The aim: to determine the peculiarities of the indices of coagulation hemostasis in patients with the former occurrence of hemorrhagic stroke, developed as a complication of essential hypertension, in comparison to the hypertensive patients without complications.
Materials and methods. There were formed 2 groups of patients: the main group and the comparison group. The main group included 20 patients (10 women and 10 men, middle age 52.9±1.7 (M±m) years old) who had undergone hemorrhagic stroke as a complication of essential hypertension 6 months and more previously, had no normalization of blood pressure over this period of time. The comparison group included 20 patients (10 women and 10 men, middle age 52.5±1.7 years old) suffered from essential hypertension without complications. They were matched groups according to key indicators. All the above-mentioned people underwent fasted analysis of venous blood with detection of coagulation hemostasis indices.
Results. In the main and the comparison group the indices of coagulation hemostasis were the following ones, respectively: thrombin time 10.6±0.6 and 11.5±0.8 s, international normalized ratio 1.0±0.1 and 1.0±0.1, activated partial thromboplastin time 50.4±2.1 and 44.7±1.8 s (p<0.05), protein C 139.2±8.0 and 143.8±10.2 %, fibrinogen 2,4±0.4 and 2.6±0.3 g/l, soluble fibrin-monomer complexes 3.9±0.2 and 3.7±0.1 μg/mL, XIIa-dependent fibrinolysis 6.3±0.9 and 10.2±0.6 min (p<0.05), antithrombin-III 90.0±6.6 and 76.1±6.8 %.
Conclusions. In the main group relatively to the comparison group there was slowing of the internal pathway of coagulation hemostasis with the quicker fibrinolysis. There was detected that 100 % of patients from the main group had at least one of the following factors out of normal values and with predisposition to bleeding: activated partial thromboplastin time >48 s, XIIa-dependent fibrinolysis <5 min, fibrinogen <2 g/l, or antithrombin-III >120 %. This information should be taken into account while prescribing the treatment, influencing hemostasis indices, in a category of hypertensive patients after hemorrhagic stroke
The aim — to compare the indices of diurnal blood pressure monitoring (DBPM) in patients with essential hypertension (EH) іn ≥ 6 months after hemorrhagic stroke (HS) before and after treatment with combination of amlodipine, valsartan, hydroclorothiazide (if necessary) and magnesium oxide monohydrate.Materials and methods. The main group included 33 patients, the comparison group comprised 13 persons. In the first group the office blood pressure (BP) was і 140/90 mm Hg, in the second one it was lower. The groups were matched by main indicators. DBPM was performed twice (before and after treatment) for the main group of patients, and once for the comparison group patients.Results and discussion. In the main group, before and after treatment the mean systolic blood pressure (SBP) was 110.1 ± 16.0 mm Hg and 102.3 ± 12.6 mm Hg, respectively, at daytime, 102.6 ± 17.3 and 83.9 ± 8.1 mm Hg at night, 109.7 ± 15.7 and 96.3 ± 11.9 mm Hg (p < 0.05) per day. The maximum SBP at daytime in the main group was higher before the treatment (169.3 ± 18.4 mm Hg, p < 0.05). The value of the standard deviation of SBP and pulse BP decreased after treatment (p < 0.05). The value of the mean real variability of SBP in the main group was 11.27 ± 2.73 mm Hg before treatment and 9.74 ± 1.84 mm Hg (p < 0.05) after it. Diurnal index of SBD in the main group was 4.95 ± 9.67 % before treatment and 11.44 ± 5.43 % after it.Conclusions. The treatment of patients with EH, who had suffered HS ≥ 6 months before and had office BP ≥ 140/90 mm Hg, with combination of amlodipine (daily dose 5 — 10 mg), valsartan (daily dose 80 — 160 mg), hydroclorothiazide (12.5 mg if necessary) on the basis of chronotherapy approach and magnesium oxide monohydrate (456 mg daily during 1 month period) permits achieving the control of BP according to DBPM data in 73 % of patients. This treatment also permits statistically significant decreasing of short‑term BP variability, in particular, the standard deviation in all time intervals and the average real variability of SBD.
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