Adherence to therapy, lifestyle modification and medical support of cardiovascular patients

Бунова, С. С.; Жернакова, Н. И.; Skirdenko, Yu. P.; Николаев, Н. А.

doi:10.15829/1728-8800-2020-2665

Cited by 9 publications

(2 citation statements)

References 12 publications

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“…Наиболее эффективным способом, улучшающим исходы хронических неинфекционных заболеваний, является повышение приверженности к терапии [6,7], которое превосходит эффективность мероприятий по созданию новых методов лечения [7]. Увеличение приверженности пациентов с ИБС к медикаментозному лечению и достижению целей вторичной профилактики является трудной задачей в кардиологии.…”

Section: Discussionunclassified

Dynamics of blood pressure indicators in patients with diabetes mellitus after planned percutaneous coronary intervention

Кочергина

Барбараш

2021

jour

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Arterial hypertension (AH) is a common modifiable cardiovascular risk factor. Despite the wide choice of antihypertensive drugs, according to epidemiological studies, just over 20% of patients demonstrate effective control of hypertension. Failure to achieve the target values of blood pressure (BP) determines a high probability of developing cardiovascular events, which is also true for patients undergoing percutaneous coronary interventions (PCI). However, there is evidence that individuals who have undergone PCI show a higher percentage of achieving the target blood pressure levels. Aim of the study was to evaluate the dynamics of blood pressure indicators in patients with stable coronary artery disease (CAD) and diabetes mellitus, depending on the fact of performing PCI.Material and methods. The study was conducted at federal state budgetary scientific institution research institute of complex issues of cardiovascular diseases as a prospective, open, not comparative. The study included 75 patients with stable CAD and type 2 diabetes who regularly received therapy for at least 1 month prior to the start of participation in this study. The majority of patients 45 (60%) are represented by males. The median age was 52.64±6.96 years. 44 patients (58.81%) had a history of myocardial infarction, and 46 patients (61.33%) had previously undergone myocardial revascularization, history of stroke had 5 patients (6.66%). All patients according to the daily blood pressure monitoring at the 1st visit had average daily blood pressure values above 130/80 mmHg. Participants were divided into 2 groups: 43 patients had indications for routine PCI at the time of inclusion in the study, 32 patients had no indications for revascularization. The groups did not have significant differences in clinical and anamnestic characteristics, and regular significant differences were noted in relation to previously undergone revascularization (46.51 and 81.25%, respectively, p=0.0022) and the SYNTAX Score (14.39±9.20 and 6.13±8.28, respectively, p=0.0001). During 4 visits (1 visit, 1 month, 3 months, 6 months), ambulatory blood pressure monitoring (ABPM) was performed using the BiPiLAB system.Results. Initially according ABPM parameters group without the alleged PCI had greater variability in systolic blood pressure (SBP) in the daytime, higher values of mean diastolic blood pressure (DBP) at night, more time index of hypertension DBP at night. After 1 month of follow — up (for the group with PCI 1 month after the procedure), there were significant differences in the average daily SBP and DBP, the index of the time of hypertension DBP in the daytime, and the average daily SBP. Patients who underwent revascularization had lower ABPM values. The previously described differences in the night time DBP and the index of hypertension time at night were preserved. After 3 months of follow-up, significant differences were observed only in the indicators of night time SAD and DBP. At the end of the study (6 months of follow-up), the groups had differences only in the indicators of mean diastolic pressure at night.Conclusion. Patients who underwent PCI for 1 month after the procedure have a significant tendency to normalize (compared to the group without revascularization) blood pressure indicators. However, over time, the effect «escapes». Most likely, the short-term improvement in blood pressure is due to a temporary improvement in treatment adherence after an invasive procedure.

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Section: Discussionunclassified

Dynamics of blood pressure indicators in patients with diabetes mellitus after planned percutaneous coronary intervention

Кочергина

Барбараш

2021

jour

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“…Despite the evidence to the contrary, there is still a tendency to focus on finding treatment adherence issues related only to patients, with relative disregard for factors, depended on the service provider and healthcare system [93][94][95]. The lack of correspondence between the patient's willingness to be treated and the medical practitioner's willingness to treat leads to the fact that treatment is often prescribed to patients who are not ready to follow the proposed volume of medical recommendations [96,97]. The strategic goal of the quality system in relation to treatment adherence should be the constant readiness of medical practitioners to assess the patient's treatment adherence and provide recommendations based on previously mentioned factors [98,99]…”

Section: ключевые слова: приверженность количественная оценка лекарственная терапия медицинское сопровождение модификация образа жизни упmentioning

confidence: 99%

Management of adherence-based treatment. Consensus document – clinical guidelines. English version

Николаев¹,

Martynov²,

Skirdenko³

et al. 2021

Medical news of the North Caucasus

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Adherence to treatment as an integral component of the management of patients with heart failure

Larina,

Zamyatin,

Sheregova

et al. 2023

Russ J Cardiol

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The problem of rational management of patients with heart failure (HF) remains extremely relevant due to its increasing incidence and poor prognosis. Based on current guidelines, therapy for patients with HF involves systematic and long-term use of many medications, and their effectiveness largely depends on the quality of the patient’s compliance. Pharmacotherapy of older patients with HF is complicated by metabolism and the coexistence of many diseases associated with polypharmacy, which significantly reduces the response to therapy. Insufficient adherence to treatment has been proven to reduce the quality of life of patients. Currently, three HF phenotypes have been identified, depending on the left ventricular ejection fraction. However, the number of studies examining the characteristics of patient adherence in different phenotypes is limited, which requires further research. The article is an analytical review devoted to various aspects of adherence to treatment in patients with HF. The terms and concepts associated with compliance, the history of its research, the main modern approaches to pharmacotherapy of HF for different phenotypes are briefly covered. The results of a number of large clinical studies are presented, including the assessment of adherence in patients with HF and its relationship with prognosis.

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Adherence to therapy, lifestyle modification and medical support of cardiovascular patients

Cited by 9 publications

References 12 publications

Dynamics of blood pressure indicators in patients with diabetes mellitus after planned percutaneous coronary intervention

Dynamics of blood pressure indicators in patients with diabetes mellitus after planned percutaneous coronary intervention

Management of adherence-based treatment. Consensus document – clinical guidelines. English version

Adherence to treatment as an integral component of the management of patients with heart failure

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