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Objective. The purpose of the study was to assess the daily profile of blood pressure (BP) and metabolic status in women with newly diagnosed breast cancer (BC) before starting chemotherapy (CHT).Design and methods. A prospective cohort study was conducted with the inclusion of 154 women aged 25 to 63 years with a median (Me) of 43,4 years with a newly diagnosed stage IIA–IIIB BC. The first group included 109 patients with normal or high normal “office” BP, the second group included 45 women with previously diagnosed stage 1 of hypertension with low and moderate cardiovascular risk according to the SCORE 2 scale. All examined patients underwent 24-hour BP monitoring (ABPM), anthropometric measurements: height, weight, waist (WC) and hip circumference (HC), calculation of body mass index, ratio WC/height × 100, WC/HC. Glucose, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, triglycerides, and cholesterol not associated with high-density lipoproteins were determined in fasting blood. Visceral adiposity index and lipid accumulation product were calculated.Results. According to the results of ABPM, two subgroups were distinguished among those examined with a normal level of clinical BP. The first included 55 women with normotension (50,5 %), the second — 54 (49,5 %) with newly diagnosed masked hypertension (MH). In those examined with hypertension (HTN) and MH, the level of systolic BP (SBP) and diastolic BP (DBP) both during the day and at night was significantly higher than in those with normotension (p < 0,0001). In those examined with MH, SBP and DBP indicators during the night exceeded similar parameters in the group of women with HTN, and during the waking period, differences were recorded only in the level of DBP, which was significantly higher in people with stable HTN. Variability, time index of SBP and DBP at night in women with MH were higher than in women with HTN. The indicator of the nocturnal decline among those examined with MH and HTN was less than 10 % (“non-dipper”). The morning rise in SBP among persons with stable HTN exceeded the level of this indicator in the MH group, and the values of the morning rise in DBP did not differ significantly. In case of BC comorbidity with HTN and MH, cardiometabolic risk factors (RF) were recorded more often: overweight, abdominal obesity, dyslipidemia. Correlation analysis showed direct relationships of varying severity between individual ABPM indicators and cardiometabolic RF.Conclusions. Among the examined subjects, a significant number of women appeared to have a combination of BC and HTN before the start of CHT. Our study showed that ABPM in women with newly diagnosed BC is a necessary tool for verifying MH before starting CHT. In turn, the presence of cardiometabolic RF increases the likelihood of comorbid BC and HTN. Taking into account the cardiotoxic effect of drug antitumor therapy for BC, the correction of RF and adequate treatment of HTN is recommended even before it is started.
Objective. The purpose of the study was to assess the daily profile of blood pressure (BP) and metabolic status in women with newly diagnosed breast cancer (BC) before starting chemotherapy (CHT).Design and methods. A prospective cohort study was conducted with the inclusion of 154 women aged 25 to 63 years with a median (Me) of 43,4 years with a newly diagnosed stage IIA–IIIB BC. The first group included 109 patients with normal or high normal “office” BP, the second group included 45 women with previously diagnosed stage 1 of hypertension with low and moderate cardiovascular risk according to the SCORE 2 scale. All examined patients underwent 24-hour BP monitoring (ABPM), anthropometric measurements: height, weight, waist (WC) and hip circumference (HC), calculation of body mass index, ratio WC/height × 100, WC/HC. Glucose, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, triglycerides, and cholesterol not associated with high-density lipoproteins were determined in fasting blood. Visceral adiposity index and lipid accumulation product were calculated.Results. According to the results of ABPM, two subgroups were distinguished among those examined with a normal level of clinical BP. The first included 55 women with normotension (50,5 %), the second — 54 (49,5 %) with newly diagnosed masked hypertension (MH). In those examined with hypertension (HTN) and MH, the level of systolic BP (SBP) and diastolic BP (DBP) both during the day and at night was significantly higher than in those with normotension (p < 0,0001). In those examined with MH, SBP and DBP indicators during the night exceeded similar parameters in the group of women with HTN, and during the waking period, differences were recorded only in the level of DBP, which was significantly higher in people with stable HTN. Variability, time index of SBP and DBP at night in women with MH were higher than in women with HTN. The indicator of the nocturnal decline among those examined with MH and HTN was less than 10 % (“non-dipper”). The morning rise in SBP among persons with stable HTN exceeded the level of this indicator in the MH group, and the values of the morning rise in DBP did not differ significantly. In case of BC comorbidity with HTN and MH, cardiometabolic risk factors (RF) were recorded more often: overweight, abdominal obesity, dyslipidemia. Correlation analysis showed direct relationships of varying severity between individual ABPM indicators and cardiometabolic RF.Conclusions. Among the examined subjects, a significant number of women appeared to have a combination of BC and HTN before the start of CHT. Our study showed that ABPM in women with newly diagnosed BC is a necessary tool for verifying MH before starting CHT. In turn, the presence of cardiometabolic RF increases the likelihood of comorbid BC and HTN. Taking into account the cardiotoxic effect of drug antitumor therapy for BC, the correction of RF and adequate treatment of HTN is recommended even before it is started.
Research objective: to evaluate arterial stiff ness indicators and its correlation with parameters of 24-hour ambulatory blood pressure monitoring (ABPM) in women with newly diagnosed breast cancer (BC).Material and methods: a prospective cohort study in 158 women aged 27 to 64 years with a median age of 45.4 years and newly diagnosed BC at stage IIA–IIIB before chemotherapy was conducted. The first group included 109 patients with normal or high-normal office blood pressure (BP), and the second group included 49 women with previously diagnosed stage 1– 2 essential hypertension (EH) with low or moderate cardiovascular risk. All patients underwent indirect arteriography and ABPM. Results. According to ABPM data, “masked” arterial hypertension (MAH) was diagnosed in 54 (49.5%) women in the fi rst group. In patients with MAH, the mean daily level and diastolic BP time index exceeded the corresponding indicators in EH, and the magnitude of the morning rise in systolic BP was significantly lower. In 35.4% of the examined patients with EH, the pulse wave velocity (PWV) was increased, and in 17.4% it was pathological. With MAH, these changes were recorded in 28.5% and 14.1% of cases, respectively. The odds ratio showed that in women with normal BP, the probability of an increase in PWV >10 m/s increased by 1.6 times, and in the presence of comorbidity with MAH and EH, it increased by 2.2 and 2.4 times, respectively. The risk of an increase in central systolic BP >125 mm Hg and pulse BP >60 mm Hg was highest in patients with EH.Conclusion: Among young and middle-aged women with newly diagnosed BC, a significant number of cases of MAH and EH are detected, which determines the need to evaluate arterial stiff ness and daily BP profiles before starting antitumor therapy.
The opinions of physicians regarding the effectiveness of the Program for Providing Certain Categories of Citizens with Necessary Medicines (Program) are the leading component of feedback conducted to create an idea of the activities of the benefit segment.Objectives. Based on a sociological survey of physicians involved in prescribing treatment to beneficiary patients, recommendations for increasing the effectiveness of pharmacotherapy included in the program.Materials and methods. Based on a sociological survey of physicians involved in prescribing treatment to beneficiary patients, recommendations for increasing the effectiveness of pharmacotherapy included in the program.Results. The questionnaire was developed and assessed quantitative indicators based on the answers of the surveyed specialists, and recommendations for increasing the effectiveness of pharmacotherapy in the Program.Conclusions. A sociological survey of physicians involved in prescribing pharmacotherapy to patients in the Program, conducted using a Questionnaire, is a highly informative method that makes it possible to meaningfully study the main problems of Preferential Medicinal Providing and offer recommendations for increasing the effectiveness of pharmacotherapy in the Program.
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