The “Contemporary History” of the drug therapy in patients with arterial hypertension: is antihypertensive therapy only one way of treating?

2016 ◽  
Vol 18 (5) ◽  
pp. 36-42
Author(s):  
S.R. Giliarevskii ◽  
◽  
M.V. Golshmid ◽  
I.M. Kuzmina ◽  
G.Yu. Zakharova ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Contemporary History ◽  
History Of

scholarly journals Arterial hypertension after heart transplantation

Kardiologiia ◽  
2020 ◽  
Vol 60 (6) ◽  
pp. 53-57
Author(s):  
M. A. Simonenko ◽  
P. A. Fedotov ◽  
Yu. V. Sazonova ◽  
M. A. Bortsova ◽  
M. Yu. Sitnikova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Therapy ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Ace Inhibitors ◽  
Antihypertensive Drugs ◽  
Channel Blockers ◽  
Newly Diagnosed ◽  
Single Drug ◽  
History Of

Aim To evaluate incidence of arterial hypertension (AH) in the posttransplantation period and to identify risk factors for this complication.Materials and methods From January, 2010 through December, 2017, 96 heart transplantations (HT) (70 men and 26 women aged 46.5±13.9 years) were performed. During the first month following HT, 8 recipients died and were excluded from the analysis. The retrospective evaluation of results included 88 patients followed up for more than one year.Results For the entire post-HT period (maximum 92 months), AH was observed in 75 of 88 (85%) recipients. Post-HT AH was correlated with male gender (r=0.24; p=0.031), history of smoking before HT (r=0.45; p<0.001), history of ischemic heart disease (IHD) (r=0.28; p=0.01), older age (r=0.35; p=0.001), higher body weight index (r=0.37; p=0.0005), creatinine level (r=0.37; p=0.001), and low-density lipoprotein cholesterol level (r=0.27; p=0.04). Interrelations with other AH risk factors were not found. Most patients developed AH within the first two years after HT. During the first year, AH was diagnosed in 60% (53 of 88) of patients (relapse, 85% (n=29); newly diagnosed, 45% (n=24), p=0.0003). At two years, AH was detected in 79% (46 of 58) of patients (relapse, 53% (n=18); newly diagnosed, 53% (n=28), p=0.9). All recipients received an adequate antihypertensive therapy. 40-63% of patients required a single-drug therapy at different points of follow-up; from 29 to 45% of patients required a two-drug therapy, and 5-15% of patients required three or more drugs. During all 5 years of treatment, most patients used angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) (70-87%) and slow calcium channel blockers (SCCB) (48-53%). The presence of AH following HT was associated with development of all cardiovascular events (CVE; r=0.31; p=0.012) whereas persistent AH, which required a combination antihypertensive treatment, was associated with a high mortality (r=0.61; p=0.015).Conclusion AH is a frequent complication of HT (85%), which is newly diagnosed in most patients during the first two years. AH incidence was higher for male recipients with a history of IHD, hypertension, and smoking. Approximately half of patients required only a single-drug antihypertensive therapy. After HT, the most frequently prescribed drugs included ACE inhibitors or ARBs and SCCBs (70-87% and 48-53%, respectively, depending on the time elapsed after HT). Persistent AH requiring a treatment with two or more antihypertensive drugs was associated with development of all CVEs and a higher long-term mortality.

scholarly journals Intensification of antihypertensive therapy in patients with uncontrolled arterial hypertension and overweight/obesity based on results of Ukrainian study SATISFACTION

2020 ◽  
Vol 27 (5) ◽  
pp. 34-50
Author(s):  
O. A. Koval
Keyword(s):  
Body Weight ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Fixed Combination ◽  
Previous Treatment ◽  
Open Label ◽  
Primary Care Doctors ◽  
History Of ◽  
Previously Treated Patients ◽  
Previously Treated

The aim – to define the profile of patients with the arterial hypertension (AH) and overweight (body mass index (BMI): 25–29.9 kg/m2) or obesity (BMI ≥ 30 kg/m2) who do not achieve office blood pressure (BP) < 140/90 mm Hg with the antihypertensive therapy.Materials and methods. One hundred eighty five (185) general practitioners/primary care doctors consecutively, at the visits enrolled 1798 patients with AH, office BP > 140/90 mm Hg and overweight/obesity into the multicenter, open-label, observational, epidemiological study. The patients were surveyed using the standard questionnaire, they had the general clinical examination, their BMI and waist circumference (WC) were measured, they received recommendations regarding the physical activity and nutrition and their antihypertensive therapy was adjusted at the doctor discretion. After 1 month, at Visit 2, BP was monitored, efficacy of the prescribed therapy was evaluated and changes of body weight, BMI, WC and compliance were assessed. After another 1 month, Visit 3 was conducted by telephone.Results and discussion. Mean age of patients was 59,06±11,38 years; there were 1203 females (66.9 %). Overweight was recorded in 33.4 % of patients and obesity in 66.6 % of patients. Mean body weight was 92.06±14.03 kg, BMI was 32.38±4.55 kg/m2, WC in males was 104.92±12.74 cm, in females –99.32±12.74 cm, i.e. abdominal obesity was prevailing. Family history of cardiovascular diseases was reported in 60.7 % of patients and 63.6 % have never smoked. Diabetes mellitus or impaired glucose tolerance was observed in 11.06 % of patients. The systolic BP (SBP) was 163.15±12.21 mm Hg, diastolic BP (DBP) was 95.62±7.78 mm Hg, heart rate (HR) was 78.16±8.98 per minute, i.e. in general, severe AH was recorded. At enrolment 38.4 % of patients received one antihypertensive product, 47.8 % of patients received two products and 13.8 % of patients received three and more products (generally renin-angiotensin-aldosterone system modulators in combination with the calcium antagonists and hydrochlorothiazide, more than half – as individual products). Initial compliance (quantity of positive responses) was 3.33 scores and was low in 73.9 % of patients and high only in 4.0 % of patients. Doctors changed the antihypertensive therapy at Visit 1: 84.43 % of patients were recommended the original fixed combination of perindopril and indapamide at 10/2.5 mg; 14.07 % of patients – at 5/1.25 mg; 0.95 % of patients – at 2.5/0.625 mg; 0.56 % of patients were prescribed another antihypertensive therapy. Following 1-month therapy, SBP decreased by 27.12±13.70 mm Hg, DBP decreased by 13.32±9.08 mm Hg, HR decreased by 5.20±8.16 per minute (all p<0.001), which ensured AH control in 74.9 % of patients and improved compliance (p<0.05). Further 1-month treatment led to further decrease in BP. After 2 months, the mean SBP was 130.29±11.58 mm Hg, DBP was 79.37±6.69 mm Hg; it decreased from baseline by 32.87±12.21 and 16.26±8.93 mm Hg (p<0.0001). All BP changes were dose-dependant (dose of the original fixed combination of perindopril and indapamide) and were the highest when the combination at 10/2.5 mg was used. Therapy efficacy and compliance did not depend on the previous treatment or age of patients. BP control was achieved in 93.09 % of patients and compliance improved in 71 %.Conclusions. Therapy with the original fixed combination of perindopril and indapamide, generally at the highest dose (10/2.5 mg) in previously treated patients with AH and the overweight/obesity is effective and allows to reach BP control after 2-month therapy in 93 % of patients regardless their age and also to significantly improve the compliance.

RESISTANT ARTERIAL HYPERTENSION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: PREVALENCE, PROGNOSTIC SIGNIFICANCE, REASONS AND APPROACHES TO ANTIHYPERTENSIVE THERAPY

2019 ◽  
Vol 23 (1) ◽  
pp. 37-44 ◽  
Author(s):  
O. B. Kuzmin ◽  
V. V. Zhezha ◽  
L. N. Landar ◽  
O. A. Salova
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Drug Therapy ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Resistant Hypertension ◽  
Antihypertensive Drugs ◽  
Refractory Hypertension ◽  
Hypertensive Patients

Arterial hypertension (AH) resistant to drug therapy is the phenotype of uncontrolled AH, in which patients receiving at least 3 antihypertensive drugs, including a diuretic, maintain blood pressure above the target level. Initially, the term refractory hypertension was also used to refer to resistant hypertension. Recently, however, refractory hypertension has been isolated into a separate phenotype of difficult to treat hypertension, which is defined as insufficient control of target blood pressure, despite the use of at least 5 different mechanisms of antihypertensive drugs, including long-acting diuretic and antagonist of mineralcorticoid receptors. Resistant hypertension is detected in 10–15 % of all hypertensive patients receiving drug therapy, and is often found in patients with chronic kidney disease. Hypertension can be a cause and/or consequence of kidney damage and is typical of most patients with chronic kidney disease. The lack of control of target blood pressure in a significant proportion of hypertensive patients with CKD who receive at least 3 antihypertensive drugs of different mechanisms of action indicates a lack of effectiveness of antihypertensive therapy, which not only accelerates the loss of renal function, but also significantly worsens the prognosis, contributing to such people risk of cardiovascular and renal complications. The review presents data on the prevalence, prognostic value of resistant hypertension in patients with chronic kidney disease, features of its formation and approaches to increasing the effectiveness of antihypertensive therapy in this patient population.

scholarly journals Resistant arterial hypertension: problems and opportunities for personalised drug therapy

2020 ◽  
Vol 27 (5) ◽  
pp. 60-73
Author(s):  
A. V. Fendrikova ◽  
V. V. Skibitskiy ◽  
E. S. Garkusha ◽  
A. I. Chesnikova ◽  
M. Е. Statsenko
Keyword(s):  
Blood Pressure ◽  
Drug Therapy ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Salt Sensitivity ◽  
Target Blood Pressure ◽  
Antihypertensive Drug Therapy ◽  
Controlled Study ◽  
Salt Loading ◽  
Resistant Arterial Hypertension

Background. Effective drug therapy for resistant arterial hypertension is among major problems in modern medicine. The actual prevalence of resistant arterial hypertension is unknown, and its pathogenetic mechanisms are actively investigated. Among its important components is salt-sensitivity of the patient. At the same time, effi cacy of combined antihypertensive therapy in relation to salt-sensitivity of patients with resistant arterial hypertension is not fully understood.Objectives. Effi cacy assessment of personalised drug therapy in salt-sensitive and salt-resistant patients with resistant arterial hypertension.Мethods. We conducted a non-randomised controlled study with the observation time of 48 weeks. All patients had ambulatory blood pressure monitoring (ABPM) in the onset and past 48 weeks of treatment. Prior to therapy, the patient’s salt-sensitivity was determined with ABPM in salt loading (V.I. Kharchenko’s test). Two cohorts were formed with respect to the test results to include salt-sensitive (n = 67) and salt-resistant (n = 54) patients. Both cohorts received a combined therapy: enalapril 10 mg twice a day, amlodipine 10 mg/day, hydrochlorothiazide 12.5 mg/day, aliskiren 150 mg/day. If a target blood pressure was not observed in 3 weeks, aliskiren was elevated to 300 mg/day. Therapeutic effi cacy was assessed with ABPM after 48 weeks. Non-parametric statistical analysis was performed using Statistica 6.10 (StatSoftInc, USA).Results. The study included 121 patients with resistant arterial hypertension, median age 63 [58;67]. With background therapy, the target blood pressure was observed in 29 (43.4%) patients in cohort 1 and in 38 (70.4%) — in cohort 2 (intergroup p < 0.05). Statistically signifi cant lower ABPM values were registered in both cohorts after 48 weeks. Daily blood pressure normalised with therapy in 62.1% of patients in cohort 1 and in 68.4% — in cohort 2. The salt-resistant cohort exhibited a more pronounced reduction in ABPM values compared to salt-sensitive patients.Conclusion. Salt-sensitivity is a factor for personalising antihypertensive drug therapy in patients with resistant arterial hypertension due to specifi city of mechanisms for maintaining high blood pressure. Combined antihypertensive therapy with aliskiren is statistically more effective in salt-resistant than in salt-sensitive patients.

On The Possibility of an Autonomous History of Modern Southeast Asia

1961 ◽  
Vol 2 (2) ◽  
pp. 73-105 ◽  
Author(s):  
John R. W. Small
Keyword(s):  
Southeast Asia ◽  
Contemporary History ◽  
The Past ◽  
History Of

It is generally accepted that history is an element of culture and the historian a member of society, thus, in Croce's aphorism, that the only true history is contemporary history. It follows from this that when there occur great changes in the contemporary scene, there must also be great changes in historiography, that the vision not merely of the present but also of the past must change.

Dental Implant Placement in Patients with a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review

2020 ◽  
Author(s):  
Judd Sher ◽  
Kate Kirkham-Ali ◽  
Denny Luo ◽  
Catherine Miller ◽  
Dileep Sharma
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Drug Therapy ◽  
Dental Implant ◽  
Case Series ◽  
Cochrane Central Register ◽  
Bisphosphonate Treatment ◽  
Implant Placement ◽  
Increased Risk ◽  
History Of

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.

The Guatemalan Genocide Through Indigenous Mayan Literature Twenty Years After the Peace Accords: Rigoberta Menchú, Humberto Ak´Abal and Victor Montejo

2017 ◽  
Vol 7 (1) ◽  
pp. 31
Author(s):  
David Caballero Mariscal
Keyword(s):  
Social Exclusion ◽  
Dark Period ◽  
Social Situation ◽  
Point Of View ◽  
Contemporary History ◽  
Rigoberta Menchu ◽  
Testimonial Literature ◽  
History Of ◽  
Peace Accords ◽  
Historical Truth

Guatemala experienced a cruel genocide in the early eighties, in the context of a repressive Conflict. Due to the different governments´ repressive policies, this terrible social situation was little known abroad, and even in the own country. Just after the Peace Accords, several organisms worked to uncover the historical truth. In any case, we cannot forget that testimonial literature is a privileged mean to know this dark period of the contemporary history of Guatemala. This genre is particularly relevant, because the main writers are originally Mayans, and have directly suffered both repression and social exclusion due to ethnic reasons. Rigoberta Menchú, Unmberto Ak´abal and Víctor Montejo represent a new and original point of view in the measure in which they describe feelings and situations from the perspective of those who experience them personally. Testimonial literature or the Testimonio becomes an ethnographic document that allows us to know not just a period but a people who have suffered from repression and exclusion for centuries.

Features of Development of the Black Sea Village in 1920s: Materials from the Black Sea Party Obkom Fond in the Documentation Center for Contemporary History of the Krasnodar Krai

2018 ◽  
pp. 1128-1136
Author(s):  
Olga V. Bershadskaya ◽  
Keyword(s):  
Rural Communities ◽  
Black Sea ◽  
Distinctive Feature ◽  
Agricultural Production ◽  
Political Development ◽  
The Black Sea ◽  
Contemporary History ◽  
Krasnodar Krai ◽  
Geographical Environment ◽  
History Of

The article studies features of socio-economic and socio-political development of the Black Sea village in 1920s. Documents from the fond of the Black Sea District Committee (Obkom) of the RCP (b) -VKP (b) stored in the Center for Documentation of the Modern History of the Krasnodar Krai allow not only to reconstruct the developments in the Black Sea village in the NEP days, but also to understand the nature of its evolution. Uniqueness of the Black Sea village was greatly determined by its geographical environment. There had formed a sectoral makeup of agricultural production: fruit-farming, viticulture, tobacco growing. Rugged relief forced peasants to form holdings or farms; therefore rural communities were rare. Its another distinctive feature was its motley national composition. Over 50 ethnic groups inhabited the district, among most numerous were the Russians, the Ukrainians, the Armenians, and the Greeks. In the first years of the NEP, the main tasks facing district authorities were to develop ‘high-intensity’ industries and to shape local peasant farms into food base for cities and resorts. While tackling these tasks, they had to deal with shortages of land and poor communications and to bring lease relations and work-hands employment up to scratch. The situation was complicated by socio-political inertia of rural population of the district that came from the absence of community tradition. Study of the documents from the fond of the Black Sea party obkom shows that local authorities were well aware of the peculiarity of their region, but in most cases had to follow guidelines set ‘from above’ to introduce all-Russian standards.

Rentier Islamism

2018 ◽  
Author(s):  
Courtney Freer
Keyword(s):  
United Arab Emirates ◽  
Muslim Brotherhood ◽  
State Theory ◽  
Government Policies ◽  
The Political ◽  
Contemporary History ◽  
Rentier State ◽  
Oil Rents ◽  
History Of ◽  
Islamist Movements

This book, using contemporary history and original empirical research, updates traditional rentier state theory, which largely fails to account for the existence of Islamist movements, by demonstrating the political capital held by Muslim Brotherhood affiliates in Kuwait, Qatar, and the United Arab Emirates (UAE). While rentier state theory predicts that citizens of such states will form opposition blocs only when their stake in rent income is threatened, this book demonstrates that ideology, rather than rent, has motivated the formation of independent Islamist movements in the wealthiest states of the region. It argues for this thesis by chronicling the history of the Brotherhood in Kuwait, Qatar, and the UAE, and showing how the organization adapted to the changing (and often adverse) political environs of those respective countries to remain a popular and influential force for social, educational, and political change in the region. The presence of oil rents, then, far from rendering Islamist complaint politically irrelevant, shapes the ways in which Islamist movements seek to influence government policies.

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