scholarly journals THE TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION IN AN ACTUAL OUT-PATIENT PRACTICE

2018 ◽  
Vol 24 (1) ◽  
pp. 4-8 ◽  
Author(s):  
O. Yu Andreeva ◽  
Aleksandr V. Melekhov ◽  
G. E Gendlin ◽  
I. G Nikitin

The arterial hypertension is considered as a serious disease both in Russia and many other countries. The level of target arterial pressure is reached far from in all patients receiving hypotensive therapy. The article presents the data concerning efficiency of hypotensive therapy applied to 144 patients. Their level of arterial pressure was evaluated during its office measurement and day monitoring. The group comprised out-patients observed in polyclinics of one of the Moscow okrugs and in departmental polyclinic of Moscow oblast. to all patients’ evaluation of compliance was applied considering gender, age and type of professional activity. The analysis established that in actual clinical practice the target values of arterial pressure are reached in 22%-50% of patients receiving hypotensive therapy. The level of arterial pressure in young people and patients of older age factually had no difference. The high compliance to applied treatment was established only in one third of patients. The target level of arterial pressure was reached only in one third of young patients. Therefore, in today's actual clinical practice a successful treatment of arterial hypertension remains ineffective as 17 years ago.

2016 ◽  
Vol 22 (4) ◽  
pp. 207-212
Author(s):  
Aleksandr V. Melekhov ◽  
E. I Emelina ◽  
O. Yu Andreeva ◽  
G. E Gendlin ◽  
L. V Sokolovskaya

The increasing of effectiveness of treatment of arterial hypertension is a key issue of prevention of complications of this disease. The level of target arterial pressure is achieved far from all patients treated because of arterial pressure. The article presents data concerning 55 individuals with office systolic arterial pressure higher than 140 mm of mercury column who in spite of hypotensive therapy prescribed by physician, demonstrated no achievement of target values of arterial pressure. Out of this group, 24 patients were acquainted with educational program including an hour lecture concerning arterial hypertension, techniques of self-control of arterial pressure, effect of non-pharmaceutical modes of treatment and role of patients themselves in therapy of this diseases. The educational program was ignored by 31 patient. All patients at the start and the completion of examination were measured office arterial pressure, monitored day arterial pressure. Also evaluation of compliance to indicated hypotensive medicinal therapy was carried out. At the second control visit after 1-3 months, in patients who attended the lecture, significant decreasing of arterial pressure was established according both office measurement and data of indices of systolic arterial pressure. Moreover, the same patients developed compliance to applied treatment. No such effects were observed in 31 patients who ignored lecture mentioned above. It is assumed that the important part of activities concerning treatment of patients with arterial hypertension from the very beginning of interaction with physician is to become increasing of awareness of patients about disease, modes of its control, importance of non-medicinal measures, regular pharmacotherapy attended by physician. It is appropriate to actively implement these measures in practical health care considering expressed clinical and social economical effectiveness of educational programs for patients with arterial hypertension.


Author(s):  
N. V. Dobryninа ◽  
S. S. Yakushin

In clinical practice, quite often the practitioner faces difficulties in correcting arterial pressure in patients with arterial hypertension. Patients mostly for various reasons prefer to be treated with generic drugs, sometimes to the detriment of the effectiveness of treatment. The regional study conducted by us clearly showed the presence of additional possibilities of the original drug Prestans (Servier, France) in reducing blood pressure compared to equivalent dosages of generic fixed combinations.


2019 ◽  
Vol 1 (3) ◽  
pp. 12-16 ◽  
Author(s):  
O. L. Barbarash ◽  
V. V. Kashtalap

The review article discusses the use of antihypertensive therapy in patients with arterial hypertension and atherosclerosis of the lower limb arteries from the perspective of current clinical guidelines. Outlined the goal of therapy, rational combination of drugs. The problems and limitations in the appointment of antihypertensive therapy to patients with peripheral arterial diseases in actual clinical practice are discussed. The postulated priority of fixed combinations in the treatment of patients with arterial hypertension and peripheral atherosclerosis to increase adherence to prescribed therapy and improve the prognosis. literature sources from open databases PubMed, MEDLINE, eLibrary are used.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17518-e17518
Author(s):  
Ilya Romanov ◽  
Ali Mudunov ◽  
Pavel Isaev ◽  
Yury Bychkov ◽  
Akgul Odzharova

e17518 Background:Long time the patients with high-differentiated thyroid cancer with distant metastases had only one type of treatment. It was radioiodine therapy courses and follow-up. In cases of revealed radioiodine (RAI) refractory process we did not have possibilities for treatment this category of patients. Results of trials DECISION and SELECT gave to oncologist new keys for successful treatment. We present our group of RAI refractory thyroid cancer patients, which was treated by Lenvatinib like routine clinical practice. Methods:We have on treatment 8 patients (3-male, 5-female). Histologically – papillary thyroid carcinoma. Provisions of national clinical recommendations were considered as criteria of a RAI-refractory status. Existence of a symptomatic progression of a tumor was main criterion. Results:Six patients received from 7 to 14 month courses of treatment. All these patients are revealed partial response of the tumor lesions by PET-FDG-CT and the dramatically decrease of thyroglobulin level is noted. Two patients stopped treatment after 1 month of therapy. One patient due to destructive pneumonia, other patient – death due to myocardial infarction. Adverse events not related with Lenvatinib. The adverse events were controllable. We noted the expressed arterial hypertension. Before correction of a dose of a drug increase of arterial pressure more than 160/100 mm Hg is noted. Arterial pressure managed to be corrected the combined scheme of therapy (amlodipin, bisoprolol, hydrochlorthiazide). Correction of a dose of lenvatinib is made at 3 patients to 20 mg daily, 2 patient – 14. Conclusions:Introduction of a lenvatinib clinical practice is very successful. But we noted of important accurate expert selection of patients for treatment after establishment of a condition of a RAI-refractory and revealed really symptomatic progression, adequate correction of the adverse effects (arterial hypertension) and well-timed correction of a dose of a lenvatinib.


Author(s):  
Б.И. Гельцер ◽  
Э.В. Слабенко ◽  
Ю.В. Заяц ◽  
В.Н. Котельников

Одним из основных требований к разработке экспериментальных моделей цереброваскулярных заболеваний является их максимальная приближенность к реальной клинической практике. В работе систематизированы данные по основным методам моделирования острой ишемии головного мозга (ОИГМ), представлена их классификация, анализируются данные о преимуществах и недостатках той или иной модели. Обсуждаются результаты экспериментальных исследований по изучению патогенеза ОИГМ с использованием различных моделей (полной и неполной глобальной, локальной и мультифокальной ишемии) и способов их реализации (перевязка артерий, клипирование, коагуляция, эмболизация и др.). Особое внимание уделяется «стабильности» последствий острого нарушения мозгового кровообращения: необратимых ишемических повреждений головного мозга или обратимых с реперфузией заданной продолжительности. Отмечается, что важное значение в этих исследованиях должно принадлежать современным методам прижизненной визуализации очагов острого ишемического повреждения, что позволяет оценивать динамику патологического процесса. Предлагаемый метод отвечает требованиям гуманного обращения с животными. Подчеркивается, что выбор релевантной модели ОИГМ определяется задачами предстоящего исследования и технологическими ресурсами научной лаборатории. Development of experimental models for acute forms of cerebrovascular diseases is essential for implementation of methods for their prevention and treatment. One of the principal requirements to such models is their maximum approximation to actual clinical practice. This review systematized major models of acute cerebral ischemia (ACI), their classification, and presented information about their advantages and shortcomings. Also, the review presented results of experimental studies on pathophysiological mechanisms of different types of modeled ACI (complete and incomplete global, local, and multifocal ischemia) and methods for creating these models (arterial ligation, clipping, coagulation, embolization, etc.). Particular attention was paid to “stability” of the consequences of acutely impaired cerebral circulation - an irreversible ischemic brain injury or a reversible injury with reperfusion of a given duration. The authors emphasized that in such studies, a special significance should be given to intravital imaging of acute ischemic damage foci using modern methods, which allow assessing the dynamics of the pathological process and meet the requirements to humane treatment of animals. The choice of a relevant ACI model is determined by objectives of the planned study and the technological resources available at the research laboratory.


2019 ◽  
Vol 17 (2) ◽  
pp. 42-48
Author(s):  
I. A. Grebenkina ◽  
◽  
A. A. Popova ◽  
S. D. Mayanskaya ◽  
S. V. Tretyakov ◽  
...  

2019 ◽  
Vol 17 (2) ◽  
pp. 74-79 ◽  
Author(s):  
A. A. Shirokova ◽  
◽  
L. A. Balykova ◽  
S. A. Ivyanskiy ◽  
K. N. Varlashina ◽  
...  

Author(s):  
Elena Korneeva ◽  
Mikhail Voevoda ◽  
Sergey Semaev ◽  
Vladimir Maksimov

Results of the study related to polymorphism of ACE gene (rs1799752)‎, integrin αIIbβ3, and CSK gene (rs1378942) influencing development of arterial hypertension in young patients with metabolic syndrome are presented. Hypertension as a component of the metabolic syndrome was detected in 15.0% of young patients. Prevalence of mutant alleles of the studied genes among the examined patients was quite high, so homozygous DD genotype was found in 21.6%, and mutant D allele of the ACE gene in 47.4%. A high risk of hypertension in patients with MS was detected in carriers of the T allele of the CSK (rs1378942) gene – 54.8%, which was most often observed in a combination of polymorphic ACE and CSK gene loci (p = 0.0053).


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