USE OF NON-DRUG METHODS IN THE TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION

2021 ◽  
pp. 10-17
Author(s):  
Olga D. Lebedeva ◽  
Abduahat A. Achilov
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Clinical Effectiveness ◽  
Cellular Tissue ◽  
Active Treatment Group ◽  
Comprehensive Treatment ◽  
Therapeutic Exercises ◽  
Baseline Group ◽  
To Receive ◽  
Selection Of

The aim of the study is to optimize the comprehensive treatment of patients with severe arterial hypertension, through the use of multicomponent rational antihypertensive pharmacotherapy, followed by the use of unloading therapeutic exercises. 32 men with severe arterial hypertension were examined. Initially, a clinical, instrumental and laboratory examination, registration of blood pressure and its 24-hour monitoring were carried out. The average daily systolic (ADBPsyst.) and average daily diastolic (ADBPdiast.) blood pressure were determined. A multicomponent rational antihypertensive pharmacotherapy, according to the clinical recommendations for the treatment of arterial hypertension was selected for all the patients. In at least 3 months after the selection of pharmacotherapy, the patients were divided into two groups, comparable in gender, age, severity of the condition, features of the disease course and medicamentous therapy. Patients of the 1st group (active treatment group) against the background of pharmacotherapy were prescribed unloading therapeutic exercises according to a patented technique. The 2nd group of patients continued to take pharmacotherapy and it was used as a baseline group. The average age in the 1st and 2nd groups was 46,3±6,8 and 43,6±7,2 years, respectively. Patients of the 1st group were prescribed unloading therapeutic exercises and in 3 months in both groups the ADBPsyst. and ADBPdiast. were compared. Initially, there was a significant increase in ADBPsyst. and ADBPdiast. compared to the normal range in both groups. These indicators in both groups differed insignificantly. In 3 months after pharmacotherapy, there was a significant decrease in ADsyst. and ADdiast. in both groups, but these indicators remained elevated and did not reach the target level. Then, in the 1st group, unloading therapeutic exercises were included in the comprehensive treatment. Patients of the 2nd group continued to receive pharmacotherapy. In 3 months after including unloading therapeutic exercises in the 1st group, there was a significant decrease in ADBP (syst. and diast.) not only in comparison with the initial data, but also with the data in 3 months after pharmacotherapy. In the 2nd group, these indicators did not change significantly compared to the three-month data. In 6 months, ADBPsyst. and ADBPdiast. in the 1st group were significantly lower compared to similar indicators in the 2nd group, which proves significant clinical effectiveness of unloading therapeutic exercises in patients of the 1st group. The results obtained confirm that patients with severe arterial hypertension have such types of disorders at the cellular-tissue and microcirculatory level that are not eliminated only by drug therapy. For their high-grade correction, along with multicomponent pharmacotherapy, it is necessary to include unloading therapeutic exercises. To optimize the treatment of severe arterial hypertension against the background of receiving multicomponent antihypertensive pharmacotherapy, it is recommended to include unloading therapeutic exercises in the therapeutic complex.

Abstract 179: Racial-ethnic Blood Pressure Differences in Acute Intracerebral Hemorrhage.

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Sebastian Koch ◽  
Mitchell S Elkind ◽  
Fernando D Testai ◽  
Mark W Brown ◽  
Sharyl R Martini ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracerebral Hemorrhage ◽  
Group Differences ◽  
Baseline Group ◽  
Racial Variations ◽  
Acute Intracerebral Hemorrhage ◽  
Baseline Characteristics ◽  
To Receive ◽  
Racial Ethnic ◽  
Control Study

Background: Intracerebral hemorrhage (ICH) incidence and hypertension prevalence vary among racial-ethnic groups. Elevated blood pressure (BP) is common following ICH, but there are few racial/ethnic comparisons of acute BP. This study assessed the BP response to acute ICH in a multi-ethnic population. Methods: We examined BP in the field (EMS), emergency department (ED) and at 24 hours after ICH in subjects enrolled in the Ethnic Racial Variations of Intracerebral Hemorrhage (ERICH) study. ERICH is a multi-center prospective case-control study of ICH in non-Hispanic whites (whites), non-Hispanic blacks (blacks) and Hispanics. Baseline characteristics and BP recordings by EMS, in the ED and at 24 hours were analyzed for group differences. Results: Of 1052 subjects enrolled, BP recordings were available by EMS in 370, ED in 1041 and at 24 hours in 1014 cases of which 24% were white, 42% black and 34% Hispanic. Whites were significantly older 68± 14 years than blacks (58±13 years) and Hispanics (59± 15 years) (p≤0.0001) and had more lobar hemorrhages (39% vs. 23% blacks and 26% Hispanics; p≤0.0001). Baseline differences included larger hematoma volumes, in whites, and more frequent hypertension history and substance use, including cocaine use and smoking, in blacks. Blacks and Hispanics had significantly higher EMS (p=0.0001) and ED (p=0.0001) systolic BPs compared to whites (blacks: 198± 39, 195± 37; Hispanics: 191± 41, 191± 39; whites: 173± 37, 176± 37 mmHg). At 24 hours blacks had a higher systolic BP (144± 25 mmHg; p=0.0014) than Hispanics and whites (139± 21 and 138± 22 mmHg). These differences remained significant after adjustment for baseline group differences, including lobar and deep location. In multivariate analysis, low GCS and being black were associated with a systolic BP> 140mmHg at 24h. Blacks were more likely to receive BP treatment in the ER when compared to whites and Hispanics (76% vs. 52% and 68%). Conclusion: We found significant differences in the acute BP response to ICH, with blacks and Hispanics having a higher systolic BP at acute presentation. At 24 hours systolic BP remained elevated in blacks. These findings contribute to our understanding of racial-ethnic differences in BP and identify groups at risk for continued BP elevation.

scholarly journals Selection of Patients with Resistant Arterial Hypertension for the Catheter-Based Renal Sympathetic Denervation

Kardiologiia ◽  
2019 ◽  
Vol 59 (4) ◽  
pp. 21-25
Author(s):  
E. V. Frolova ◽  
A. N. Vachev ◽  
N. V. Morkovskikh ◽  
V. K. Koryttsev
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Sympathetic Denervation ◽  
Renal Sympathetic Denervation ◽  
Vascular Insufficiency ◽  
Hypotensive Therapy ◽  
Resistant Arterial Hypertension ◽  
Selection Of Patients ◽  
Selection Of ◽  
Renal Sympathetic

Purpose: elaboration of algorithm for selection of patients with resistant arterial hypertension (AH) for Catheter-Based Renal Sympathetic Denervation (CBRSD). Materials and methods. We examined 284 patients with resistant AH. On stage 1 we excluded most frequent causes of secondary AH. In 247 patients (86.9 %) we established secondary character of AH, in 37 patients (13.1 %) AH was found to be essential. On stage 2 patients with essential AH were given 3–5 component hypotensive therapy. At the background of this therapy we conducted 24‑hour ambulatory blood pressure monitoring (ABPM). CBRSD procedure was considered indicated if according to ABPM average 24‑hour blood pressure (BP) was above 150 and 100 mm Hg, and 24‑hour elevated BP load exceeded 60 %. In 13 of 37 patients (35 %) BP level satisfied these conditions. For CBRSD we used high frequency generator. Ablation was performed using the Symplicity Catheter. Results were assessed in 1, 2, 9, 12, and 28 months. Results.Target BP level at the background of minimal doses of hypotensive drugs was achieved in 11 patients (85 %), what was confirmed by ABPM data. Levels of mean 24–4 hour systolic and diastolic BP significantly decreased from 173.9±14.9 to 143±21.3, р<0.05, and from 108.2±8.7 to 91.4±13.8 mm Hg., р<0.05, respectively. Index of elevated systolic BP time decreased from 78.2±14.6 to 49.8±29.6 %, р<0.05. Best effect was achieved in patients with AH duration before the procedure less than 7 years. None of the patients had episodes of cerebral vascular insufficiency or heart failure progression. Conclusion. While determining indications to bilateral CBRSD one should be governed by such criteria as exclusion of symptomatic AH and objective proofs of AH resistance (according to ABPM at the background of hypotensive therapy). 

scholarly journals Is relaxation exercise therapy effective in the management of patients with severe arterial hypertension?

2021 ◽  
Author(s):  
Olga. D. Lebedeva ◽  
Abduahat A. Achilov ◽  
Zilola F. Mavlyanova ◽  
Alexey V. Baranov ◽  
Shachnosa A. Achilova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Exercise Therapy ◽  
Blood Pressure Monitoring ◽  
Pharmacological Therapy ◽  
Comprehensive Treatment ◽  
Arterial Blood ◽  
Promising Treatment ◽  
Male Patients ◽  
Relaxation Exercise

Arterial hypertension (AH) is a burning problem in the world. Antihypertensive pharmacological therapy combined by physical exercises is well-studied in patients with mild and moderate AH. However, studies that have investigated relaxation in patients with severe AH in addition to drug therapy are lacking. Optimization of a comprehensive treatment for patients with severe AH, by using a multicomponent rational antihypertensive pharmacotherapy (PT) with subsequent application of relaxation exercise therapy (RET). The study involved 32 male patients with severe AH. Initially, clinical-instrumental and laboratory examination, blood pressure registration and daily arterial blood pressure monitoring were carried out. Suitable PT was selected for all the patients. 3 months after starting PT the patients were divided in 2 groups. The patients of the 1st group were prescribed RET in addition to PT. The 2nd group of patients continued receiving PT alone. 3 months later, average daily blood pressure (ADBP)-syst and ADBP-diast were compared in both groups. Three months after PT both groups demonstrated a significant decrease in ADBP-syst and ADBP diast, but these indicators remained higher than normal and did not reach the target level. Three months after the inclusion of RET in the comprehensive treatment, the 1st group demonstrated a significant decrease in ADBP (systolic and diastolic), not only in comparison with the initial data, but also with the data observed three months after PT. After 6 months, ADBP-syst and ADBP-diast in the 1st group were significantly lower compared with those of patients in the 2nd group. The inclusion of RET in addition to a multicomponent antihypertensive PT is a promising treatment option for severe AH.

scholarly journals Influence of long-term controlled therapeutic exercises on blood pressure profile parameters, elastic properties of arterial wall, metabolic and mineral indices in females with arterial hypertension

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
T Petelina ◽  
SG Bykova ◽  
NA Musikhina ◽  
KS Avdeeva ◽  
EV Zueva ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Sex Hormones ◽  
Bone Mineral ◽  
Mineral Metabolism ◽  
Vascular Wall ◽  
Body Structure ◽  
Bone Mineral Metabolism ◽  
Therapeutic Exercises ◽  
Metabolic Indices

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia Objective To study the role of therapeutic exercises (TE) in the correction of blood pressure, stiffness of the vascular wall, metabolic indices of body structure (volume, mass, area of visceral fat)  and  bone mineral metabolism in postmenopausal hypertensive patients. Methods. The study included 138 patients (mean age was 58.32 ± 7.61 years). All patients are divided into 3 groups. The first control group is 20 women without arterial hypertension and menopausе. The second group consisted of 58 patients with arterial hypertension (AH) and postmenopause who was not undergone complex of TE and the 3rd group - 60 women with AH and postmenopause who was undergone TE complex. Patients of all groups were examined in dynamics: at the starting point of the study and in 12 months after, ambulatory monitoring of blood pressure; sphygmography; densitometry and test for serum biochemistry parameters of blood samples, including sex hormones, vitamin D. Results. In the course of the study, blood pressure, vascular wall stiffness parameters,  metabolic indices of body structure and disorder parameters of bone mineral metabolism  were comparable in group 2 and 3 against the background of significantly reduced levels of sex hormones. Multidirectional correlation relationships between the studied parameters are revealed. The basic therapy in combination with therapeutic exercises  led to a significant decrease in blood pressure and metabolic indices of body structure (p&lt;.001) and to  a persistent tendency of decrease  the pulse wave velocity and increase of bone mineral metabolism in gr.3. Conclusion. The result of the study indicates that the exercise therapy complex used in the form of regular classes  can be recommended for implementation in clinical practice with the aim of comprehensively affecting the patient’s body and developing personalized treatment tactics for postmenopausal women with hypertension.

The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Task ◽  
Well Being ◽  
Control Group ◽  
Double Blind ◽  
Main Effect ◽  
The Difference ◽  
Being There ◽  
To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

Meaning of innovative technologies for improvement of results in treating burned patients

2020 ◽  
pp. 44-47
Author(s):  
A. A. Alekseev ◽  
A. E. Bobrovnikov ◽  
V. V. Bogdanov
Keyword(s):  
Clinical Practice ◽  
Medical Care ◽  
Clinical Effectiveness ◽  
High Tech ◽  
Comprehensive Treatment ◽  
Case Histories ◽  
Innovative Technologies ◽  
Treatment Technologies ◽  
Burn Disease ◽  
Complications And Mortality

In order to include innovative technologies in clinical recommendations, confirmation of their clinical effectiveness in comprehensive treatment of burned patients is necessary. 1,696 case histories of patients with burns were audited, which are divided into two groups depending on peculiarities of treatment. The use of innovative treatment technologies for burned patients has reduced the incidence of burn disease complications and mortality. Introduction of innovative technologies in treating burned patients into broad clinical practice improves results of provision of specialized, high-tech medical care for victims of burns.

Ambulatory blood pressure monitoring-based definition of true arterial hypertension

2020 ◽  
Vol 111 (6) ◽  
Author(s):  
Ramón C. Hermida ◽  
Artemio Mojón ◽  
José R. Fernández ◽  
Alfonso Otero ◽  
Juan J. Crespo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Definition Of
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