Vol 13, No 1 (2016)


The role of b-blockers in treatment of hypertension, according to Russian and European experts

Ostroumova O.D., Fomina V.M., Shchukina G.N., Smoliarchuk E.A.


The article focuses on the use of b-blockers for the treatment of arterial hypertension (AH). Given the situation of modern Russian and European recommendations about the place of b-blockers in the treatment of AH, including their benefits with a combination of hypertension with coronary heart disease, chronic heart failure, atrial fibrillation. Analyzed the efficacy and safety of b-blockers in diabetes mellitus, metabolic syndrome, dyslipidemia, peripheral artery, chronic obstructive pulmonary disease, sexual dysfunction, in individuals of different age and gender. It is emphasized that the selection of b-blockers inside of a class is determined by its selectivity, the study in clinical studies, pharmacokinetic characteristics. Data about efficiency and safety of application of metoprolol succinate.
Systemic Hypertension. 2016;13(1):6-10
pages 6-10 views

Predictors of progression of atrial fibrillation in patients with arterial hypertension

Podzolkov V.I., Tarzimanova A.I.


Recently progress has been made in the study of the natural history of atrial fibrillation (AF) from the stage without clinical manifestations, to the final stage, represent an irreversible arrhythmia associated with the development of serious cardiovascular complications. The progression of the arrhythmia worsens the clinical status of patients and prognosis. Slowing down progression of AF should be considered as a priority treatment of this cardiac arrhythmia.Aim. The study the predictors of AF progression in patients with arterial hypertension.Materials and methods. The study included 136 patients with essential hypertension and paroxysms of AF. Prospective observation of the patients was carried out from 2011 to 2015. The progression of the arrhythmia was considered: increased frequency of paroxysms of AF; the emergence of long-term persistent attacks or permanent form of arrhythmia.The results of our work allow to conclude that the predictors of progression of AF in patients with hypertension and preserved systolic left ventricular function are: endothelial dysfunction, increased vascular wall stiffness, left ventricle hypertrophy and increased size of the left atrium.
Systemic Hypertension. 2016;13(1):11-14
pages 11-14 views

Regulatory adaptive status in determining the effectivenessof bisoprololum and sotalolum in patients with hypertensive disease and ventricular arrhythmias

Shubitidze I.Z., Tregubov V.G., Pokrovsky V.M.


Aim. Compare the effectiveness of treatment with bisoprololum or sotalolum in patients with hypertensive disease (HD) and ventricular arrhythmias (VA) taking into account quantitative evaluation of the regulatory adaptive status (RAS).Materials and methods. 48 patients with HD of stages II-III and VA of grade I-IV based on the В.Lown grading system, II-III groups based on J.Bigger grading system took part in the research, they were randomized into two groups for treatment with bisoprololum (6.2±1.7 mg/day) or sotalolum (159.1±47.4 mg/day). As part of combination therapy, patients were administered lisinoprilum (12.8±4.2 mg/day and 13.7±4.5 mg/day), acetylsalicylic acid when required (93.1±19.0 and 95.0±16.2 mg/day), atorvastatinum (15.9±4.6 mg/day and 15.6±4.9 mg/day), respectively. Initially and 6 months after therapy, the following was done: quantitative assessment of RAS (by cardio-respiratory synchronism test), echocardiography, triplex scanning of brachiocephalic arteries, treadmill test, six-minute walk test, all-day monitoring of blood pressure and electrocardiogram, subjective assessment of quality of life.Results. Both drug regimens comparably improved structural and functional condition of the heart, increased exercise tolerance, controlled arterial hypertension, effectively suppressed ventricular arrhythmia, improved the quality of life. At the same time, the use of sotalolum decreased the RAS to a lesser degree than the use of bisoprololum.Conclusion. In patients with HD of stages II-III and VA the use of sotalolum as part of combination therapy may be preferable to bisoprololum due to its less negative impact on the RAS.
Systemic Hypertension. 2016;13(1):15-21
pages 15-21 views

Current possibilities of nuclear imaging in arterial hypertension

Ansheles A.A., Sergienko V.B.


The review represents current possibilities of nuclear imaging methods in assessment of the functional status of various organs and biological processes in arterial hypertension.
Systemic Hypertension. 2016;13(1):22-28
pages 22-28 views

The possibility of perindopril in angioprotective in patients with metabolic syndrome after combination therapy with a thiazide diuretic

Nedogoda S.V., Smirnova V.O., Khripaeva V.Y., Palashkin R.V., Ledyaeva A.A., Chumachok E.V., Salasyuk A.S.


Aim. To assess the possibility of monotherapy with perindopril after transferring from combination therapy with losartan and hydrochlorothiazide with respect to correction of the anthropometric, metabolic parameters, premature vascular aging and vascular elasticity in patients with metabolic syndrome. Material and methods. Held open prospective controlled study of 50 patients with metabolic syndrome (IDF, 2005), which reached BP<140/90 mm Hg during three months of therapy with losartan (50 mg) + hydrochlorothiazide (12.5 mg) with conversion to monotherapy with perindopril 10 mg for 12 weeks. Patients were evaluated anthropometric and metabolic parameters, levels of adipokines, and indices of vascular elasticity and age was estimated on the date of the transfer with casinadirosa combination monotherapy with perindopril and after 12 weeks thereafter.Results. The results of the study demonstrated the possibility of a transfer with combination antihypertensive therapy monotherapy perindopril patients with metabolic syndrome that contributes to slow vascular aging, improve the elasticity of blood vessels, reduces inflammation and has a beneficial impact on adipokines.Conclusion. When achieved BP<140/90 mm Hg on combination with a thiazide diureticpossible in patients with MS monotherapy perindopril with consequent improvement in elasticity of blood vessels and of adipokines.
Systemic Hypertension. 2016;13(1):30-33
pages 30-33 views

The validation of the questionnaire for the early detection of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension

Valieva Z.S., Glukhova S.I., Martyniuk T.V., Chazova I.E.


The objective: to identify pathognomonic symptoms and signs of different groups of pulmonary hypertension (PH), analyze the possibility of early diagnosis of patients with PH and the validity of the questionnaire.Material and methods. The questionnaire consists of 6 sections: clinical symptoms, physical examination, anamnestic information; diseases associated with PH; signs of pulmonary arterial hypertension (PAH) according to electrocardiography, chest radiography, echocardiography. All sections of the questionnaire were filled by physician. Was held an analysis of clinical symptoms, medical history, physical examination, methods of instrumental examination of 81 patients with idiopathic PH in comparison with 29 patients with PAH due to congenital heart defects - PAH-CHD, 36 patients chronic thromboembolic PH - CTEPH and the control group - 48 patients with essential hypertension. In addition, the validity of the questionnaire was evaluated: structural, the criterion and discriminant validity.Results. The leading complaint in IPAH patients was syncope; in patients with PAH-CHD the most often detected signs were cyanosis and accentuated pulmonary component of 2d heart sound; in patients with CTEPH - cough, they had a history of venous thrombosis of the lower limbs and the debut of the disease has been associated with pregnancy.Conclusion. Development and validation of a screening questionnaire allows to improve approaches to early detection of various forms of PH, allows identify specific symptoms that more typical of definite forms of PH.
Systemic Hypertension. 2016;13(1):34-38
pages 34-38 views

MicroRNA in the diagnosis of chronic heart failure: state of the problem and the results of a pilot study

Zhirov I.V., Kochetov A.G., Zaseeva A.V., Liang O.V., Skvortsov A.A., Abramov A.A., Gimadiev R.R., Masenko V.P., Tereshchenko S.N.


The article provides information about the class of non-coding RNA (microRNA), their role in the diagnosis of chronic heart failure and the results of a pilot study.
Systemic Hypertension. 2016;13(1):39-46
pages 39-46 views

Loop diuretics in the treatment of hypertension and edema syndrome

Kirichenko A.A.


The comparison of the pharmacological properties, clinical efficacy of furosemide and torasemide in patients with hypertension and edema. Torasemid similar to furosemide mechanism of diuretic action but has a higher bioavailability (>80%) and a longer half-life (3-4 h). In-non-diuretic doses (2.5-5 mg/day) torasemide used in the treatment of essential hypertension, both as monotherapy and in combination with other antihypertensive drugs. When used in these doses torasemide reduces diastolic blood pressure to below 90 mm Hg in 70-80% of patients. In patients with chronic heart failure torasemide in a dose of from 5 to 20 mg/day is an effective diuretic. The bioavailability of torasemide when administered in patients with CHF decreases only slightly, the diuretic action is smoother, it is less likely to cause the phenomenon of "rebound". Total and cardiovascular mortality in patients treated with torasemide, was lower (2.2% compared with 4.5% in the comparison group; p<0.05). Pharmacokinetic parameters are not changed when torasemide III (GFR 30-59 ml/min) and IV (GFR 15-29 ml/min) CKD stages. In patients with chronic renal failure therapy furosemide torasemide and is accompanied by a comparable increase in natriuresis and blood pressure reduction.
Systemic Hypertension. 2016;13(1):47-51
pages 47-51 views

Pharmacological therapy, slows the heart rate, in patientswith hypertension and chronic heart failure: theory and application in clinical practice

Ponomareva A.I., Kompaniets O.G., Linchak R.M., Ivanchura G.S.


The purpose of the study is to determine the spectrum used drugsslows the heart rate in patients with arterial hypertension and chronic heart failure in clinical practice and compliance of prescribing with clinical guidelines.Materials and methods. Consistently formed a retrospective sample of medical records of patients with arterial hypertension and chronic heart failure. Used sources of primary medical documentation for 2012-2015 (320 patients). Estimated the amount and quality therapyslows the heart ratein patients with arterial hypertension and chronic heart failure.Results and discussion. b-blockers prescribed for 72.5% of patients. Calcium antagonists range recommended by 13.1%. On the background of optimal doses of b-blockers in patients with arterial hypertension and chronic heart failure with the exile faction of less than 40 and heart rate more than 70 BPM, ivabradine is not assigned in 81.3% of patients, although it is in these situations of particular urgency is the drug given its bright positive effect on hard end points, proved in international multicenter trials.
Systemic Hypertension. 2016;13(1):52-57
pages 52-57 views

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