Effective strategies for prevention of cardiovascular complications in elderly patients with arterial hypertension and obesity (clinical example)

2020 ◽  
pp. 10-18
Author(s):  
A. P. Pereverzev ◽  
O. D. Ostroumova ◽  
E. V. Mironova
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Blood Pressure ◽  
Body Weight ◽  
Arterial Hypertension ◽  
Cognitive Training ◽  
Blood Pressure Reduction ◽  
Cardiovascular Complications ◽  
Effective Control

The frequency of arterial hypertension has a clear tendency to increase with age. The presence of obesity imposes additional difficulties on the choice of antihypertensive therapy regimen due to the variety of pathophysiological mechanisms of raising blood pressure in patients with a combination of hypertension and obesity. This article presents the clinical case of a 68-year-old patient with hypertension and obesity, discusses a comprehensive approach that includes diet, regular physical activity, cognitive training and pharmacotherapy with the fixed combination of amlodipine with telmisartan and the imidazoline receptor agonist moxonidine. The choice of this combination is due to the following reasons: the ultra-prolonged action of both drugs, which allows you to control blood pressure during the day, including in the morning, when there is the greatest number of cardiovascular events; organoprotective properties; improving carbohydrate metabolism; reducing the risk of diabetes; antiatherosclerotic properties. The choice of moxonidine is due to the need of effective control of blood pressure, reduction of the activity of the sympathetic nervous system, because hypersympathicotonia is one of the central pathogenetic mechanisms for raising blood pressure in patients with hypertension and obesity, and the decrease in resting heart rate less than 80 bpm (an independent risk factor for cardiovascular complications in hypertension). Dietary recommendations will help to reduce body weight and blood pressure, slow the progression of atherosclerosis, prevent the development of cardiovascular catastrophes, and improve the quality of life. The aim of physical activity is reducing body weight, improve cognitive functions and reduce cardiovascular risks. Cognitive training will help improve cognitive function and, consequently, increase patient adherence to treatment. After six weeks of complex treatment, the patient noted the achievement of the target blood pressure, weight loss, improved mood, increased exercise tolerance, improved quality of life, as well as a decrease in proteinuria, which completely disappeared after another three months of therapy.

scholarly journals Experience of using a fixed combination of ramipril and indapamide in clinical practice

2021 ◽  
Vol 23 (1) ◽  
pp. 103-108
Author(s):  
Irina V. Kochetkovа ◽  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Clinical Practice ◽  
Arterial Hypertension ◽  
Fixed Combination ◽  
Adult Population ◽  
Blood Pressure Reduction ◽  
Stage Ii ◽  
Life Questionnaire

Relevance. Arterial hypertension is one of the most common cardiovascular diseases in the adult population, but much has already been achieved in its treatment. The advantages of combination therapy, according to the clinical recommendations "Arterial Hypertension in Adults" in 2020, are as follows: an increase in the degree of blood pressure reduction is much stronger than an increase in the dose of a single drug; the possibility of physiological and pharmacological synergy between drugs of different classes, which may underlie a more pronounced reduction in blood pressure and better tolerability of treatment; suppression of the opposite mechanisms of increasing blood pressure. Aim. Aim of the study was to study the effect of the antihypertensive drug – Konsilar-D24 on the clinical picture, HRV data, and hemodynamic parameters in patients with stage II hypertension of the 2nd degree. Materials and methods. 40 patients with stage II AH and grade 2 AH were examined. During the outpatient examination, all patients were evaluated for HRV, SCAD, SMAD, ECHO-KG, ECG, GFR, laboratory and biochemical examination (UAC, OAM, blood bch-creatinine, urea, glucose, ASAT, ALAT), and the SF-36 quality of life questionnaire. Results. An increase in SVVR, a decrease in blood pressure, and an increase in the quality of life of the patient. Discussion: Konsilar-D24 is an effective antihypertensive agent for grade 2 hypertension in the complex treatment of stage II hypertension. Against the background of therapy, there is a persistent achievement of target figures, an increase in vagal tone. There is a metabolic neutrality of the drug, as well as nephro and cardioprotective effects. Keywords: arterial hypertension, ramipril, indapamide For citation: Kochetkovа I.V. Experience of using a fixed combination of ramipril and indapamide in clinical practice. Consilium Medicum. 2021; 23 (1): 103–108. DOI: 10.26442/20751753.2021.1.200759

scholarly journals EXPRESS: Association of daily physical activity with psychosocial aspects and functional capacity in patients with Pulmonary Arterial Hypertension: a cross-sectional study

2021 ◽  
pp. 204589402199995
Author(s):  
Layse Nakazato Lima ◽  
Felipe Mendes ◽  
Ilma Paschoal ◽  
Daniela Oliveira ◽  
Marcos Mello Moreira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Functional Capacity ◽  
Daily Physical Activity ◽  
Cross Sectional ◽  
Pulmonary Arterial ◽  
The Mean

Pulmonary arterial hypertension (PAH) impairs exercise tolerance and daily physical activity (PA). Aside from the hemodynamic limitations, physical, cognitive and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the PA level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the PA level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable PAH subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the anxiety and depression scale (HADS), and the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Transthoracic echocardiography, the 6-Minute walk test (6MWT), the 1-minute sit-to-stand test (STST), and spirometry were performed. For statistical analysis we used Chi-square tests or Fisher's test as appropriate and the Mann-Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic PAH, and 20% had connective tissue disease . The mean daily step count was 4,280 ± 2,351, and the mean activity time was 41.6 ± 19.3 minutes. The distance covered (6MWT) was 451.5 m, and the number of movements (1-STST) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (HADS). There was a significant correlation between accelerometer data and walking distance (6MWT), number of movements (1-STST), level of daily physical activity (MRADL), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with PAH.

Valutazione Del Benessere Psico-Fisico Nell’aderenza Terapeutica Nelle Donne Con Malattia Renale Policistica Autosomica Dominante: Uno Studio Osservazionale

2019 ◽  
Vol 31 (3) ◽  
pp. 160-166
Author(s):  
Elena Brioni ◽  
Cristiano Magnaghi ◽  
Giulia Bruna Delli Zotti ◽  
Eleonora Sangiovanni ◽  
Maria Teresa Sciarrone Alibrandi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Blood Pressure ◽  
Kidney Disease ◽  
Educational Intervention ◽  
Water Intake ◽  
Pharmacological Therapy ◽  
Therapeutic Education ◽  
Prospective Longitudinal

BACKGROUND: Autosomal dominant polycystic kidney disease is the most common inherited renal disease and affects less than 1 every 400-1,000 people. There are many effective treatments, including blood pressure management, physical activity, low sodium diet and hydration. Therapeutic education is part of a patient’s care and treatment. This approach is an essential strategy in order to face the current healthcare scenario, in which the number of people affected by chronic diseases is progressively increasing. OBJECTIVES: This article aims to analyze the effect of therapeutic education in patients with ADPKD, the level of adherence to pharmacological therapy and their compliance to dietetic and lifestyle recommendations as part of a nursing-led education. METHODS: This is a prospective, longitudinal, observational pilot study. The following measurements were used: Kidney Disease Quality of life - Short Form, Hospital Anxiety and Depression Scale, Body Uneasiness Test. At the T0 visit, a nurse selected patients and carried out a personalized educational intervention with the aims of adhering to drug therapies, monitoring blood pressure and dietary behavior (physical activity and water intake). At the T1 visit, patients performed psychological tests. At the T2 visit, the following evaluations were performed: a psychological interview together with the delivery and evaluation of the tests performed, an interview with the nurse to evaluate the adherence to the prescriptions, and a control of parameters such as physical activity, diet, water intake, drug therapy, and blood pressure. RESULTS: Therapeutic education can have a positive impact on patients’ health by improving adherence to the pharmacological therapy, diet and lifestyle. CONCLUSIONS: Therapeutic education improve the patient’s knowledge, treatments and correct behaviors as well as promotes an independent management of the disease. Through an educational intervention, the patient acquires the ability and the awareness to modify the wrong behaviors and to guarantee a balance between his needs and the pathology, thus improving the quality of life.

scholarly journals Presenting Health Status in Children Using a Radar Plot

Sports ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 53 ◽  
Author(s):  
Asgeir Mamen ◽  
Lars Erik Braaum ◽  
Per Morten Fredriksen
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Blood Pressure ◽  
Health Status ◽  
Vigorous Physical Activity ◽  
Density Lipoprotein ◽  
Activity Level ◽  
Cholesterol Concentration ◽  
Lower Systolic Blood Pressure

Background: To try out the feasibility of presenting the health status of children 6 to 12 years old by using radar plots. Methods: With data from the Health Oriented Pedagogical Project (HOPP) we have described the health status for 1340 children aged 6 to 12 years. We collected or calculated: stature, body mass, waist circumference, waist to height ratio, high density lipoprotein (HDL) and total cholesterol concentration, blood pressure, accelerometer assessed physical activity, endurance interval running performance, and quality of life. Pertinent variables were presented through a radar plot for both individual cases and groups. Results: The boys showed better endurance and recorded more moderate to vigorous physical activity than the girls. The activity level dropped from age 6 to age 12 for both sexes. The girls showed a lower systolic blood pressure compared with boys. Self-rated quality of life was high among boys and girls. Conclusions: This cohort showed good health and the radar plot made it easy to visualise health status for groups and individuals.

scholarly journals Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy

2018 ◽  
Vol 46 (5) ◽  
pp. 1779-1790 ◽  
Author(s):  
Evangelos Agathos ◽  
Anastasios Tentolouris ◽  
Ioanna Eleftheriadou ◽  
Panagiota Katsaouni ◽  
Ioannis Nemtzas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Body Weight ◽  
Diabetic Neuropathy ◽  
Lipoic Acid ◽  
Social Life ◽  
Brief Pain Inventory ◽  
Arterial Blood ◽  
Acid Administration

Objective To examine the effect of α-lipoic acid on neuropathic symptoms in patients with diabetic neuropathy (DN). Methods Patients with painful DN were treated with 600 mg/day α-lipoic acid, orally, for 40 days. Neuropathy Symptom Score (NSS), Subjective Peripheral Neuropathy Screen Questionnaire (SPNSQ) and douleur neuropathique (DN)4 questionnaire scores were assessed at baseline and day 40. Quality-of-life treatment effects were assessed by Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI) and Sheehan Disability Scale (SDS). Changes in body weight, arterial blood pressure, fasting serum glucose and lipids were also assessed. Results Out of 72 patients included, significant reductions in neuropathic symptoms were shown by reduced NSS, SPNSQ and DN4 scores at day 40 versus baseline. BPI, NPSI, and SDS in terms of work disability, social life disability, and family life disability scores were also significantly reduced. Moreover, 50% of patients rated their health condition as ‘very much better’ or ‘much better’ following α-lipoic acid administration. Fasting triglyceride levels were reduced, but no difference was found in body weight, blood pressure, fasting glucose, or other lipids at day 40 versus baseline. Conclusions A-lipoic acid administration was associated with reduced neuropathic symptoms and triglycerides, and improved quality of life.

scholarly journals Self-perception: Does Obesity Influence Quality of Life

2021 ◽  
Author(s):  
Amra Zalihic ◽  
Maja Barbaric ◽  
Mirela Mabic ◽  
Marnela Palameta ◽  
Ankica Mijic Maric ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Body Weight ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Self Perception ◽  
Cross Sectional ◽  
Overweight People ◽  
The World

Abstract The number of obese and overweight people around the world rapidly grows and takes on epidemic proportions. The aim of this research is to determine the influence of body weight on quality of life and to investigate our patients' consciousness about their body weight and its impact on their quality of life.Methods : The cross-sectional study was conducted by interviewing 1067 respondents, using the WHOQOL-BREF questionnaire.Results : Out of 1067 patients, 684 were females. 65.5 % of patients had BMI ≥25 kg/m 2 . 21.7% of 699 patients who had BMI ≥25 kg/m 2 think that their increased body weight doesn’t affect their health, 27.9 % of respondents think that their overweight is unrelated to physical activity, 41.8 % of respondents have no problems purchasing the clothes due to their weight and 31.6 % of respondents with BMI ≥25 kg/m 2 think that it doesn’t affect their quality of life.Conclusion : Quality of life is significantly better in respondents with BMI <25 kg/m 2 . The alarming result is that slightly less than half of respondents think that overweight doesn’t affect their health and don’t understand the seriousness of the problem.

scholarly journals The Distance Monitoring of Blood Pressure as a Tool for Improving of the Quality of Follow-Up Observation of Patients with Arterial Hypertension

2021 ◽  
Vol 11 (4) ◽  
pp. 255-263
Author(s):  
I. A. Starodubtseva ◽  
Yu. A. Sharapova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Cardiovascular Complications ◽  
Pressure Monitoring ◽  
Blood Pressure Targets ◽  
Distance Counseling ◽  
The Right

This article focuses on the distant blood pressure monitoring for patients with arterial hypertension. As numerous studies show, even slightly elevated blood pressure significantly raises the risk of cardiovascular complications. And, vice versa, a 5 mmHg decrease in blood pressure reduces the lethality risk. Therefore, it is not enough to prescribe the right medication but also it is of paramount importance to monitor patients’ compliance with the treatment. Clinical observation of patients with arterial hypertension is an effective tool for the prevention of cardiovascular complications. However, to date, the coverage of follow-up and the achievement of blood pressure targets in patients with arterial hypertension is one of the most problematic aspects. Distance monitoring of blood pressure opens more opportunities for the doctor’s involvement, timely assessment and adjustment of the medication. The results of domestic and foreign research show high efficacy of the distance blood pressure monitoring. Positive results regarding the achievement of target blood pressure after 3 months are shown when using the technology of blood pressure monitoring and distance counseling of patients with arterial hypertension. In particular, the article considers the technology of mobile health care (mHealth), which is a more flexible platform for a patient’s continuous self-care.

scholarly journals Maintenance of physical activity and body weight in relation to subsequent quality of life in postmenopausal breast cancer patients

2010 ◽  
Vol 21 (10) ◽  
pp. 2094-2101 ◽  
Author(s):  
D.W. Voskuil ◽  
J.G.H. van Nes ◽  
J.M.C. Junggeburt ◽  
C.J.H. van de Velde ◽  
F.E. van Leeuwen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Activity ◽  
Body Weight ◽  
Cancer Patients ◽  
Postmenopausal Breast Cancer ◽  
Breast Cancer Patients

scholarly journals A Prospective Randomized Controlled Trial to Study the Impact of a Nutrition-Sensitive Intervention on Adult Women With Cancer Cachexia Undergoing Palliative Care in India

2016 ◽  
Vol 16 (1) ◽  
pp. 74-84 ◽  
Author(s):  
Neha Kapoor ◽  
Jane Naufahu ◽  
Sundus Tewfik ◽  
Sushma Bhatnagar ◽  
Rakesh Garg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Body Weight ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Controlled Trial ◽  
Intervention Group ◽  
Randomized Controlled ◽  
Nutrition Sensitive

Purpose. Advanced cancer patients with disease progression develop cachexia. Nevertheless, cancer patients at nutritional risk have shown improved body weight and quality of life with oral nutritional supplements. Method. This was a randomized controlled trial in adult female cancer patients (n = 63) attending palliative clinics, with symptoms of cachexia. Eligible patients were randomly distributed into control (n = 33) and intervention (n = 30) groups. Both groups were provided with nutritional and physical activity counseling, but the intervention group received an additional 100 g of Improved Atta (IAtta) for 6 months daily consumption. This study was designed to assess the efficacy of IAtta (with counseling) in enhancing the health status of cachexic patients. Anthropometric measurements, dietary intake, physical activity level and quality of life parameters were assessed at baseline, after 3 months, and at the end of 6 months. Results. Patients in the control group (n = 15) had significantly decreased body weight ( P = .003), mid–upper-arm circumference ( P = .002), and body fat ( P = .002) by the end of intervention. A trend of body weight gain in the intervention group (n = 17; P = .08) and significant increase of body fat ( P = .002) was observed; moreover, patients reported a significant improvement in fatigue ( P = .002) and appetite scores ( P = .006) under quality-of-life domains at the end of intervention. Conclusions. Embedding a nutrition-sensitive intervention ( IAtta ) within Indian palliative care therapy may improve quality of life and stabilize body weight in cancer cachexia patients.

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