inhibitors, enalapril, significantly improving QoL.

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