Sympathometabolic profile of a fixed combination of lercanidipine with enalapril in the treatment of obese hypertensive patients (study review)

The publication highlights the main possibilities of fixed combinations of angiotensin-converting enzyme inhibitors with calcium channel blockers in the treatment of hypertension and the advantages of the combination of enalapril 20 mg / lercanidipine 10 mg in terms of sympathomodulatory properties. Clinical data are provided that indicate the benefit of using this combination in patients with hypertension and concomitant obesity

Regarding the management of an elderly patient with atrial fibrillation

The increase in the proportion of elderly people observed in the population is accompanied by an increase in the prevalence of age-related diseases, including atrial fibrillation. In the treatment of such patients it is necessary to discuss the feasibility of prescribing anticoagulants to prevent ischemic stroke and systemic thromboembolism. The article presents scales that are used to assess the risk of thromboembolic complications and the risk of bleeding. The parameters that should be taken into account when prescribing oral anticoagulants to elderly patients are determined, the principles of bleeding risk management are given. The listed risk factors for bleeding, which are modified, potentially modified and not modified. Attention is paid to the description of specific antidotes to oral anticoagulants, the use of which has expanded in recent years, so many health professionals should know the main pharmacological effects of these drugs, be able to assess their anticoagulant effect in critical conditions and optimally cancel if necessary.

Choosing the optimal antihypertensive therapy

The article considers approaches to the selection of optimal antihypertensive therapy in order to achieve the target blood pressure in patients with hypertension in accordance with the latest Recommendations on hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology; ESC), as well as the circadian rhythm of blood pressure. Fixed combinations of renin-angiotensin-aldosterone system blockers, which include angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors, with calcium antagonists should be preferred. Taking such a fixed combination at night can prevent the morning rise in blood pressure, when patients with hypertension usually have cardiovascular accidents.

Diagnosis and pharmacological treatment of chronic heart failure in accordance with the recommendations of ESC 2021

The article presents a new universal definition of chronic heart failure, patient’s phenotypes, algorithm for diagnostics of HF, considers the guidelines of their managements and the prognosis of the disease determiner’s factors. The article will be useful for cardiologists, doctors of the emergency departments.

The role of insulin-like growth factor-1 in prognostication metabolic disorders in patients with arterial hypertension

The article reviews the sources of scientific literature on the role of somatomedin - insulin-like growth factor-1 (IGF-1) in predicting the development of metabolic disorders in patients with hypertension, the depth of the search for a period of 10 years. It is noted that this scientific problem has been studied in different countries, the connection between IGF-1 deficiency and the occurrence of metabolic disorders in patients with hypertension (AH) is considered to be one of the predictors of cardiovascular disease. It was experimentally established that the study of the content of IGF-1 in the blood revealed a significant decrease in the level of somatomedin in groups of patients with varying degrees of hypertension. Studies have confirmed the pathogenetic role of IGF-1 deficiency in the development of left ventricular hypertrophy and heart failure in patients with hypertension in combination with type 2 diabetes mellitus (DM). It is the deficiency of IGF-1 in the blood was associated with the development of degenerative processes. Immune-modulating ability of IGF-1 has been established, antithrombotic and antiremodeling properties of somatomedin have been proved. It was found that people with normal blood pressure and people without signs of impaired glucose tolerance had significantly higher levels of IGF-1 in the blood. It is established that the study of the role of IGF-1 in the prediction of metabolic disorders in patients with hypertension is a promising scientific problem.

The use of potassium and magnesium supplements for cardiovascular diseases

The article substantiates the role of potassium and magnesium deficiency in the pathogenesis of cardiovascular diseases and the effectiveness of the use of combined preparations of these electrolytes, which has been confirmed in numerous clinical studies. The combination of potassium and magnesium aspartate has proven itself best in the complex therapy of arrhythmias, coronary heart disease (in particular, post-myocardial infarction), chronic heart failure, and arterial hypertension.

Gastric ulcer: etiological and pathogenetic causes

The causes of peptic ulcer of the stomach and duodenum so far not definitively established. The article analyzes two scientific theories of the origin of this disease, which in the process of practical research will be able to improve the treatment of patients with this fairly common pathology

The frequency of the main factors of cardiovascular risk and the presence of comorbidity in patients with chronic ischemic disease is the heart of the elderly and senile age

The purpose of the work is to study the frequency of the main factors of cardiovascular risk (CWR) and the presence of comorbidity in patients with coronary heart disease (CHD) in elderly and senile age. Materials and methods. A retrospective assessment of the case histories of 454 patients with coronary artery disease who underwent inpatient treatment at the cardiology department of the State Institution «Dmitry F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine» for the period from 1997-2017. All the examined patients were hospitalized for the first time and later were observed with the main diagnosis of IHD: stable angina of I–IV FC. The diagnosis of the underlying disease was established on the basis of general clinical examinations and special instrumental and laboratory methods in accordance with current recommendations for the diagnosis of coronary artery disease at the stage of examination of patients. Monitoring patients lasted from 5–20 years. Cardiovascular death was taken as the end point. Results. According to the data obtained in the elderly, the most common cardiovascular risk factors (CVR) are: arterial hypertension (AH), hypercholesterolemia (HChol), obesity, and diabetes mellitus (DM) are largely associated with the possibility of drug correction. In 70.2 % of IHD patients over 60 years old, a simultaneous combination of three or more CVR factors was detected. Conclusions. 1. The most common cardiovascular risk factors in IHD patients over 60 years old were hypertension (66.9 %), HChol (60.7 %), Obesity (23.9 %), and diabetes (14.3 %) are largely associated with the possibility of medical correction. 2. In the elderly, there is comparable data with the control group for the prevalence of the main factors of CVR. In older patients, the prevalence of smoking, obesity, and dyslipidemia was significantly lower than in the comparison groups. 3. In 70.2 % of IHD patients over 60 years old, a simultaneous combination of three or more RFs was revealed, which indicates the need for an active integrated approach to their correction at a younger age

Stress, distress, its types and correction

Chronic and acute, physiological, psychological and informational stress are considered. It is noted that stress is a protective reaction of the body in response to a very strong emotional, physical or psychological action from the outside. Instead, distress develops as a result of: prolonged inability to meet their physiological needs, unpleasant, sad and threatening changes in life, unusual, inappropriate living conditions, body damage, illness, injury, prolonged pain or negative emotions. The best way to deal with stress is to prevent it: regular walks in the fresh air, sports, adequate sleep and more. ADAPTOL® anxiolytic helps to curb excessive anxiety and irritability, to restore strength after the transferred stress.

Comparison of Effect of Nebivolol and Bisoprolol on Sexual Function of Hypertensive Female Patients

Introduction Male and female sexual dysfunction is frequently found in patients with hypertension. Many studies indicate that this is found more frequently in patients treated with beta-blockers rather than due to hypertension itself; however, almost all studies have been done on male population. This study aims to study the effect of two commonly used beta-blockers on sexual function of a hypertensive female patient. Methods This two-arm open-label randomized prospective study was conducted from April 1, 2019 to March 30, 2020 in a tertiary care hospital at Pakistan. One hundred and fifty participants randomized to group A were given nebivolol 5 mg once daily in addition to their current hypertensive treatment. Another 150 participants randomized to group B were given bisoprolol 5 mg once daily in addition to their hypertensive therapy. Sexual function was assessed on day 0 and day 90 using female sexual function index (FSFI). Results The mean sexual score in the nebivolol group significantly improved after day 90 in comparison to day 0 (24.16 ± 2.1 vs. 26.91 ± 2.6; p-value < 0.0001), while no difference in sexual score in bisoprolol group after day 90 was observed (24.14 ± 2.1 vs. 24.12 ± 2.0; p-value = 0.91). Conclusion In this study, nebivolol group was associated with a significant improvement in sexual function. This can be due to additional vasodilation properties and a low risk of sexual side effects associated with nebivolol. https://www.cureus.com/articles/59290-comparison-of-effectof-nebivolol-and-bisoprolol-on-sexual-function-of-hypertensivefemale-patients DOI: 10.7759/cureus.15062