FEATURES OF DIURNAL BLOOD PRESSURE PROFILE, ARTERIAL STIFFNESS AND CENTRAL AORTIC PRESSURE IN PATIENTS WITH ARTERIAL HYPERTENSION AND PREDIABETES

Background. Anxiety-depressive disorders (ADD) afflict almost half of patients with arterial hypertension (AH). AH aggravation by psychoemotional disorders causes a more severe illness and rapid target organ injury, particularly, the increased arterial stiffness and central aortic pressure (CAP). However, the prospects of combined antihypertensive-antidepressant treatments in AH-ADD patients remain largely unexplored.Objectives. The effect assessment in combined antihypertensive-psychocorrective therapy on circadian blood pressure (BP), vascular stiffness and CAP, anxiety and depression in women with AH and ADD.Methods. The study enrolled 60 AH-ADD women randomised between two cohorts. Cohort 1 received a fixed combination of valsartan and hydrochlorothiazide, bisoprolol and sertraline antidepressant; cohort 2 only had same combined AH therapy. Past 24 weeks of trial, all patients had a general clinical examination and daily blood pressure monitoring (DBPM) with BpLab Vasotens (Petr Telegin Ltd., Russia) and control of daily BP, CAP and vascular stiffness. The psychometric HADS and CES-D scales were used along with psychiatric counselling.Results. Past four weeks of treatment, the target blood pressure (TBP) was revealed in 60 and 36.7% patients, and in 90 and 66.6% — past eight weeks in cohorts 1 and 2, respectively. Cohort 1 vs. 2 required a lower valsartan dose to attain TBP. Past six months, both cohorts showed improved main DBPM values reflecting vascular stiffness and CAP. However, a statistical decrease in nocturnal central and peripheral BP, as well as improved BP variability and vascular stiffness were registered at antidepressant use. A normalised daily BP profile was significantly more frequent in cohort 1. In addition, sertraline had a significant ADD-reductive impact.Conclusion. An antidepressant-combined conventional AH therapy in AH-ADD women facilitated a faster TBP achievement at lower AH agent doses and the significantly improved DBPM (nocturnal specifically), arterial stiffness and CAP values. A sertraline treatment improved the psychoemotional patient state.

Download Full-text

FIVE-YEAR DYNAMICS OF CIRCADIAN BLOOD PRESSURE PROFILE IN FAR NORTH WORKERS WITH ARTERIAL HYPERTENSION

Russian Journal of Cardiology ◽

10.15829/1560-4071-2013-6-48-53 ◽

2013 ◽

pp. 48-53 ◽

Cited By ~ 1

Author(s):

I. L. Zapesochnaya ◽

A. G. Avtandilov

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Pressure Profile ◽

Far North ◽

Circadian Blood Pressure ◽

Blood Pressure Profile ◽

Circadian Blood Pressure Profile

Download Full-text

The problem of concomitant diseases with a focus on the cardiovascular system condition in patients with arterial hypertension and acid-related diseases

Kazan medical journal ◽

10.17816/kmj1776 ◽

2013 ◽

Vol 94 (1) ◽

pp. 80-85 ◽

Cited By ~ 5

Author(s):

O V Khlynova ◽

A V Tuev ◽

L N Beresneva ◽

A V Agafonov

Keyword(s):

Blood Pressure ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Arterial Hypertension ◽

Reflux Disease ◽

Medical Science ◽

Clinical Manifestations ◽

Pressure Profile ◽

Arterial Blood ◽

Blood Pressure Profile

At present, the problem of concomitant diseases still remains very important for medical science as well as for medical practice. Arterial hypertension is one of the most actual global healthcare problems, holding the leading place among cardiovascular diseases. Acid-related diseases, including gastroesophageal reflux disease and duodenal ulcer are also widely-spread with the tendency of prevalence growth, and are having the leading place among gastrointestinal diseases. The combination of arterial hypertension and acid-related diseases is a new state of an organism regulation. Their synchronism is not accidental, as both diseases share links of the general etiology and pathogenesis. The daily arterial pressure profile and heart rhythm variability has a number of distinctive features when the diseases collide. The presence and progression of esophageal and duodenal mucous membranes inflammation in these patients promotes the certain arterial blood pressure profile formation. The data concerning the prevalence, common etiology and pathogenesis, features of hemodynamics and clinical manifestations in patients with arterial hypertension associated with peptic ulcer disease and gastroesophageal reflux disease are reviewed. Data of autonomic regulation features, 24-hour blood pressure profile and central hemodynamics condition in patients the combination with the mentioned diseases are also covered.

Download Full-text

Effectiveness of Chrono-Pharmacotherapy Depending on the Salt Sensitivity of Patients with Arterial Hypertension and Diabetes Mellitus Type 2

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2018-14-6-846-851 ◽

2019 ◽

Vol 14 (6) ◽

pp. 846-851

Author(s):

V. V. Skibitskiy ◽

A. A. Kiselev ◽

A. V. Fendrikova

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Arterial Stiffness ◽

Diabetes Mellitus Type 2 ◽

Blood Pressure Monitoring ◽

Aortic Pressure ◽

Diabetes Mellitus Type ◽

Pressure Monitoring ◽

Central Aortic Pressure

Aim. To study the effect of two regimens of combined antihypertensive therapy during the day on daily monitoring of arterial pressure, central aortic pressure, and arterial stiffness, depending on the salt sensitivity of hypertensive patients with diabetes mellitus type 2. Material and methods. 130 hypertensive patients with type 2 diabetes mellitus were included into the study. They were divided into 2 subgroups: salt-sensitive (group 1) and salt-resistant (group 2), and then randomized to subgroups A and B of ongoing therapy: in the morning ramipril and indapamide retard, bedtime – amlodipine (subgroup 1A and 2A); or in the morning amlodipine and indapamide retard, bedtime – ramipril (subgroup 1B and 2B). Initially and after 24 weeks of antihypertensive therapy, 24-hour blood pressure monitoring was performed, the indices of central aortic pressure and arterial stiffness were determined. Results. After 24 weeks, in all subgroups, there was a significant positive dynamics of the parameters of 24-hour blood pressure monitoring, central aortic pressure and arterial stiffness indices. In the subgroup 1В, it was registered a significant improvement in the majority of parameters of 24-hour blood pressure monitoring (decrease in 24-hours systolic BP by 24.4%, 24-hours diastolic BP by 22.1%; p<0.05), central aortic pressure (decrease in aortal systolic BP by 15.9%, aortal diastolic BP by 20.8%; p<0.05) and vascular wall stiffness parameters (decrease in pulse wave velocity by 13.8%; p<0.05) in comparison with group 1A (decrease in 24-hours systolic BP by 17.5%, 24-hours diastolic BP by 14.6%, aortal systolic BP by 12.7%, aortal diastolic BP by 9.7%, pulse wave velocity by 9.2%; p<0.05 in comparison with the group 1B). In the case of salt-resistant patients, there were comparable positive changes in the parameters of 24-hour blood pressure monitoring, central aortic pressure and arterial stiffness indices against the background of both dosing regimens during the day. Conclusion. In the study, it was demonstrated the more pronounced antihypertensive and vasoprotective efficacy of the combination of thiazide-like diuretic with calcium channel blocker in the morning and ACE inhibitor in bedtime compared to the alternative regimen of prescribed pharmacotherapy in salt-sensitive patients, and comparable efficacy of both regimens in salt-resistant hypertensive patients with diabetes mellitus type 2.

Download Full-text