scholarly journals The Capabilities of Amlodipine/Lisinopril Single-Pill Combination in the Treatment of Newly Diagnosed Arterial Hypertension in a Middle-Aged Patient (Case Report)

2020 ◽  
Vol 16 (2) ◽  
pp. 221-230
Author(s):  
A. I. Kochetkov ◽  
M. V. Lopukhina ◽  
E. A. Kotaeva ◽  
A. A. Kirichenko ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular ◽  
Favorable Effect ◽  
Newly Diagnosed ◽  
Functional Changes ◽  
Collagen Formation ◽  
Cardiovascular Morbidity And Mortality ◽  
Single Pill ◽  
Left Atrial Stiffness

Arterial hypertension (AH) is one of the most significant modifiable risk factors that increase cardiovascular morbidity and mortality worldwide, including Russia. The complex of structural and functional changes in the heart that occurs during AH consists not only in the formation of left ventricular (LV) myocardial hypertrophy, but also in the myocardial stiffness increasing due to collagen formation and cardiomyocytes apoptosis. These abnormalities are substrate for diastolic function disturbances, electrical myocardial instability and ischemia. The article provides a clinical case of amlodipine/lisinopril single-pill combination (A/L SPC) use in real clinical practice in a patient with stage II grade 2 newly diagnosed AH and its effect on blood pressure and echocardiographic myocardial fibrosis markers, including speckle tracking parameters The high antihypertensive efficacy of A/L SPC, a favorable effect on blood pressure circadian rhythm, as well as pronounced target-organ protective properties, in particular the ability to reduce LV and left atrial stiffness, were demonstrated. So, we conclude that A/L SPC improve the elastic properties of the left heart.

Abstract 1590: Association Between Arterial Stiffness, Coronary Microcirculation And Left Ventricular Function In Patients With Newly Diagnosed Arterial Hypertension.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ignatios Ikonomidis ◽  
John Lekakis ◽  
Ioannis Paraskevaidis ◽  
Helen Triantafyllidi ◽  
Costas Papadopoulos ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Diastolic Function ◽  
Coronary Flow ◽  
Left Ventricular ◽  
Coronary Microcirculation ◽  
Healthy Controls ◽  
Newly Diagnosed ◽  
Flow Reserve ◽  
Cardiovascular Morbidity And Mortality

Arterial stiffness is an independent marker of cardiovascular morbidity and mortality. Coronary microcirculation is impaired in patients with arterial hypertension. We investigated the relationship between arterial stiffness, coronary microcirculation and left ventricular (LV) systolic and diastolic function. METHODS: 80 untreated consecutive patients (mean age: 55±11 years 38 males), with newly diagnosed arterial hypertension and 20 healthy controls matched for sex, age and atherosclerotic factors, were studied. We measured a) Carotid to femoral artery pulse wave velocity (PWV) using the Complior apparatus b) Peak Systolic (Vs) and diastolic (Vd) coronary blood flow velocity, Vd/Vs ratio, Deceleration Time (DT-Vd) and time integral (VTI-Vd) of Vd using a 7MHZ transducer by means of colour-guided Doppler echocardiography at the distal tract of the LAD c) Ratio of VTI-Vd after adenosine infusion (140 μ g/kg/min) to VTI-Vd at baseline to assess coronary flow reserve (CFR) d) E and A doppler, Em, Am mitral annulus velocities TDI and E/Em ratio to assess LV diastolic function d) Mean Longitudinal, Transverse, Circumferential and Radial Strain and Strain Rate by 2-D Strain to assess LV systolic function. RESULTS: Patients and controls had normal ejection fraction. Compared to controls, patients with hypertension had higher PWV (10.4±1.7 vs. 8.2±1.4 m/s, p<0.001), E/Em (8.3±2.8 vs. 5.7±1.4, p=0.001) and lower CFR (2.6±0.6 vs. 3.4±0.7, p<0.001), Vd/Vs (1.78±0.31 vs. 1.97±0.38, p=0.04), DT-Vd (973±226 vs 1113±332 ms, p<0.001), Em/Am (0.93±0.42 vs. 1.6±0.51, p<0.001), mean longitudinal strain (−17.8±3 vs. −19.8±3.1%, p=0.031) and mean circumferential strain ( −19.6±4.5 vs. −22±3.4 %, p=0.04). Increasing PWV was related to increasing E/Em (r=0.26, p=0.045) and decreasing CFR (r=−0.68, p<0.001). Increasing E/Em was related to decreasing Vd/Vs (r=−0.3, p<0.005) and CFR (r=−0.32, p=0.002). CONCLUSIONS: Patients with arterial hypertension present subclinical systolic LV dysfunction and significant LV diastolic dysfunction compared to healthy controls. Increased LV diastolic filling pressures caused by arterial stiffness may increase the resistance of myocardial microcirculation leading to impaired coronary flow

scholarly journals Pre-treatment condition effects on blood pressure and heart rate variability change in patients with arterial hypertension on therapy

2018 ◽  
Vol 90 (12) ◽  
pp. 23-27
Author(s):  
P G Talabanov ◽  
I L Kozlovskaya ◽  
G V Ryabykina ◽  
A V Sobolev ◽  
E Sh Kozhemyakina
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Glycated Hemoglobin ◽  
Combined Therapy ◽  
Fasting Blood Glucose ◽  
Weighted Average ◽  
Left Ventricular ◽  
Dynamic Monitoring ◽  
Functional Changes ◽  
Normal Limits

Aim. To study the relationship of the initial clinical and functional state of patients with arterial hypertension (AH) with the dynamics of daily indices of blood pressure (BP) and sinus rhythm on antihypertensive therapy. Materials and methods. 38 patients were examined (general clinical examination, electrocardiography, echocardiography, daily bifunctional monitoring with the determination of weighted average rhythmogram variations - WARV, clinical and biochemical analysis of blood, glycated hemoglobin, thyroid hormones) and distribyted according to the use of hypotensive drugs of main classes and combined therapy AH. Dynamic monitoring of the effectiveness of treatment was carried out (after 2-4 weeks, then every 1-2 months), clinically and with bifunctional monitoring, correction of therapy. The observation period was 8 months. Results and discussion. By the end of the study, 27 patients had target blood pressure, significant decrease in systolic / diastolic blood pressure (10/5 mm Hg and more) occurred in 30 patients. A correlation was found between the effectiveness of antihypertensive treatment and the initial clinical and instrumental parameters of patients: age, heart size (including left ventricular hypertrophy - LVH), thyroid stimulating blood hormone (TSH) level and fasting blood glucose (within normal limits). The level of WARV also correlated with these indicators and was significantly higher in patients who achieved a significant reduction in blood pressure. No significant dynamics of WARV was detected. No relationship between baseline blood pressure with WARV and their changes were identified. The connection of the myocardial mass index with the level of TSH and glycated hemoglobin was demostrated. Conclusion. The WARV reflects the severity of organic heart changes associated with age, disease duration, metabolic profile, LVH - heart damage as a target organ in AH, but is not suitable for analyzing its functional changes within one stage of the disease.

scholarly journals Dyslipidemia in patients with arterial hypertension and extrasystoles

2016 ◽  
Vol 7 (2) ◽  
pp. 73-77
Author(s):  
N. V. Didyc
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Diastolic Dysfunction ◽  
Pressure Profile ◽  
Ventricular Volume ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Clinical Group ◽  
Hypertensive Disease ◽  
Functional Changes

The significant incidence of hypertensive disease among the Ukrainian population makes the search for new methods of management and treatment of patients suffering from this pathology a matter of high priority. Our research is focused on study of changes of some biochemical parameters in patients suffering from hypertensive disease as well as patients suffering from hypertensive disease and coexistent extrasystoles. Arterial hypertension leads to different structural and functional changes in the cardiovascular system. In many patients these changes may result in rhythm disorders. 120 patients have been examined (42 men and 78 women) between the ages of 27 to 81 (average 59.8) suffering from hypertensive disease of the II stage as defined by the Ukrainian Association of Cardiologists and from extrasystoles (more than 30 episodes per hour of research) of different topography and 30 persons (13 men and 17 women) suffering from hypertensive disease of the II stage between the ages 30 to 76 (average 56.4) without rhythm disturbance). The first clinical group was formed by 54 (45%) patients suffering from repeated supraventricular extrasystoles (SE) (average 62 ± 2 SE per hour of research). The second clinical group was formed by 42 (35%) patients suffering from repeated ventricular arhythmia (VA) (average 37 ± 2 VA per hour of research). The third group was formed by 24 (20%) patients suffering from both repeated SE and VA (average 48 ± 3 SE and 32 ± 3 VA per hour of research). We conducted 24 hours’ monitoring of blood pressure and electrocardiography using the “Dia Card”-system (“Solvaig”, Ukraine) for all patients. This revealed that ventricle extrasystoles and combined extrasystoles in patients with essential hypertension, II stage are associated with more unfavourable changes in 24 hours’ profile of blood pressure. The paper analyses the cardiac arhythmia structure of heart rate variability in patients with arterial hypertension (AH) and extrasystoles. The findings confirmed the presence of desynchronization in the activity of the neurohnmoral system. Thus, different mechanisms of arhythmogenesis were revealed in patients with arterial hypertension. In the results, frequent ventricular and combined extrasystoles were associated with an unfavourable blood pressure profile during 24-hours monitoring as well as higher end-diastolic left ventricular volume, diastolic dysfunction, aortic valve fibrosis, aorta remodeling, endothelial dysfunction and more prominent lipid disorders. Supraventricular extrasystoles were associated with hypertriglyceridemia, left ventricular diastolic dysfunction and left atrium enlargement. 

scholarly journals Effect of the Single-Pill Amlodipine/Valsartan Combination on Hypertrophy and Myocardial Deformation Characteristics in Middle-Aged Patients with Essential Arterial Hypertension

2019 ◽  
Vol 15 (3) ◽  
pp. 305-314
Author(s):  
A. I. Kochetkov ◽  
E. V. Borisova ◽  
O. D. Ostroumova ◽  
M. V. Lopukhina ◽  
G. V. Piksina
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Stage Ii ◽  
Middle Aged ◽  
Aged Patients ◽  
Single Pill ◽  
Essential Arterial Hypertension

Aim. To investigate the impact of amlodipine/valsartan single-pill combination (A/V SPC) on left ventricular hypertrophy (LVH) and left ventricular (LV) myocardial strain and stiffness parameters in naїve middle-aged patients with stage II grade 1-2 essential arterial hypertension (EAH).Material and methods. A group of patients with stage II grade 1-2 EAH who had not previously received regular antihypertensive treatment (AHT) [n=38; mean age 49.7±7.0 years] was retrospectively formed. All the patients were treated with A/V SPC and all of them achieved target office blood pressure (BP) (less than 140/90 mm Hg). And after 12 weeks follow-up (since the time of reaching the target BP) the AHT effectiveness assessment, its impact on LVH and LV myocardial strain and stiffness parameters (general clinical data, ambulatory blood pressure monitoring, conventional and 2D-speckle tracking echocardiography) were performed in all included patients.Results. The number of patients with LVH significantly (p=0.039) decreased from 25 individuals (65.8%) at baseline to 15 patients (39.5%) at the end of follow-up. Among patients with LVH at baseline after the treatment with A/V SPC significantly decreased (p<0.001 for all) interventricular septum thickness (from 1.36±0.19 to 1.28±0.18 cm), LV posterior wall thickness (from 1.08±0.09 to 0.97±0.11 cm) and the LV myocardial mass index (from 123.3±19.3 to 110.8±20.8 g/m2). At the end of follow-up end-systolic elastance significantly (p<0.001) decreased from 4.01±1.12 to 3.46±0.88 mm Hg/ml. In the subgroup of patients with reduced (in absolute value) LV longitudinal 2D-strain (n=27) at baseline, there was a significantly (p=0.005) increasing in this parameter at the end of the study (from -16.14±2.21% to -17.30±2.13%, Δ%=8.45±13.35).Conclusion. In naive patients 40-65 years old with stage II grade 1-2 EAH AHT with A/V SPC provides effective 24 hours BP control, significantly reduced LVH and improves LV strain parameters, which indicates decreasing of LV myocardial stiffness.

Gender difference in the relation blood pressure–left ventricular mass and geometry in newly diagnosed arterial hypertension

2012 ◽  
Vol 21 (4) ◽  
pp. 255-264 ◽  
Author(s):  
Franco Cipollini ◽  
Enrica Arcangeli ◽  
Emanuela Greco ◽  
Flavia Franconi ◽  
Giuseppe Pettinà ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gender Difference ◽  
Arterial Hypertension ◽  
Left Ventricular Mass ◽  
Left Ventricular ◽  
Newly Diagnosed ◽  
Ventricular Mass

Initial left-ventricular mass predicts probability of uncontrolled blood pressure in arterial hypertension

2011 ◽  
Vol 29 (4) ◽  
pp. 803-808 ◽  
Author(s):  
Raffaele Izzo ◽  
Giovanni de Simone ◽  
Richard B Devereux ◽  
Renata Giudice ◽  
Marina De Marco ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular Mass ◽  
Left Ventricular ◽  
Uncontrolled Blood Pressure ◽  
Ventricular Mass

scholarly journals Single Pill Indapamide and Perindopril Arginine Combination: Optimal Coupling of Vascular Protection and Hemodynamic Risk Factors Reduction in Patients with Essential Arterial Hypertension

Kardiologiia ◽  
2019 ◽  
Vol 59 (3) ◽  
pp. 18-26 ◽  
Author(s):  
E. V. Borisova ◽  
A. I. Kochetkov ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Arterial Compliance ◽  
Stage Ii ◽  
Stiffness Index ◽  
Single Pill ◽  
Essential Arterial Hypertension ◽  
The Impact

Objective: to investigate the impact of indapamide / perindopril single-pill combination (I / P SPC) on arterial stiffness parameters, blood pressure (BP) level and BP variability (BPV) in middle-aged patients with stage II grade 1–2 essential arterial hypertension (EAH). Materials and methods. We retrospectively formed a group of patients with stage II grade 1–2 EAH who had not previously received regular antihypertensive therapy (AHT) (n=52, mean age 52.9±6.0 years). All patients were treated with I / P SPC and all of them achieved target office BP level (less than 140 / 90 mm Hg). After 12 weeks of follow-up (from the time of reaching the target BP) assessment of AHT effectiveness (general clinical data, ambulatory blood pressure monitoring [ABPM], volume sphygmography, echocardiography), and vascular stiffness evaluation were performed.Results. At the end of follow-up office systolic BP (SBP), diastolic BP (DBP), pulse BP, day-time, night-time and 24‑hour SBP and DBP significantly (p<0.001 for all) decreased. According to the ABPM data day-time, nighttime, and 24‑hour systolic BPV significantly decreased (p=0.029, p=0.006 and p<0.001, respectively); day-time and 24‑hour diastolic BPV also significantly decreased (p=0.001 and p<0.001, respectively). Day-night standard deviation (SDdn) significantly decreased too (p=0.002 and p<0.001, respectively). Volumetric sphygmography showed significant decrease of right cardio-ankle vascular index (CAVI) (from 8.20±1.29 to 7.58±1.44, p=0.001) and of left CAVI (from 8.13±1.40 to 7.46±1.43, p<0.001), as well as reduction of the number o f patients with a right- and / or left-CAVI >9.0 (from 32.7 to 11.5 %, p=0.018). According to assessment of arterial stiffness using the Vasotens24 software package, the arterial stiffness index (ASI) significantly (p<0.001) decreased from 153.5±29.9 to 138.3±20.0 (by –9.2±13.1 %). Transthoracic echocardiography data demonstrated significant decrease (p<0.001) in effective arterial elastance (from 1.82±0.43 to 1.58±0.36 mm Hg; by –11.85±16.29 %) and significant (p<0.001) increase in the arterial compliance – from 1.27±0.34 to 1.54±0.38 mm Hg / ml (+26.95±38.06 %).Conclusion. In AHT naive patients 40–65 years old with stage II grade 1–2 EAH therapy with I / P SPC provided effective 24‑hour BP control, reduced BPV and improved arterial stiffness parameters. 

scholarly journals Cushing’s Disease: Assessment of Early Cardiovascular Hemodynamic Dysfunction With Impedance Cardiography

2021 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Jurek ◽  
Paweł Krzesiński ◽  
Grzegorz Gielerak ◽  
Przemysław Witek ◽  
Grzegorz Zieliński ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Cushing’S Disease ◽  
Impedance Cardiography ◽  
Left Ventricular ◽  
Cushing's Disease ◽  
Control Group ◽  
Stroke Index ◽  
Disease Group ◽  
Hemodynamic Assessment

BackgroundCushing’s disease is a rare condition associated with a high cardiovascular risk and hypercortisolemia-related hemodynamic dysfunction, the extent of which can be assessed with a noninvasive method, called impedance cardiography. The standard methods for hemodynamic assessment, such as echocardiography or ambulatory blood pressure monitoring may be insufficient to fully evaluate patients with Cushing’s disease; therefore, impedance cardiography is being currently considered a new modality for assessing early hemodynamic dysfunction in this patient population. The use of impedance cardiography for diagnosis and treatment of Cushing’s disease may serve as personalized noninvasive hemodynamic status assessment and provide a better insight into the pathophysiology of Cushing’s disease. The purpose of this study was to assess the hemodynamic profile of Cushing’s disease patients and compare it with that in the control group.Material and MethodsThis observational prospective clinical study aimed to compare 54 patients with Cushing’s disease (mean age 41 years; with 64.8% of this population affected with arterial hypertension) and a matched 54-person control group (mean age 45 years; with 74.1% of this population affected with arterial hypertension). The hemodynamic parameters assessed with impedance cardiography included the stroke index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), (ACI), Heather index (HI), and thoracic fluid content (TFC).ResultsThe Cushing’s disease group was characterized by a higher diastolic blood pressure and a younger age than the control group (82.9 vs. 79.1 mmHg, p=0.045; and 41.1 vs. 44.9 years, p=0.035, respectively). Impedance cardiography parameters in the Cushing’s disease group showed: lower values of SI (42.1 vs. 52.8 ml/m2; p ≤ 0.0001), CI (2.99 vs. 3.64 l/min/m2; p ≤ 0,0001), VI (42.9 vs. 52.1 1/1000/s; p=0.001), ACI (68.7 vs. 80.5 1/100/s2; p=0,037), HI (13.1 vs. 15.2 Ohm/s2; p=0.033), and TFC (25.5 vs. 27.7 1/kOhm; p=0.006) and a higher SVRI (2,515 vs. 1,893 dyn*s*cm-5*m2; p ≤ 0.0001) than those in the control group.ConclusionsCushing’s disease is associated with significantly greater vasoconstriction and left ventricular systolic dysfunction. An individual assessment with impedance cardiography may be useful in Cushing’s disease patients in order to identify subclinical cardiovascular complications of chronic hypercortisolemia as potential therapeutic targets.

scholarly journals Microalbuminuria as a Marker of Preclinical Diastolic Dysfunction in Newly Diagnosed and Never-Treated Essential Hypertension

2013 ◽  
Vol 35 (1) ◽  
pp. 3-8
Author(s):  
RM Gajurel ◽  
A Sayami
Keyword(s):  
Essential Hypertension ◽  
Diastolic Dysfunction ◽  
Myocardial Dysfunction ◽  
Public Health Problem ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Newly Diagnosed ◽  
Spot Urine ◽  
Functional Changes ◽  
Ventricular Diastolic Dysfunction

Introduction: Hypertension (HTN) is a global public health problem with one fourth adults worldwide estimated to have high blood pressure (BP)1 The incidence of hypertension continues to increase in all developed and developing societies as the population grows older and more obese. The Framingham Study and other epidemiological surgeys have clearly defined HTN as an important cause of morbidity and mortality. The aim of this study was to determine the spot urine Microalbuminuria as a marker of preclinical cardiac structural and functional changes in the form of left ventricular diastolic dysfunction in newly diagnosed and never treated essential hypertensive subjects. Methods: A cross sectional study was used for those patients who were attended outpatient clinic of MCVTC with diagnosis of newly diagnosed and never treated hypertension over a period of October 2011 to November 2012. Results: A total of 130 essential hypertensive patients underwent for spot urine for microalbuminuria estimation and Echocardiography for evaluation of left ventricular diastolic function. Among 56 (43.1%) urine samples showed negative test [(Microalbuminuria -); ( UACR 30 mg/Gm)] and those 74 (56.9%) samples revealed positive test [(Microalbuminuria+); (UACR 30 to 300 mg/Gm)]. Patients with microalbuminuria positive was found to have more left ventricular diastolic dysfunction than those who were negative for Microalbuminuria. Conclusion: Microalbuminuria was found to have early preclinical marker of myocardial dysfunction in the form of left ventricular diastolic dysfunction in new and never treated essential hypertension. DOI: http://dx.doi.org/10.2126/joim.v35i1.8890  Journal of Institute of Medicine, April, 2013; 35:3-8

scholarly journals No association of the CYP3A5*1 allele with blood pressure and left ventricular mass and geometry: the KORA/MONICA Augsburg echocardiographic substudy

2006 ◽  
Vol 111 (6) ◽  
pp. 365-372 ◽  
Author(s):  
Wolfgang Lieb ◽  
Juliane Bolbrinker ◽  
Angela Döring ◽  
Hans-Werner Hense ◽  
Jeanette Erdmann ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular Mass ◽  
Posterior Wall ◽  
Pressure Control ◽  
Population Based ◽  
Left Ventricular ◽  
Genotype Distribution ◽  
Cytochrome P450 3A ◽  
Ventricular Mass

A polymorphism in the cytochrome P450 3A CYP3A5 enzyme has been implicated in BP (blood pressure) control and arterial hypertension. Carriers of the CYP3A5*1 allele had high, whereas homozygous carriers of the CYP3A5*3 allele exhibit low, CYP3A5 expression in the kidney, where CYP3A5 represents the major CYP3A enzyme. The aim of the present study was to investigate the association of the CYP3A5*1 allele with BP, arterial hypertension, LVM [(left ventricular) mass] and LV geometry in a large Caucasian-population-based cohort. We compared BP, LVM and the prevalence of hypertension between carriers (CYP3A5*1/*1 and CYP3A5*1/*3 genotypes) and non-carriers (CYP3A5*3/*3 genotype) of the CYP3A5*1 allele in the echocardiographic substudy of the third MONICA (MONItoring trends and determinants in CArdiovascular disease) Augsburg survey. After exclusion of 269 individuals who were taking antihypertensive medication, 530 women and 554 men were available for analysis, revealing allele frequencies of 5.8 and 94.2% for the CYP3A5*1 and CYP3A5*3 alleles respectively. Overall, the presence of the CYP3A5*1 allele exhibited no effect on systolic or diastolic BP in either gender. One-third of the individuals in this cohort were hypertensive (BP ≥140/90 mmHg), and the genotype distribution between normotensive and hypertensive individuals revealed no association between CYP3A5*1 and hypertension after adjustment for age, BMI and gender (odds ratio, 1.02; P=0.92). Moreover, no effect of CYP3A5*1 on LVM, thickness of the septal and posterior wall and LV end-diastolic diameter was found. We conclude that CYP3A5*1 exhibits no significant effect on BP, LVM and LV geometry in the KORA/MONICA echocardiographic substudy.

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