Vol 13, No 3 (2016)

Articles
The possibility of a new receptor blocker to angiotensin in improving control of hypertension. Non-intervention international multicenter observational prospective study of the use azilsartan medoxomil in patients with arterial hypertension and overweight or obesity in the Russian Federation and the Republic of Kazakhstan
Zhernakova Y.V., Chazova I.E.
Abstract
Currently, there is evidence of a rather low efficacy of antihypertensive therapy, especially in patients with obesity and metabolic disorders that indicate the need for the search of new highly effective antihypertensive agents that have additional features to prevent destruction of target organs and cardiovascular complications. On the Russian pharmaceutical market antihypertensive drugs presents receptor blocker to angiotensin - azilsartan medoxomil (Edarbi®). The article is published design of study of the effectiveness of azilsartan medoxomil in patients with arterial hypertension and overweight or obesity in daily clinical practice of the Russian Federation and the Republic of Kazakhstan.
Systemic Hypertension. 2016;13(3):6-12
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Workplace hypertension": focus on emotional and personality traits in patients
Ostroumova O.D., Pervichko E.I., Zinchenko Y.P.
Abstract
This article discusses the literature data on the prevalence, diagnosis and mechanisms of development of “workplace hypertension”. The paper contains the results of our own studies indicating that patients with “workplace hypertension” are suffering from different emotional and personality traits, such as high emotionality, suppression of emotional expression, and use of inefficient emotion regulation strategies, significant perfectionism associated with socially prescribed perfectionism.
Systemic Hypertension. 2016;13(3):13-20
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Main questions of β-blockers application in clinical practice: do they all the same?
Nebieridze D.V.
Abstract
The present review shows the modern view on β-blockers in different clinical situations. Class β-blockers is a heterogeneous group in terms of clinical use. Several variants of β-blockers, especially non-selective, have negative effects and cannot be used in several clinical situations (metabolic disorders, chronic obstructive pulmonary disease, peripheral arteriosclerosis). Modern superselective β-blockers, including Betaloc ZOK, does not possess the mentioned adverse effects and can be widely used in clinical practice, even in case of metabolic syndrome, type 2 diabetes and chronic obstructive pulmonary disease. Another problem associated with β-blockers is the rare application of the drug and the underdosing of the drug. In this regard, it is very necessary for the practitioner not to be afraid and to start prescribing them in the recommended therapeutic doses according to the instructions for the medical applications for drugs in different clinical situations.
Systemic Hypertension. 2016;13(3):21-24
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Application of advanced electrovectorcardiographic methods in the diagnosis of left ventricular hypertrophy on the basis of Uryupinsk central district hospital
Vishnyakova N.A., Ryabykina G.V., Sakhnova T.A., Blinova E.V., Kozhemiakina E.S., Volkov V.E.
Abstract
The aim of the study was to evaluate the possibilities of left ventricular hypertrophy (LVH) detection with the use of a complex including a system of remote 12-lead electrocardiography (ECG) analysis, orthogonal lead ECG and vectorcardiography (VCG), during the medical examination of the population of Uryupinsk district of the Volgograd region. The work was organized in two rural district hospitals of Uryupinsk district. 180 persons were randomly selected out of the total data bank. Of these, according to ECG and VCG, 54 persons (30%) were considered to be practically healthy, and in 63 cases (35%) automatical analisys of ECG or VCG revealed signs of LVH. In 32 cases (50.7%) left ventricular hypertrophy was revealed for the first time. The most often finding was the increase of the parameters of synthesized orthogonal ECG and VCG: the sum of Rx+Sz and maximal QRS vector (89%, 95%). About 10% of the patients had high blood pressure without electrocardiographic signs of LVH. Introduction of the remote ECG analisys to the work of medical institutions of Uryupinsk district allowed to increase LVH detection.
Systemic Hypertension. 2016;13(3):25-31
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The role of bisoprolol in the management of patients with arterial hypertension
Nedogoda S.V.
Abstract
According to the different recommendations (NICE, JNC-8, ASH/ISH) concerning the treatment of AH, β-blockers are in 3rd-4th place among the other antihypertensive drugs (AHD), because the results of various meta-analyses show that their antihypertensive activity was less potent in comparison with other classes of drugs, their worst impact on hard endpoints (especially in people over 60). The application of beta-blockers can increase the risk of diabetes mellitus (especially in combination of thiazide-type diuretics) and shows negative effects on aortic elasticity. However, "new" β-blockers occupy leading positions because of number of main AHD characteristics (cardioselectivity, amphiphilicity, duration of action, metabolic neutrality, etc.). Bisoprolol can be regarded as the drug of choice in patients with AH associated with ischemic heart disease (stable angina), especially with the trend towards high heart rate, and in patients with chronic heart failure. Bisoprolol is effective both in elderly patients (people over 60) and in younger one (younger than 60).
Systemic Hypertension. 2016;13(3):32-34
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Features of cutaneous microcirculatory blood flow in patients with pulmonary hypertension of different etiology
Dolgova E.V., Fedorovich A.A., Martynyuk T.V., Rogoza A.N., Chazova I.E.
Abstract
Aim: to evaluate features of the functional state of microvascular bed of the skin in patients with pulmonary arterial hypertension associated to congenital cardiac disease (PAH-CCD) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods. In study included 25 patients (41.6±15.8) with PAH-CCD, 25 patients (48.8±14.2) with CTEPH and 25 healthy volunteers (39.3±10.1 years). All the patients underwent a six-minute walking test (6-MWT), transthoracic echocardiography, thorax organs radiography, right heart catheterization (RHC) and Laser Doppler flowmetry (LDF) with amplitude and frequency wavelet analysis of blood flow oscillations and evaluation of constrictory and dilatatoryskin resistive microvesselsfunctions. Results. In the PAH-CCD in relation to the CTEPH groupaccording to the RHC were noted significantly higher values of systolic pressure in pulmonary artery (93.2 and 77.8 mm Hg respectively) and venous mixted blood saturation(63 and 57% Hg respectively). On this background 6- MWT distance was 356 and 325 m, the Borg dyspnea scale index was on average 3.12 and 3.76 respectively. According to the LDF pulseoximetry PAH-CCD and CTEPH patients had 90.1 and 94.7% respectively. According to the LDF with amplitude and frequency wavelet analysis the PAH-CCD patients had sig-nificantly higher values of the amplitude of myogenic, respiratory and pulse sectionof blood flow modulation, and also increased constrictory activity smooth muscle cells of skin precapillary arterioles in response to the stretching at venous occlusion and decreased dilatatory reserve at post-occlusi-ve reactive hyperemia. According to the LDF the CTEPH patients had elongationof time development of microvessel constriction in response to acti-vation of sympathetic nervous systemin respiratory and cold tests. Conclusion. According to the LDF functional state of skin microvessels in systemic circulation of the CTEPH patients was comparable with control groupexcept for elongation of time development of microvessel reactions for sympathetic vasoconstrictor stimulations. The PAH-CCD patients demonstrated basal tonus decreasing of smooth muscle cells of skin precapillary arterioles in systemic circulation, which can be regarded as a manifestation of autoregulatory response to systemic hypoxia.
Systemic Hypertension. 2016;13(3):35-41
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Control of cardiovascular risk in patients with diabetes
Zhernakova Y.V., Chazova I.E.
Abstract
Prevalence of diabetes mellitus (DM) is a version of pandemic, in Russia as well, nowadays. Mortality of patients suffering from DM is associated with the development of macrovascular complications and successful prevention of these complications depends on the complex approach to identify and to correct all modifiable risk factors, included in risk indexes. According to many experts’ point of view, key moments in reducing the risk of cardiovascular complications in patients with DM are to achieve target blood pressure and target levels of lipid metabolism, including the application of non-drug therapies. However, the appearance of new data concerning the possibility of antihyperglycemic therapy, no doubt, will change our point of view on managing cardiovascular risk in patients with DM, in particular empagliflozin, which can influence on cardiovascular outcomes.
Systemic Hypertension. 2016;13(3):42-47
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Ethnogenetic aspects of obesity and disorders of carbohydrate metabolism as a risk factor of arterial hypertension
Mulerova T.A., Tsygankova D.P., Voropaeva E.N., Maksimov V.N., Ogarkov M.Y.
Abstract
Objective - to explore the association of candidate genes of arterial hypertension ACE, ADRA2B, ADRB1, MTHFR and eNOS with obesity and impaired glucose metabolism based on ethnicity. Materials and methods. Clinical and epidemiological study of compactly living population in the remote areas of the Mountain Shoria (Orton, Ust-Kabyrza, Sheregesh settlements, Kemerovo region). 1178 residents of these settlements were surveyed with the help of continuous sampling method; the sample consisted of adults (18 years and older). Results. In the group of respondents of the indigenous nationality averages Quetelet index, waist circumference and fasting blood glucose, depending on the polymorphism of candidate genes of arterial hypertension ACE, ADRA2B, ADRB1, MTHFR and eNOS were lower than in non-indigenous ethnic group surveyed. In a population of Shor was found a statistically significant relationship with the body mass index of ACE gene genotypes in a population of non-indigenous representatives - with genotypes of ADRA2B gene. In the group of indigenous ethnic group revealed the relationship from ACE gene polymorphism. Regardless of nationality, found associative connection of the indicator polymorphism of ADRA2B gene. The level of plasma glucose levels in a population of non-indigenous ethnic group was correlated with genotypes of ADRA2B gene. Conclusion. Metabolic abnormalities were detected less frequently in indigenous ethnic group compared with the non-indigenous. In Shor group ACE DD genotype and ADRA2B genes associated with obesity, the genotype 4a/4a eNOS gene - with abdominal obesity. In the group of non-indigenous ethnic group CC genotype of the MTHFR gene was associated with abdominal obesity, II genotype of ACE gene and DD ADRA2B gene - with impaired carbohydrate metabolism.
Systemic Hypertension. 2016;13(3):48-57
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Combined pharmacotherapy of arterial hypertension. Overview fixed combination antihypertensive drugs
Morozova T.E., Andrushchishina T.B., Yudina I.Y.
Abstract
Hypertension remains the cornerstone of the cardiovascular continuum. An increasing number of patients receive a combination antihypertensive therapy to achieve target blood pressure, expanding indications for combination therapy at the onset of treatment. Constantly growing market of fixed combinations (FC) of antihypertensive drugs. The article gives an overview of the FC, registered in the Russian Federation, discussed the clinical situation for the preferential destination of a FC. A more detailed analysis of FC comprising the angiotensin II receptor blocker and diuretics, in particular, discusses the benefits of FC comprising angiotensin II receptor blocker candesartan and hydrochlorothiazide.
Systemic Hypertension. 2016;13(3):58-63
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Prolonged release verapamil: application in clinical practice
Gaponova N.I., Abdrakhmanov V.R.
Abstract
The review shows the results of the use of prolonged release verapamil (Isoptin® SR) in clinical practice. Numerous randomized clinical studies confirm the high efficiency and safety of Isoptin® SR in patients with arterial hypertension, as well as in patients with arterial hypertension in combination with ischaemic heart disease, chronic obstructive pulmonary diseasesand disorders of carbohydrate and lipid metabolism. The advantage of Isoptin® SR (verapamil) application in case of supraventricular arrhythmias has been proven.
Systemic Hypertension. 2016;13(3):64-68
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