scholarly journals COMPARISON BETAXOLOL AND METOPROLOL TARTRATE THERAPIES IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH STABLE ANGINA

2009 ◽  
Vol 5 (2) ◽  
pp. 59-64
Author(s):  
A. A. Anderzhanova ◽  
J. V. Gavrilov ◽  
V. A. Sulimov
Keyword(s):  
Arterial Hypertension ◽  
Stable Angina ◽  
Metoprolol Tartrate

scholarly journals New opportunities to improve the treatment effectiveness of patients with stable angina

Kardiologiia ◽  
2020 ◽  
Vol 60 (6) ◽  
pp. 47-52
Author(s):  
N. Yu. Grigoryeva ◽  
O. E. Vilkova ◽  
M. O. Samolyuk ◽  
K. S. Kolosova
Keyword(s):  
Heart Rate ◽  
Beta Blocker ◽  
Stable Angina ◽  
Treatment Effectiveness ◽  
Functional Class ◽  
Metoprolol Tartrate ◽  
St Segment ◽  
Group 2 ◽  
Heart Rate Slowing

Aim To study the antianginal and heart rate slowing effects in patients with stable angina (SA) who failed to achieve the heart rate (HR) goal and were switched from the beta-blocker (BB) metoprolol tartrate to a combination of metoprolol tartrate and ivabradine.Materials and methods The study included 54 patients with SA not higher than functional class (FC) III (35 (64.8 %) men and 19 (35.2 %) women) aged 59 [48; 77] years. Prior to the study start and at 4 and 8 weeks of follow-up, electrocardiography (ECG) and 24-h ECG monitoring (24h-ECGM) were performed for all patients. The follow-up period duration was 8 weeks. The antianginal and heart rate slowing effects of therapy were clinically evaluated by a decrease in frequency of anginal attacks and patients’ requirement for nitrates, a decrease in HR, and the effect on 24h-ECGM indexes characterizing myocardial ischemia. At the first stage, all patients were prescribed metoprolol tartrate (Egilok®, Egis, Hungary) 25 mg twice a day. Patients with resting HR still higher than 70 bpm after 4 weeks of treatment were switched from metoprolol tartrate to a fixed ivabradine/metoprolol combination (Implicor®, Servier, France) 5 / 25 mg twice a day. Thus, based on achieving/ non-achieving the HR goal, two groups of patients were formed. Statistical analysis was performed with a STATISTICA 10,0 software package.Results After 4 weeks of therapy with metoprolol tartrate 25 mg twice a day, 18 (33.3%) patients of group 1 achieved the HR goal of 70 bpm, while  36 (66.7%) patients of group 2 did not achieve the goal. For further correction of HR, patients of group 2 were switched from metoprolol tartrate to ivabradine/metoprolol 5 / 25 mg twice a day. After 4 weeks of the ivabradine/metoprolol treatment, 31 (86.1 %) patients achieved the HR goal with median resting HR of 62 [56; 70] bpm. The number of angina attacks decreased from 6 [3; 8] to 2 [1; 3] per week (р<0.001). 24hECGM showed that the mean diurnal HR decreased from 81 [76; 96] to 66 [56; 76] bpm (р<0.001); mean night HR decreased from 69 [73; 80] to 52 [43; 60] bpm (р=0.012); and the ischemic ST segment depression was absent.Conclusion Only 33.3% of patients with stable angina achieved the HR goal on metoprolol tartrate 25 mg twice a day. Supplementing the beta-blocker metoprolol tartrate at the same dose with ivabradine allowed 86.1% of patients to achieve the HR goal and exerted a pronounced anti-anginal effect.

scholarly journals Influence of Meldonium on Blood Lipid Spectrum and Echocardiography Parameters in Patients with Coronary Heart Disease and or Withoutconcomitant Arterial Hypertension

2021 ◽  
Vol 2-3 (35-36) ◽  
pp. 50-57
Author(s):  
D. Volynskyi ◽  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Arterial Hypertension ◽  
Total Cholesterol ◽  
Stable Angina ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Positive Effect ◽  
Lipid Spectrum ◽  
Concomitant Hypertension

Introduction. Coronary heart disease (CHD) is one of the main causes of high mortality, disability and reduced quality of life for patients in both Europe and Ukraine. Modern drug therapy of coronary heart disease in combination with arterial hypertension (AH) does not always achieve a satisfactory therapeutic effect. The use of meldonium, which has antioxidant properties, has a positive effect on NO release and has a lipid-lowering effect is promising for patients with AH. The aim of the study. To evaluate the influence of meldonium on lipid metabolism and echocardiography parameters in combination therapy in patients with CHD with stable angina and concomitant AH. Materials and methods. We examined 66 patients with CHD, stable angina pectoris II-III functional class, 40 of them with concomitant AH stage II-III. Patients were divided into 2 groups of 40 and 26 patients, respectively. The first group included patients with CHD and concomitant AH, the second - without pre-existing hypertension. Each of the groups was further divided into 2 subgroups: 1) Patients who were prescribed meldonium at a dose of 750.0 mg/d for 6 months in addition to the basic therapy of the underlying disease (n = 20 for CHD + AH and n = 14 for CHD without hypertension). 2) Patients who continued basic antianginal, disaggregating, hypolipidemic therapy (n = 20 for CHD + AH and n = 12 for CHD without hypertension). Serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol were assessed. Indicators of cardiac hemodynamics were determined by echocardiography with assessment of left ventricular end systolic and diastolic volumes and diameters (LVESV, LVEDV, LVESD, LVEDD respectively), the thickness of the interventricular septum and posterior wall of the left ventricle (IVST, LVPWT respectively), pulmonary artery pressure (PAP), LV myocardial mass (LVM) and LV myocardial mass index (LVMI). Results. The use of meldonium for 6 months in patients with CHD and concomitant AH led to a decrease in the concentration of total cholesterol from 5.07 to 4.34 mmol/l and LDL from 2.07 to 1.70 mmol/l. In the group of patients without concomitant hypertension there was a decrease in the concentration of total cholesterol from 4.80 to 3.93 mmol/l, LDL from 1.62 to 1.18 mmol/l and an increase in HDL from 1.18 to 1.37 mmol/l. At 6-month administration of meldonium as a part of combination therapy of patients with CHD with concomitant AH, there is a decrease in LVM from 216.90 g to 181.50 g and LVMI from 109.10 g/m2 up to 91.20 g/m2. In patients without concomitant hypertension, a decrease in LVM from 232,20 g to 183.90 g and LVMI from 121.50 g/m2 to 96.40 g/m2 was observed. Conclusions. Our study showed that meldonium has a positive effect on lipid metabolism and echocardiography. In the group of patients with coronary heart disease and concomitant hypertension on the background of additional use of meldonium for six months, we registered a decrease in TC, LDL and AI. LVPWT, PAP, LVM and LVMI also significantly decreased. In the group of patients with coronary heart disease without concomitant hypertension, we registered a decrease in TC, LDL, AI and an increase in HDL. LVM and LVMI also decreased significantly. Therefore, we consider it appropriate to use meldonium in the complex treatment of patients with coronary heart disease with stable angina and concomitant hypertension. Keywords: coronary heart disease, arterial hypertension, meldonium, echocardiography, blood lipid spectrum.

scholarly journals Assessing the impact of isosorbide mononitrate on sinoatrial node pacemaker activity in patients with III and IV functional class of stable angina

2013 ◽  
Vol 94 (2) ◽  
pp. 163-168
Author(s):  
E A Safronova ◽  
I M Shadrina
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Arterial Hypertension ◽  
Stable Angina ◽  
Sinoatrial Node ◽  
Wave Structure ◽  
Isosorbide Mononitrate ◽  
Pacemaker Activity ◽  
Functional Classes ◽  
The Impact

Aim. To evaluate the peripheral autonomic effects of isosorbide mononitrate on sinoatrial node pacemaker activity using wave structure analysis by rhythmocardiography. Methods. The study included 162 patients with III and IV functional classes of stable angina, among them 122 - with hypertension. The control group consisted of 42 healthy volunteers. In addition to standard techniques (electrocardiography, echocardiography, bicycle ergometry, electrocardiogram daily monitoring), high-resolution rhythmocardiography using a KAP-RK-01-«Mikor» diagnostic complex with time and spectral analysis of the sinus rhythm wave structure was performed. The method is based on the evaluation of peripheral autonomic regulation in the sinoatrial pacemaker and influence of humoral and metabolic environment on it. Results. In all patients with III and IV functional classes of stable angina regardless of the concomitant arterial hypertension heart rate variability, as well as Valsalva maneuver response increased in a number of patients taking isosorbide mononitrate. Negative events related to isosorbide mononitrate intake were reduced parasympathetic fluctuations in a number of cases, humoral-metabolic regulation growth, and increase of sympathetic regulation role in patients with concomitant arterial hypertension. Rhythmocardiography allowed to access the influence of isosorbide mononitrate on heart rate variability in patients with ischemic heart disease. Conclusion. Both positive (increased heart rate variability) and negative (spectral features redistribution with humoral, metabolic and sympathetic components increase and parasympathetic component decrease) effects were associated with isosorbide mononitrate intake with lesser sinoatrial node dysregulation in patients with concomitant arterial hypertension.

Effect of amlodipine and lacidipine on left ventricular diastolic and long axis functions in arterial hypertension and stable angina pectoris

2005 ◽  
Vol 60 (3) ◽  
pp. 239-246 ◽  
Author(s):  
Remigijus ZALIUNAS ◽  
Renaldas JURKEVICUS ◽  
Vytautas ZABIELA ◽  
Julija BRAZDZIONYTE
Keyword(s):  
Angina Pectoris ◽  
Arterial Hypertension ◽  
Stable Angina ◽  
Left Ventricular ◽  
Stable Angina Pectoris

scholarly journals USE OF MELDONIUM IN THE TREATMENT OF PATIENTS WITH CORONARY ARTERY DISEASE AND CONCOMITANT ARTERIAL HYPERTENSION

2019 ◽  
Vol 6 ◽  
pp. 9-14
Author(s):  
Denys Volynskyi ◽  
Ihor Vakaliuk
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Arterial Hypertension ◽  
Stable Angina ◽  
Well Being ◽  
Functional Class ◽  
Basic Therapy ◽  
Complex Therapy ◽  
Artery Disease

Coronary artery disease (CAD) remains one of the leading causes of mortality and disability in Ukraine. Arterial hypertension (AH) is one of the most common diseases and a leading risk factor for coronary artery disease. The aim of the work is to evaluate the antianginal activity of meldonium in the complex therapy in patients with CAD with stable angina and concomitant AH. Materials and methods. The study included 82 patients with CAD, stable angina pectoris II–III functional class, including 52 patients with concomitant AH stage II. The patients were divided into 2 groups. Patients in group 1 were prescribed meldonium at a dose of 750 mg/d for 2 months in addition to basic therapy for the underlying disease. Patients in group 2 continued basic antianginal, disaggregant, hypolipidemic therapy. Results. The use of meldonium led to a decrease in the frequency of angina attacks and the need for nitroglycerin. From the 1st month of therapy and up to 2 months treatment decreased it consumption by 63 and 82.3 % respectively. Adding meldonium to basic therapy led to a likely reduction in shortness of breath, episodes of palpitations, tinnitus, and headache. In all patients, after the treatment, an increase in exercise tolerance was observed, which was more pronounced in the group where patients were receiving meldonium. In the group of patients receiving meldonium, normalisation of blood pressure was faster and more pronounced. Conclusions. Meldonium has antianginal activity, which is manifested by an increase in the physical tolerance of patients, a decrease in the frequency of angina attacks, the need for sublingual nitroglycerin intake and improvement in the well-being of patients. Additional use of meldonium promotes faster and better normalization of blood pressure. The use of meldonium in the complex therapy of patients with stable angina and concomitant AH allows to increase the effectiveness of traditional antianginal therapy and to improve the quality of life of such patients.

scholarly journals Influence of therapy of metoprolol on some indices of central nervous system, diastolic function of myocardium and exercise training test in patient with stable angina pectoris II-III and arterial hypertension I-II

2006 ◽  
Vol 12 (2) ◽  
pp. 165-172
Author(s):  
E. V. Parmon ◽  
E. R. Bemgardt ◽  
T. V. Treshkur ◽  
M. A. Ovetchkina ◽  
E. V. Shlyakhto
Keyword(s):  
Angina Pectoris ◽  
Arterial Hypertension ◽  
Diastolic Function ◽  
Stable Angina ◽  
Positive Influence ◽  
Treadmill Test ◽  
Stable Angina Pectoris ◽  
Biochemical Analyses ◽  
Treatment Onset ◽  
Antiarrhythmic Actions

The article reveals the results of original study about effects of therapy of metoprolol (“Metocard”, Polfarma) in 32 patients with stable angina pectoris II-III and arterial hypertension I-II. Average maximal effective and well-tolerated dose of Metocard was 93,0±5,62 mg per day. The 24-hour monitoring of blood pressure and ECG, as well as treadmill test, biochemical analyses, Echo-CG, MMPI, and the Midlsec tests were performed before and six weeks after the treatment onset. It’s effective antiischemic, hypotensive and antiarrhythmic actions were revealed. Metocard demonstrated positive influence on cognitive functions and psychoemotional status of patients; there were no any negative influences on lipid metabolism and diastolic function of left ventricle.

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