Guidelines for diagnostics and treatment of hypertension 2018 - European experts’opinion [Guidelines]

Chazova, I E; Евгеньевна, Чазова Ирина; Zhernakova, Yu V; Жернакова, Ю В

doi:10.26442/2075-082_2018.3

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Проблема раннего выявления и эффективной фармакотерапии артериальной гипертонии (АГ) является одной из наиболее значимых в современной медицине, что обусловлено ее широкой распространенностью и значимым вкладом в смертность населения от сердечно-сосудистых заболеваний [1,2].…”

Section: Introductionunclassified

Combined antihypertensive and psychocorrective therapy in patients with arterial hypertension and anxiety-depressive disorders: are there any advantages?

et al. 2021

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Relevance. Arterial hypertension (AH) and anxiety-depressive disorders (ADD) are comorbid pathologies that are common in clinical practice. At the same time, the possibility of including an antidepressant in antihypertensive therapy for optimal control of hypertension, as well as to ensure a vasoprotective effect, has not been studied enough. Aim. To compare the effect of traditional antihypertensive therapy and therapy, including an antidepressant, on indicators of the daily profile of blood pressure (BP), stiffness of the vascular wall and central aortic pressure (CAP), the severity of anxiety and depression, as well as on cognitive function (CF) in patients AH and ADD. Materials and methods. The study included 90 patients with AH and ADD, who were randomized into two groups: group 1 patients who received a fixed combination of an angiotensin II receptor blocker and a diuretic, a b-blocker and an antidepressant; group 2 persons who took only three-component antihypertensive therapy. Before and after 24 weeks, all patients underwent a general clinical examination, 24-hour BP monitoring ABPM (BpLab Vasotens, Petr Telegin, Russia) with an assessment of the daily profile of BP, CAP and vascular stiffness. In addition, testing was carried out on the HADS, CES-D scales; CF were rated according to the Montreal scale. Results. In the group of patients treated with an antidepressant, it was noted that the target BP level was achieved more quickly when lower doses of angiotensin II receptor blockers were prescribed. After 6 months of therapy in both groups, there was a comparable positive dynamics of the main indicators of ABPM. In group 1, a statistically more pronounced decrease in both peripheral and CAP at night was recorded. In both groups of patients, a decrease in the augmentation index was noted; however, a statistically significant improvement in the parameters of the speed of propagation of the pulse wave in the aorta and the time of propagation of the reflected wave was recorded only in persons receiving antidepressant. In group 1, there was a regression of ADD, as well as a significant improvement in CF. Conclusions. The use of sertraline as part of a combination antihypertensive therapy in patients with AH and ADD contributed to a more rapid achievement of target BP values, a significant improvement in ABPM (especially at night), vascular wall stiffness and CAP. It is also important that the appointment of sertraline was accompanied by a regression of anxiety-depressive symptoms, an improvement in CF.

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Section: Introductionunclassified

Combined antihypertensive and psychocorrective therapy in patients with arterial hypertension and anxiety-depressive disorders: are there any advantages?

et al. 2021

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“…Существенным представителем данной группы заболеваний является артериальная гипертензия (АГ) и прежде всего это связано с широким её распространением (43,4%), поражением органов мишеней, утратой работоспособности и ранней инвалидизацией населения. Кроме того, АГ является основным фактором риском возникновения сердечно-сосудистых осложнений, таких как инфаркт миокарда и инсульт, которые и составляют высокую смертность в мире [2]. Однако при доступности лечения АГ, эффективного контроля артериального давления (АД) добиваются лишь 14,4% мужчин и 30,9% женщин [3].…”

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Prognostic Role of Melatonin in Assessment of Clinical Course of Arterial Hypertension

Budnevsky¹,

Rezova²,

Кожевникова³

2020

HMJ

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Background. Sleep disorders are one of the most common problems in patients with arterial hypertension (AH). Circadian blood pressure (BP) cycles are most likely associated with the regulatory influence of melatonin. However, in patients with hypertension, if melatonin production de-creases, no respective reduction of BP is noted during sleep. Aim. Analyze the quality of sleep, chronotypes, clinical, instrumental and laboratory parameters depending on urinary melatonin level (UML), to determine a prognosis for the course of AH in patients with insomnia. Materials and Methods. We examined 178 patients with AH and insomnia aged from 30 to 70 years (mean age 61.3±0.92 years). The AH diagnosis was based on 2018 ESC/ESH guidelines for the management of AH, and on Clinical guidelines of Russian Society of Cardiology – AH in adults (2020). The diagnosis of insomnia was based on the international classification of sleep disorders (2005). Using Multiple Regression Analysis, we determined the factors that influence the levels of systolic BP (SBP) and diastolic BP (DBP) in AH patients with insomnia. Results. Patients with AH and insomnia have a more severe clinical course of the disease, with frequent turning for medical help, altered BP variability, high anxiety level, high depression level and low level of the quality of life. The patients with AH and insomnia have low UML which correlated with the degree of hypertension, chronotypes, high systolic and diastolic BP, BMI, high depression and anxiety level, and low level of the quality of life in the physical and psychological aspects. Conclusion. The developed methods for calculating the levels of SBP and DBP, depending on the level of UML, body mass index, anxiety and depression level, and PSQI, allow reliable evaluation and control of the BP level in patients with AH and insomnia.

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Predictors of cardiovascular complications in patients with arterial hypertension and comorbid pathology

Муркамилов¹,

Fоmin²,

Yusupov³

et al. 2021

System. Hyper.

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Aim. To study the relationship between central arterial pressure (BP) and cystatin C in patients with arterial hypertension and comorbid pathology, depending on gender differences. Materials and methods. The study involved 162 patients aged 39 to 82 years, suffering from hypertension and comorbid pathology. The average age of the surveyed was 58.610.3 years. The following nosological forms were revealed: coronary heart disease 40.7% of the examined, overweight 33.9%, 1st degree obesity 30.8%, type 2 diabetes mellitus 29.0%, chronic obstructive disease lungs 16.6%, cerebrovascular diseases 13.5%. All participants underwent general clinical examinations. The concentration of the lipid spectrum was investigated: the levels of total cholesterol, triglycerides, cholesterol high density lipoproteins (HDL cholesterol) and low density lipoprotein cholesterol (LDL cholesterol) and plasma cystatin C. Glomerular filtration rate (GFR) was calculated according to F. Hoek's formula (80.35/cystatin C 4.32=GFR). Study of central aortic pressure (CAP), mm Hg Art., was carried out using the device "AngioScan". Echocardiography was performed on a "Vivid q" apparatus (USA, 2014) according to the generally accepted technique. All examined patients were divided into 2 subgroups. The 1st subgroup includes women, the 2nd men. Results. In patients with hypertension and comorbid pathology, the most common abnormalities were an increased level of LDL cholesterol (58%), a decreased level of HDL cholesterol (51.8%), hypercholesterolemia (54.3%), hypertriglyceridemia (43.8%) and tachycardia (40.7%). In 51.8% of the surveyed, and more among males, the achievement of the target blood pressure level was detected. In women, the indicators of average age, body mass index, the content of total cholesterol, LDL cholesterol and HDL cholesterol were significantly higher. In male patients, the indicators of the diameter of the aortic outflow tract, end systolic and diastolic dimensions of the left ventricle (LV) significantly exceeded those of women, and the ejection fraction of the LV was significantly lower. The prevalence of LV hypertrophy (LVH) was 37% in the total sample, and it was higher in women than in men (45.9 and 26.6%, respectively, p=0.012). At the same time, the frequencies of concentric and eccentric types of LVH in both subgroups were similar. The incidence of LV concentric remodeling in women and men was 5.7 and 13.3%, respectively (p=0.001). In both subgroups, a negative correlation was found between the LV myocardial mass index and the calculated GFR. A positive correlation was noted between the levels of systolic blood pressure and CAP, the concentrations of cystatin C and plasma triglycerides. Conclusion. In hypertension, the structure of comorbid pathology is dominated by coronary heart disease, obesity and type 2 diabetes mellitus, when hyper- and dyslipidemia were often detected. The incidence of LVH in the general group of subjects was 37.0%, and in women this indicator was higher. In the subgroup of men, cases of LV concentric remodeling were significantly more frequent. An increase in the level of CAP and systolic blood pressure, as well as the concentration of cystatin C, was associated with an increase in the LV myocardial mass index, especially in the subgroup of women.

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Guidelines for diagnostics and treatment of hypertension 2018 - European experts’opinion [Guidelines]

Cited by 3 publications

References 4 publications

Combined antihypertensive and psychocorrective therapy in patients with arterial hypertension and anxiety-depressive disorders: are there any advantages?

Combined antihypertensive and psychocorrective therapy in patients with arterial hypertension and anxiety-depressive disorders: are there any advantages?

Prognostic Role of Melatonin in Assessment of Clinical Course of Arterial Hypertension

Predictors of cardiovascular complications in patients with arterial hypertension and comorbid pathology

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