scholarly journals Optimization of premedication of patients with arterial hypertension and severe ventricular rhythm disturbances with Amiodarone-associated thyrotoxicosis

2021 ◽  
Vol 7 (4) ◽  
pp. 55-62
Author(s):  
Andrey V. Safronenko ◽  
Sergey V. Lepyavka ◽  
Igor A. Demidov ◽  
Marina I. Nazheva ◽  
Yuri S. Maklyakov
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Dynamic Assessment ◽  
Cardiovascular Complications ◽  
Systemic Hemodynamics ◽  
Clinical Group ◽  
Type I ◽  
Daily Monitoring ◽  
Pressure Load ◽  
Long Acting

Introduction: The effectiveness of premedication of patients with arterial hypertension and severe ventricular rhythm disturbances against the background of Amiodarone-associated thyrotoxicosis, high anxiety and cyclothymiae disorders should be based on the pharmacological positions of the need to reduce the risk of dangerous adverse cardiovascular reactions. Materials and methods: During the research, a clinical group of 114 patients with arterial hypertension, severe ventricular arrhythmias and Amiodarone-associated type I thyrotoxicosis was formed: four subgroups were identified. In Subgroup 1 (n=22), no premedication was given. In Subgroup 2 (n=32), premedication was given with Diazepam and magnesium sulfate in a prolonged mode. In Subgroup 3 (n=30), the patients received Diazepam the day before surgery. In Subgroup 4 (n=30), premedication was given with Midazolam. A dynamic assessment of the severity of anxiety, depression, sedation and daily monitoring of blood pressure and ECG were carried out. Results and discussion: After surgery, in Subgroup 1, the level of anxiety and depression increased. In all other Subgroups, regardless of the type of premedication, the use of benzodiazepines was accompanied by a decrease in the level of anxiety after surgery. A decrease in pressure load and an increase in the stability of the parameters of systemic hemodynamics were registered in Subgroup 2 of patients, whereas in Subgroup 4 of patients, the pressure load increased while limiting the differences in blood pressure values during the day. After surgery, in Subgroup 2, cardiac rhythm disturbances were less common; in Subgroup 3, the structure of rhythmogenesis disturbances in the heart almost did not change, and in Subgroup 4, there was an unfavorable trend of an increase in the frequency of supraventricular, single and group ventricular extrasystoles. Conclusion: The prolonged premedication with long-acting benzodiazepines and magnesium preparations in patients with arterial hypertension, ventricular rhythm disturbances against the background of Amiodarone-associated thyrotoxicosis reduces the level of anxiety, as well as the risk of developing cardiovascular complications and instability of systemic hemodynamics.

The optimal combination of Lysinopril and Amlodipine for the treatment of patients with hypertension

2020 ◽  
Vol 1-2 (211-212) ◽  
pp. 31-39
Author(s):  
Gulnara Junusbekova ◽  
◽  
Meiramgul Tundybayeva ◽  
Tatyana Leonovich ◽  
Manshuk Yeshniyazova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Cardiovascular Complications ◽  
Antihypertensive Activity ◽  
Daily Monitoring ◽  
Very High

Arterial hypertension (AH) remains one of the most common diseases in the world. Reducing cardiovascular risk of mortality from cardiovascular complications is a priority in the treatment of hypertension. Targets of hypertension therapy is to achieve SBP/DBP <140/80 mm Hg. article, regardless of cardiovascular risk and comorbidity. The choice of antihypertensive therapy depends on blood pressure levels, the presence or absence of concomitant diseases, lesion of target organs. Effective and long-lasting control of AH proved by the use of combinations of antihypertensive drugs, including antagonists and ACE inhibitors. The purpose of the study. Evaluation of clinical efficacy and safety of fixed combination antihypertensive therapy using lisinopril combined with amlodipine in patients with hypertension. Material and methods. The study included 30 respondents from essential hypertension II-III degree (ESH/ESC, 2018) aged 35 to 75 years. Patients were treated with the schema a (lisinopril 10 mg, amlodipine 5 mg) and scheme b (lisinopril 20 mg, amlodipine 10 mg) fixed combination therapy with the drug VivaCor® once in the morning. The period of observation was 3 months. At the time of inclusion and at the end of the study all respondents was performed echocardiography, daily monitoring of blood pressure, evaluation of laboratory and instrumental methods of research. Results and discussion. The combination of lisinopril with amlodipine has a fairly high antihypertensive activity, provides a significant cardioprotective effect and is an integral part of antihypertensive therapy in the long-term strategy of administering patients with high hypertensive / very high total cardiovascular risk. Conclusions: 1. The use of a fixed combination of lisinopril and amlodipine in patients with hypertension instead of free or other two-component combinations leads to its target level within 3 months of therapy. 2. Taking a fixed combination of lisinopril and amlodipine is effective and safe. 3. Therapy using the combined drug VivaCor® in patients with high / very high risk of hypertension prevents further pathological remodeling of the heart. 4. The combination of amlodipine and lisinopril is metabolically neutral and well tolerated by patients. Keywords: arterial hypertension, lisinopril, amlodipine, VivaCor.

Modern approach to the treatment of arterial hypertension

2021 ◽  
pp. 28-34
Author(s):  
Dmitriy Sergeevich Kovalev
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Pathological Condition ◽  
Cardiovascular Complications ◽  
European Population ◽  
Modern Approach ◽  
Appropriate Treatment ◽  
Literary Sources ◽  
The Impact

Arterial hypertension (AH) refers to an increase in blood pressure above the level of 140/90 mm Hg; the risk of cardiovascular complications increases significantly with this pathological condition. Thus, arterial hypertension is an independent risk factor for the development of prediabetes / type 2 diabetes mellitus, heart failure, coronary heart disease, chronic kidney damage, and multifocal atherosclerosis. The frequency of arterial hypertension occurrence varies in different countries: in particular, it is from 23 to 36% for the European population, according to various literary sources. The main goal of treatment is to minimize the overall risk of developing cardiovascular complications. This involves the impact on all identified reversible risk factors, such as smoking and high cholesterol levels, and most importantly, appropriate treatment of concomitant diseases (diabetes mellitus, thyroid gland pathology, kidney disease, etc.), as well as the correction of high blood pressure.

scholarly journals Effects on cognitive function, psychoemotional state, efficiacy and safety of antihypertensive therapy by metoprolol retard in females with the mild to moderate hypertension

2006 ◽  
Vol 12 (4) ◽  
pp. 358-361
Author(s):  
T. S. Poljatykina ◽  
I. E. Mishina ◽  
G. I. Bulychev ◽  
V. L. Geller ◽  
G. I. Sevastjanova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Cognitive Function ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Moderate Hypertension ◽  
Combined Therapy ◽  
Psychoemotional State ◽  
Long Acting

The paper presents the results of research in which 50 women with essential hypertension illness (arterial hypertension I-II degree) have taken part. 20 patients received long-acting metoprolol therapy (Egilok - retard, EGIS AO) in the dose of 25-100 mg, if necessary in a combination with hydrochlorothiazide 25 mg. In group of comparison (30 subjects) treatment with enalapril (5-10 mg/сут) or by a combination of enalapril and hydrochlorothiazide was administarted. It is shown, that monotherapy by metoprolol-retard allowed to reach a «target» levels of blood pressure in 89,5 % of women, in 10,5 % cases the combined therapy was required. At 12-week of treatment significant improvement of parameters of concentration of attention and anxiety decrease was observed.

scholarly journals PECULIAR FEATURES OF STRUCTURAL AND FUNCTIONAL INDICES OF CARDIOVASCULAR SYSTEM IN YOUNG MEN WITH ARTERIAL HYPERTENSION ASSOCIATED WITH METABOLIC SYNDROME

2017 ◽  
Vol 34 (6) ◽  
pp. 17-21
Author(s):  
R T Rizvanova ◽  
N I Maksimov
Keyword(s):  
Arterial Hypertension ◽  
Cardiovascular System ◽  
Antihypertensive Therapy ◽  
Dynamic Assessment ◽  
Young Men ◽  
Systolic Arterial Pressure ◽  
Cardiovascular Complications ◽  
Group 2 ◽  
Functional Indices ◽  
Group 1

Aim. To carry out dynamic assessment of the structural and functional indices of cardiovascular system in young men with arterial hypertension (AH) associated with excess body mass (Ebm) against the background of therapy. Materials and methods. Examination of 86 young men aged 18-27 years, including the group of comparison with practically healthy persons ( n = 24) and the group of observation ( n = 62) was performed. The group of observation joined patients with AH without EBM and AH+EBM. The study was conducted initially and 6 months later. Patients with AH+EBM ( n = 25) were divided into 2 subgroups: group 1 (12 persons) without therapy and group 2 (13 persons) against the background of antihypertensive therapy. Results. Six months later, in group 1 there was observed a growth of “office” systolic arterial pressure (SAP) by 3,8 % (145,0 ± 2,88 and 150,54 ± 2,99 Hg mm), p = 0,001, but in the group with antihypertensive therapy, SAP decreased by 12,7 % (145,75 ± 2,80 and 129,33 ± 1,5 Hg mm), p = 0,01 and DAP - by 12,1 % (86,5 ± 1,95 and 77,16 ± 2,41 Hg mm), p = 0,02. Pulse wave propagation velocity (PWPV) along the vessels of muscular and elastic types among patients without therapy was found to grow in dynamics by 12,2 and 16,2 %, respectively. Against the background of therapy, there was a tendency to a reliable reduction in PWPV indices. Conclusions. Antihypertensive therapy in patients with AH+EBM, while decreasing AP, leads to reduction of LVMM, LVMMI, PWPV and IMCV. The early diagnosed lesion of target organs among young men with AH+EBM and timely antihypertensive therapy can improve structural and functional characteristics of cardiovascular complications.

scholarly journals The clinical case of successful combined treatment of refractory arterial hypertension. Case report

2021 ◽  
Vol 93 (9) ◽  
pp. 1086-1090
Author(s):  
Tatiana D. Solntseva ◽  
Anastasiia R. Denisova ◽  
Olga A. Sivakova ◽  
Nikolai M. Danilov ◽  
Dmitrii V. Pevzner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Renal Denervation ◽  
Clinical Case ◽  
Combined Treatment ◽  
Cardiovascular Complications ◽  
Refractory Hypertension ◽  
Clinical Variant

In recent years, there has been an increase of patients with arterial hypertension, one of the variants of which is refractory arterial hypertension. This unfavorable clinical variant of the course of hypertension worries clinicians, due to the higher risk of developing cardiovascular complications, realizing the need for a better control of blood pressure. The presented clinical case demonstrates the successful combined treatment of refractory hypertension using antihypertensive therapy and renal denervation.

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.

When to expect cognitive disorders in hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Khomazyuk ◽  
V.U Krotova
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Arterial Hypertension ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Cognitive Disorders ◽  
Monitoring Data ◽  
Moderate Degree ◽  
Daily Monitoring ◽  
Systolic Blood Pressure Variability

Abstract   In large-scale clinical studies, age, arterial hypertension (AH), multi-focal atherosclerosis, and cognitive disorders (CD) are interrelated, affecting the level of disability, quality of life, and social adaptation of patients with cardiovascular diseases. Aim of the study To determine the prognostic criteria for cognitive disorders in patients with hypertension. Methods To achieve the aim of the study, the examinations were performed in 182 outpatients with AH II stage, 34–68 years, in 164 of them were CD according to neuropsychological tests of MMSE and MoCA, mostly of mild and moderate degree. The relationship between clinical data, cognitive function characteristics and daily monitoring data of hypertension were evaluated. The data obtained were analyzed using medical methods statistics. Results Among factors such as age (&gt;60 years), gender (male / female), disease duration (&gt;10 years), waist circumference, overweight or obesity, hypercholesterolemia, no influence on the development of CD was detected (p&gt;0.05)). Risk factors for the development of CD in hypertension were an burdensome history of CD in closest relatives (2.79 (95% CI 1.15–6.77) relative to practically healthy individuals and 2.41 (1.01–5.88)), high vegetative index (rs +0,15; p&lt;0,05). The correlation between CD and high rates of blood pressure variability according to daily monitoring of blood pressure in patients with hypertension, even under conditions of blood pressure control, is confirmed by the results of correlation and one-factor logit analysis. Thus, elevated levels of systolic blood pressure variability in the day and at night increased the chances of developing CD in patients with hypertension by 2.11 times, (rs = +0.57 and rs = +0.61; p&lt;0.001). It was found that the likelihood of developing cognitive impairment exceeds 50% (high risk) if the level of systolic blood pressure variability is above 12 mm Hg in the day (area under ROC curve AUC = 0.891; 95% CI 0.883–0.940. (AUC = 0.891; 95% CI 0.883–0.940; ST = 82.5% and SP = 92.9%) and at night over 10 mm Hg (AUC = 0.922; 95% CI 0.861–0.963; ST = 82.5% and SP = 85.7%) according to daily blood pressure monitoring. Conclusion The prognosis for the development of cognitive impairment in arterial hypertension is influenced by: evidence of family CD history, autonomic nervous system index and variability of day and night blood pressure characteristics, according to ambulatory daily monitoring data. Funding Acknowledgement Type of funding source: None

Abstract P084: When To Expect And Why To Analyze Cognitive Disorders In Arterial Hypertension

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Viktoriia Krotova ◽  
Tatyana Khomazyuk
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cognitive Impairment ◽  
High Risk ◽  
Arterial Hypertension ◽  
Social Activity ◽  
Life Quality ◽  
Cognitive Disorders ◽  
Daily Monitoring ◽  
Close Relatives

To study the relationship between quality of life (LQ) and cognitive impairment, as well as to identify risk factors for their development in patients with arterial hypertension (AH). Examined 509 outpatients with controlled AH stage II with SCORE risk of CVD <5 %. Non-dementia cognitive impairment were found 24,32±0,11 points on МCA scale in 164 (32.2 %). Patients also demonstrated a significant (p <0.001) decrease in the LQ indicators on all SF-36 scales compared to healthy ones by an average of 24.5-66.0 points. According to the results of correlation analysisthe most significant was the direct relationship between cognitive impairment on МCA scale and assessment of physical health (rs=+0,65; p<0,001), mental health (rs=+0,60; p<0,001), life activity limitations (rs=+0,33; p<0,001) and social activity (rs=+0,35; p<0,001), indicating an association between deterioration in LQ components and cognitive impairment.It turned out that the risk factors for developing cognitive impairment with AH were a history of cognitive impairment in close relatives (2.79 (95 % CI 1.15-6.77) compared with healthy people and 2.41 (95 % CI 1.01-5.88) - AH patients without cognitive impairment), a high vegetative index (rs +0.15; p <0.05) according to daily monitoring of BP and elevated levels of systolic BP variability in day and at night, that increased the chances of developing cognitive impairment in AH patients by 2.11 times, (rs = + 0.57 and rs = + 0.61; p<0.001). It was found that the likelihood of developing cognitive impairment exceeds 50 % (high risk) if the level of systolic BP variability is above 12 mm Hg in day (area under ROC curve AUC = 0.891; 95 % CI 0.883-0.940. (AUC = 0.891; 95 % CI 0.883-0.940; ST = 82.5 % and SP = 92.9 %) and at night – over 10 mm Hg (AUC = 0.922; 95 % CI 0.861-0.963; ST = 82.5 % and SP = 85.7 %) according to daily BP monitoring. In patients with AH for more than 10 years with dissatisfaction of life quality, even with controlled blood pressure, the presence of cognitive impairment needs to be clarified in immediate families, and pay attention to the high autonomic index and variability of systolic blood pressure monitored day and night, due to the high risk of development and progression of cognitive impairment, which worsens the prognosis of cardiovascular events.

Early Disturbances of Ambulatory Blood Pressure Load in Normotensive Type I Diabetic Patients With Microalbuminuria

Diabetes Care ◽  
1992 ◽  
Vol 15 (11) ◽  
pp. 1614-1619 ◽  
Author(s):  
P. Y. Benhamou ◽  
S. Halimi ◽  
R. D. Gaudemaris ◽  
R. Boizel ◽  
M. Pitiot ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Diabetic Patients ◽  
Type I ◽  
Pressure Load ◽  
Blood Pressure Load

scholarly journals Prevention of Arterial Hypertension in Adolescents with Existing Risk Factors in Rural Clinics

2016 ◽  
pp. 60-66
Author(s):  
Larysa Matіukha ◽  
Nataliia Orlovska ◽  
Tetiana Buchanovska
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Absolute Risk ◽  
Family Doctor ◽  
Exertional Dyspnea ◽  
Sinus Arrhythmia ◽  
Daily Monitoring ◽  
The Family ◽  
The Impact

The objective: to determine the frequency and impact of risk factors among adolescent children in the countryside on the possibility of arterial hypertension (AH) development and to devise the family doctor recommendations for its prevention. Patients and methods. The cohort study of 214 children at the age of 12–17 years who attend Khotiv educational complex «Secondary school of I–III levels – gymnasium» in Kiev region was implemented in order to identify the elevated numbers of blood pressure (BP) and the impact of risk factors on the development of hypertension in future. The sociological poll about the existing risk factors for cardio-vascular disease, the measurement of height and weight with the following bodymass index (BMI) calculation, the Rufe’s test for evaluating the physical efficiency, the BP measurement in the office, the electrocardiography (ECG), the blood pressure daily monitoring (BPDM) and the ophthalmoscopy were carried out. Results. Pre-hypertension was revealed among 29 children that made 13,6±2,3% of respondents, and arterial hypertension was diagnosed for 25 children that made 11,6±2,2%. Arterial hypertension was detected 2.5 times more often among boys in comparison with girls (8,3±1,9% and 3,3±1,5% accordingly). Most of respondents with arterial hypertension were 141year1old children. The most common complaints of the respondents were sleep disturbance (59,3±3,6%), exertional dyspnea (57,0±3,4%), headache (41,1±3,4%) and rapid fatigue (21,0±2,8%). The following risk factors as sex, hereditary factor for arterial hypertension especially combined with diabetes, myocardial infarction, stroke; smoking of respondents, smoking of parents, overuse of products containing the excess of table salt, insufficient use of vegetables and fruit (less than 200 g/day or no daily usage), the use of energy drinks, inactive way of life, low physical activity, the change of body weight (the overweight and the underweight) were significant. Conclusions. The frequency of arterial hypertension among the examined children who live in the countryside is 11.6%, including 8.3% among boys and 3.3% among girls. The main risk factors of arterial hypertension are the overweight, the underweight, the family history of arterial hypertension, the smoking of parents and physical inactivity of children. It has been found out that the absolute risk of arterial hypertension development in future is 40 per cent higher among the smokers, 10 per cent higher among the children whose parents smoke, 20 per cent higher among the dyspn(o)eic respondents, 20 per cent higher among the underweight children, 30 per cent higher among the overweight children, 30 per cent higher among the children with the changes of the fundus of eye, 20 per cent higher among the children with sinus tachycardia and 40 per cent higher among children with a single supraventricular extrasystole or sinus arrhythmia.

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