scholarly journals Features of target organ damage in patients with resistant arterial hypertension

HYPERTENSION ◽  
2020 ◽  
Vol 13 (2-3) ◽  
pp. 66-74
Author(s):  
L.A. Mishchenko ◽  
O.G. Kupchynska ◽  
O.O. Matova ◽  
K.I. Serbeniuk ◽  
O.V. Gulkevych ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Resistant Arterial Hypertension

scholarly journals Resistant arterial hypertension: clinical and pathogenetic peculiarities and predictors of therapy effectiveness

2019 ◽  
Vol 26 (4) ◽  
pp. 77-89
Author(s):  
L. A. Mishchenko ◽  
O. G. Kupchynska ◽  
O. O. Matova ◽  
K. I. Serbeniuk ◽  
O. V. Gulkevych
Keyword(s):  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Fixed Dose ◽  
Low Grade ◽  
Plasma Aldosterone Concentration ◽  
Tnf Α ◽  
Resistant Arterial Hypertension

The aim – to evaluate the features of the target organs damage, neurohumoral and proinflammatory status and to determine the predictors of the effectiveness of antihypertensive therapy in patients with resistant arterial hypertension (RAH). Materials and methods. The study included 257 patients with apparent RAH. The secondary hypertension was revealed in 8.5 % of patients. After 3 months therapy with triple fixed-dose combination (FDC) of antihypertensive drugs in maximum tolerated doses, patients were distributed into two groups – true RAH (n=103) and patients with pseudo resistant AH (PRAH) (n=132). We performed the comparative analysis of clinical characteristics, target organ damage degree, features of neurohumoral (plasma concentration of aldosterone and active renin, 24 – hour urinary metanephrines) and proinflammatory (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor – α (TNF-α) in plasma) status among groups. The predictors of effectiveness of the 4th antihypertensive drug addition (spironolactone, eplerenone, nebivоlol, moxonidine) to triple FDC in patients with RAH were studied. Results and discussion. Higher levels of office and ambulatory blood pressure (BP), frequent (up to 14 %) disturbance of BP rhythm as night-peaker type, high BP morning surge are typical for RAH patients. 95 % of RAH patients had concentric left ventricular hypertrophy and 80 % – carotid atherosclerosis, a lower glomerular filtration rate and higher level of urinary albumin excretion rate (UAER). RAH patients had higher level of CRP – by 17.3 % (p=0.02), IL-6 – by 21.8 % (p=0.01), TNF-α – by 13 % (p=0.003) in comparison with PRAH patients. The predictors of spironolactone and eplerenone efficacy are plasma aldosterone concentration (β=0.653; p=0.002), aldosterone-renin ratio (β=0.542; p=0.003), UAE (β=–0.362; p=0.01) and the level of CRP (β=–0.315; p=0.03). Conclusions. Higher level of BP, target organ damage, more expressed activation of low – grade inflammation, sympathetic and renin-aldosterone-angiotensin systems activity are typical for RAH patients. The most effective drugs in addition to three – component FDC are MRA – spironolactone and eplerenone, which lead to the achievement of target BP at 48.5 % and 46.9 % (according to office and ambulatory testing) RAH patients. Nebivolol application contributed to BP normalization at 39.7 % and moxonidine – at 41.2 % RAH patients.

DAILY VARIABILITY OF ARTERIAL STIFFNESS INDEX IN RELATION TO TARGET ORGAN DAMAGE AND SEVERITY OF ARTERIAL HYPERTENSION

2018 ◽  
Vol 36 (Supplement 1) ◽  
pp. e179
Author(s):  
A. Merezhanova ◽  
E. Tarlovskaya ◽  
K. Mazalov ◽  
M. Mazalova ◽  
N. Kamardina ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Stiffness Index ◽  
Daily Variability ◽  
Arterial Stiffness Index

Comparison of Early Target Organ Damage Between Blacks and Whites with Mild Systemic Arterial Hypertension

1997 ◽  
Vol 79 (12) ◽  
pp. 1695-1698 ◽  
Author(s):  
Roland E Schmieder ◽  
Jürgen K Rockstroh ◽  
Gerd Lüchters ◽  
Uschi Hammerstein ◽  
Franz H Messerli
Keyword(s):  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Systemic Arterial Hypertension ◽  
Blacks And Whites

scholarly journals Efficacy of a fixed-dose combination (amlodipine/losartan) in the treatment of a patient with arterial hypertension, dyslipidemia and obesity

2020 ◽  
pp. 74-78
Author(s):  
V. P. Mikhin
Keyword(s):  
Arterial Hypertension ◽  
Clinical Case ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
High Cardiovascular Risk ◽  
Steady Level ◽  
Dose Combination

The article substantiates the feasibility of combination antihypertensive therapy in patients with arterial hypertension without target organ damage and high cardiovascular risk. The authors consider a clinical case of the use of amlodipine and losartan in a fixed-dose combination (Lozap AM) as part of complex therapy in a patient with arterial hypertension, dyslipidemia and obesity. The clinical case showed the ability of the drug to both achieve a steady level of target blood pressure and improve its daily profile by transferring the Night-peaker type to the Non-dipper type.

scholarly journals Cardiovascular risk profile in patients with arterial hypertension who first seek medical attention

2018 ◽  
Vol 17 (5) ◽  
pp. 5-10
Author(s):  
D. V. Nebieridze ◽  
T. V. Kamyshova ◽  
A. A. Sarycheva ◽  
A. S. Safaryan
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Density Lipoprotein ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Medical Attention ◽  
Cardiovascular Morbidity And Mortality

Aim.Objective assessment of cardiovascular risk (CVR) in patients with arterial hypertension (AH), who first contact with primary care setting.Material and methods. 300 patients (age 40-65 years) with sustained increase in arterial pressure and first seek medical attention were included in the study. All patients underwent medical examination, history taking to identify risk factors, blood pressure measurement and anthropometric research, biochemical blood assay to estimate levels of total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, glucose. Based on the specified parameters, the risk was determined by SCORE (Systematic Coronary Risk Evaluation). After the risk assessment, all patients underwent an echo-cardiography, duplex ultrasonography screening of the brachiocephalic arteries and determination of microalbuminuria to detect target organ damage. According to results of a complex survey, the risk was reclassified based on the presence of target organ damage.Results.The study showed that patients with sustained AH who first seek medical attention have a large number of risk factors and their combinations, among which the most common are dyslipidemia (89,3%), smoking (37,7%) and obesity (28,3%). Patients with AH who first seek medical attention without clinical signs of atherosclerosis often have various disorders of target organs, such as left ventricular hypertrophy — 67,3%, thickening of carotid intima-media complex — 46,3%, atherosclerotic plaques in carotid arteries — 34,7%, microalbuminuria — 25,3%, as well as different combinations thereof. After a complex examination, the CVR profile of patients changes increases. According to SCORE 60% of patients with low and mean risk is reclassified to high risk.Conclusion.One of the most important tasks of health care system in Russia is to increase the efficiency of the CVR stratification systems, as well as to develop a new standards of examination of patients with AH on an outpatient stage, in order to reduce cardiovascular morbidity and mortality.

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