scholarly journals Clinical-pharmacological priorities in the election of blockators of the renin-angiotenzine system and diuretics in patients with uncompleted hypertension

2017 ◽  
Vol 14 (2) ◽  
pp. 75-79
Author(s):  
A I Ponomareva ◽  
G G Ketova ◽  
O G Kompaniets
Keyword(s):  
Clinical Practice ◽  
Arterial Hypertension ◽  
Ace Inhibitors ◽  
Antihypertensive Medication ◽  
Antihypertensive Drugs ◽  
National Guidelines ◽  
Good Tolerability ◽  
Wide Range ◽  
Treatment Of Hypertension ◽  
Efficacy Studies

The article discusses the problem of using ACE inhibitors and diuretics in arterial hypertension. Analysis of the position of doctors when prescribing ACE inhibitors and diuretics showed its compliance with current national guidelines for the treatment of hypertension. Physicians use more adequate criteria for antihypertensive drugs usage. There were no non-rational use of diuretics in combination, regardless of indications and contraindications. If there are indications for the use of a diuretic and a preparation of ACE inhibitors, you have to make greater use of fixed combinations of drugs. The article discusses the results of clinical efficacy studies of perindopril and indapamide in clinical practice. Noliprel® forte is an effective antihypertensive medication, not only reducing BP, but also organoprotective aim and good tolerability in wide range of patients with arterial hypertension.

scholarly journals Fixed combination of lercanidipine with enalapril - pharmacological features, clinical feasibility, advantages in the treatment of hypertension

2021 ◽  
pp. 21-24
Author(s):  
P. О. Lazarev
Keyword(s):  
Oxidative Stress ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Mechanisms Of Action ◽  
High Efficacy ◽  
National Guidelines ◽  
Treatment Of Hypertension ◽  
And Oxidative Stress

According to current international and national guidelines for the management of arterial hypertension preference is given to the use of fixed combinations of antihypertensive drugs of different classes, thus increasing the effectiveness of therapy acting in a complementary manner to affect different pathogenic mechanisms of arterial hypertension and reducing the frequency of side effects. A fixed combination of lercanidipine and enalapril contains antihypertensive drugs that have complementary mechanisms of action. This combination effectively reduces blood pressure, has high efficacy and tolerability, it may provide an additive effect on macro- and microvascular structures, arterial stiffness and oxidative stress. It has a beneficial influence on renal function, especially in patients with comorbidities.

scholarly journals Fixed-dose combinations in the treatment of hypertension to increase adherence

2020 ◽  
Vol 25 (11) ◽  
pp. 4184
Author(s):  
T. E. Morozova ◽  
E. O. Samokhina
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Fixed Dose ◽  
Optimal Solutions ◽  
Comorbid Conditions ◽  
Treatment Regimens ◽  
Wide Range ◽  
Treatment Of Hypertension ◽  
Artery Disease ◽  
Initiation Of Therapy

Despite a wide range of antihypertensive drugs, blood pressure (BP) control often remains unsatisfactory, and every year the number of people with uncontrolled high BP increases. One of the strategies aimed at improving medical adherence is the use of fixed-dose combinations of 2 antihypertensive drugs for starting therapy, and, if necessary, 3 drugs. Initiation of therapy with 2 drugs in one tablet is recommended for most patients. A review of algorithms for choosing combinations of antihypertensive drugs in different clinical situations, including in patients with various comorbid conditions, is presented. Simplification of treatment regimens makes it possible to choose the most optimal solutions in various clinical situations, in particular, with stage I-II hypertension, with a combination of hypertension with chronic kidney disease, as well as with a combination of hypertension with coronary artery disease and a number of other diseases.

scholarly journals ORIENTIR Study: design and results

2011 ◽  
Vol 10 (3) ◽  
pp. 89-96
Author(s):  
S. Yu. Martsevich ◽  
Yu. V. Lukina ◽  
I. B. Bondareva
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Clinical Practice ◽  
Controlled Release ◽  
Adverse Effects ◽  
Arterial Hypertension ◽  
Study Medication ◽  
Good Tolerability ◽  
Post Marketing ◽  
Therapy Compliance

The paper summarizes the specific features of post-marketing studies, which are performed after the medication registration, in the settings close to the real-world clinical practice. In particular, the authors discuss the design and results of the Russian post-marketing study of nifedipine CR (controlled release) — ORIENTIR Study. The aim of the study was to assess antihypertensive effectiveness and tolerability of nifedipine CR in patients with arterial hypertension (AH). Results. The study included 38 doctors from 24 clinical centres in 16 Russian cities, as well as 3179 patients with AH. Mean blood pressure (BP) reduction reached 22,9±6,75/16,56±8,74 mm Hg. Target BP levels were achieved in 94,9 % of AH patients without diabetes mellitus (DM), and in 72,1 % patients with a combination of AH and DM. At the last visit, 98 % of the participants continued taking the study medication. Adverse effects were registered in 1,5 % of the participants. Doctor-assessed effectiveness, tolerability, and therapy compliance for nifedipine CR were “excellent” or “good” in 95,8 %, 96,4 %, and 97,7 % of the patients, respectively. Conclusion. The results of this study are consistent with the data from other post-marketing studies of nifedipine CR, confirming its antihypertensive effectiveness and good tolerability.

scholarly journals Elderly Patient with Hypertension in General Practice: Clinical Features and Antihypertensive Therapy

2021 ◽  
pp. 61-66
Author(s):  
Viacheslav Zhdan ◽  
Yevdokiia Kitura ◽  
Maryna Babanina ◽  
Oksana Kitura ◽  
Maksym Tkachenko
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
High Frequency ◽  
Antihypertensive Drugs ◽  
White Coat Hypertension ◽  
Aged Patients ◽  
Increased Risk ◽  
Treatment Of Hypertension

The prevalence of arterial hypertension (AH) increases with age: among people over 60 years old this index is more than 2 times higher in the general population, 2/3 of people over 65 years old suffer from hypertension. Among patients 65–89 years old with hypertension, 2/3 patients have isolated systolic hypertension (ISAG). Features of hypertension in the elderly patients are: lability of blood pressure (BP), increasing frequency of pseudohypertension, high frequency of «white coat hypertension», decreased sensitivity of pressor factors for antihypertensive drugs, high frequency of resistant to treatment of hypertension. The new recommendations of the European Society of Cardiology for the diagnosis and treatment of hypertension emphasize 2 groups of elderly patients: 65–79 years old and ≥80 years old, which described the epidemiological features, the prevalence of risk factors for cardiovascular events, blood pressure levels for antihypertensive therapy and target blood pressure, and the recommended principles of drug therapy that are different from young and middle-aged patients. For most patients, fixed combinations are indicated as starting AGT, but monotherapy is recommended for the treatment of hypertension in very elderly patients (over 80 years old) and elderly patients over 65 years old with senile asthenia. The decreasing of blood pressure should be gradual, taking into consideration the increased risk of orthostatic reactions at this age. European and American experts recommend os first-line drugs low doses of thiazide diuretics and calcium channel antagonists (mainly dihydropyridine), which are especially indicated in isolated systolic arterial hypertension to effectively reduce the frequency of cardiovascular complications in the treatment of elderly patients with hypertension.

scholarly journals Russian innovations in the treatment of arterial hypertension in clinical practice — a real way to achieve success

2020 ◽  
Vol 96 (7) ◽  
pp. 503-507
Author(s):  
N. Yu. Borovkova
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
Fixed Combination ◽  
Wide Range ◽  
Rational Combination ◽  
Pharmaceutical Plant

The review is devoted to introducing a wide range of internists to the new fixed combination of ramipril and indapamide (Concealar-D24), created by Russian scientists. This is the first original domestic development for the treatment of arterial hypertension, which is successfully produced by the first Russian resident of the special economic zone, the pharmaceutical plant «VERTEX» in St. Petersburg. The advantage of Concealar-D24 is a rational combination of two drugs that have not only antihypertensive and organoprotective effects, but also a large convincing base of research on their impact on the prognosis of life in patients with cardiovascular diseases: arterial hypertension, coronary heart disease, heart failure.

scholarly journals АНАЛИЗ ПРИМЕНЕНИЯ ГИПОТЕНЗИВНЫХ СРЕДСТВ ПО ДАННЫМ АНКЕТИРОВАНИЯ ПОСЕТИТЕЛЕЙ АПТЕК В г. ГРОДНО

2020 ◽  
Vol 18 (5) ◽  
pp. 597-601
Author(s):  
H. H. Al-Zeyadi ◽  
◽  
V. I. Kozlovski ◽  
A. V. Cymbalisty ◽  
V. V. Goncharuk ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Antihypertensive Drug ◽  
Ace Inhibitors ◽  
Questionnaire Survey ◽  
Antihypertensive Drugs ◽  
Middle Aged ◽  
International Guidelines ◽  
Aged Group ◽  
Hypotensive Drugs

The aim of the study is to assess the structure of use of hypotensive drugs and adherence to the antihypertensive therapy among pharmacy visitors in Grodno. Material and methods. We conducted questionnaire survey among 109 pharmacy visitors who bought antihypertensive drugs.Results. ACE inhibitors is the most widely used group of antihypertensive drugs among the pharmacy visitors in Grodno. 44% of them took one drug. The most of the pharmacy visitors used hypotensive drugs regularly; however, 19,3% respondents were non-adherent, mostly from the middle-aged group (45-59 years). Conclusion. The structure of use of antihypertensive drugs among the pharmacy visitors in Grodno complies to the international guidelines for the management of arterial hypertension. However, there are some disadvantages: 1) relatively large number of respondents use only one antihypertensive drug; 2) some respondents, especially among middle-aged persons, take antihypertensive drugs not regularly.

Methods of Physiotherapy in the Medical Rehabilitation of Children with Primary Arterial Hypertension

2020 ◽  
Vol 98 (4) ◽  
pp. 55-61
Author(s):  
L.V. Kuyantseva ◽  
E.A. Turova ◽  
I.I. Trunina ◽  
M.S. Petrova ◽  
I.A. Lomaga
Keyword(s):  
Blood Pressure ◽  
Central Nervous System ◽  
Nervous System ◽  
Arterial Hypertension ◽  
Self Regulation ◽  
Medical Rehabilitation ◽  
Medication Therapy ◽  
Wide Range ◽  
Treatment Of Hypertension ◽  
The Central Nervous System

Introduction. Arterial hypertension (AH) is a widely occurring disease of the cardiovascular system in the children’s population, which often debuts in childhood, persists into adulthood, which dictates the need for early treatment and prevention of arterial hypertension. The formation of AH is associated with maladaptation of physiological mechanisms of self-regulation, with a complex interaction of psychosocial and genetic factors. The use of non-medicinal agents to reduce blood pressure is a starting approach in the treatment of children and adolescents with hypertension and complements medication therapy. Purpose. analysis of literature sources on the effectiveness of hardware physiotherapy methods in the treatment of hypertension in children. Discussion. In the treatment of children with hypertension, the leading role belongs to hardware physiotherapy technologies. Widely used sedative, hypotensive and vegetative-corrective methods are pathogenetically justified and can be used at all stages of arterial hypertension development. Transcranial pulsed electrotherapy (transcranial electrostimulation, electroson, infitotherapy), darsonvalization, aromafitotherapy and medicinal electrophoresis of sedatives belong sedative methods aimed at enhancing inhibitory processes in the Central nervous system. Amplipulster therapy, intermittent normobaric hypoxytherapy, low-intensity magnetic therapy, medicinal electrophoresis of spasmolytic drugs, EHF therapy, laser therapy, which lead to a decrease in arterial hypertension and improve microcirculation, are hypotensive methods. Bio-controlled aerionotherapy, aimed at correcting vegetative dysfunction, is a vegetative corrective method. Conclusion. Currently, there is a wide range of scientifically-based methods of hardware physiotherapy used in the medical rehabilitation of children with arterial hypertension, allowing to improve cerebral hemodynamics, normalize neurophysiological and hemodynamic processes in the Central nervous system, provide sedative and hypotensive effects, stimulate peripheral vasodepressor mechanisms, normalize neuroendocrine processes. The use of hardware physiotherapy methods in the complex treatment of hypertension can improve the quality of life of patients, achieve stable normalization of blood pressure, and reduce the risk of early cardiovascular diseases.

scholarly journals The role of beta-blockers in the treatment of arterial hypertension: what do we know today

2015 ◽  
Vol 12 (1) ◽  
pp. 10-18
Author(s):  
Yu V Zhernakova ◽  
I E Chazova
Keyword(s):  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Vascular Diseases ◽  
The United States ◽  
National Guidelines ◽  
Function Classes ◽  
The United Kingdom ◽  
Cardio Vascular ◽  
Number Of Publications

Beta adrenergic receptor blocking agentsare one of the multi-function classes of the drugs, prescribing to treatvarious cardio-vascular diseases, and at the same time, this class have been mostly discussing for several years due to the number of publications with the critical comments and rule this class of drugs out from priority groups for the treatment of arterial hypertension (AH), as, for example, it took place in the United Kingdom and the United States. However, national guidelines for the diagnosis and treatment of arterial hypertension (AH), as well as the guidelines from the European Society of Hyper- tension keep the same position on the β-blockers, including them on equal ground with list of 5 major classes of antihypertensive drugs to treat AH.

scholarly journals Features of the use of torasemide in arterial hypertension

2017 ◽  
Vol 14 (4) ◽  
pp. 27-31
Author(s):  
G A Baryshnikova ◽  
S A Chorbinskajya
Keyword(s):  
Arterial Hypertension ◽  
Loop Diuretic ◽  
Antihypertensive Drugs ◽  
Antihypertensive Efficacy ◽  
Electrolyte Balance ◽  
Good Tolerability ◽  
Antihypertensive Action ◽  
Target Organs ◽  
Negative Effect ◽  
Positive Effect

The article deals with the choice of diuretic in arterial hypertension and presents data on the antihypertensive efficacy of the loop diuretic torasemide. Data on the mechanisms of antihypertensive action of torasemide are presented, including a unique antialdosterone effect. The article reports on the absence of a negative effect of the drug on carbohydrate, lipid, purine metabolism and electrolyte balance, positive effect on the target organs, very good tolerability. It is advisable to use torasemide more widely in a "non-diuretic" dose (2.5-5 mg / day) for the treatment of arterial hypertension as in monotherapy as in combination with other antihypertensive drugs.

scholarly journals The results of the pharmacoepidemiological study PIFAGOR IV concerning arterial hypertension (AH patients survey)

2015 ◽  
Vol 12 (3) ◽  
pp. 11-18
Author(s):  
M V Leonova ◽  
Yu B Belousov ◽  
L L Shteinberg ◽  
E E Alimova ◽  
E P Smirnova ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Ace Inhibitors ◽  
Calcium Antagonists ◽  
Antihypertensive Drugs ◽  
Angiotensin Ii Receptor ◽  
Blood Pressure Targets ◽  
Blocking Agents ◽  
Receptor Blockers ◽  
Acting Agent ◽  
High Degree

Group of researchers analytical group of PIFAGOR IV study The aim is to study the next step of pharmacoepidemiology of arterial hypertension (AH) in Russia to evaluate the structure and frequency of different classes of antihypertensive drugs (AHD) usage in clinical practice.Material and methods. The prospective pharmacoepidemiological multicenter study (PIFAGOR IV). We interrogated AH patients using special prepared questionnaires. The collection of questionnaires took place from February to July, 2013. The study included 2533 valid questionnaires from 52 cities and towns of Russia.Results. 80% of the patients regularly take AHD; 32.8% of patients receive monotherapy, 38.6% receive two AHD combinations, 28.4% - 3 or more AHD combinations. The average number of AHD was 2.02 per patient. The structure of AHD consisted of 5 recommended classes: ACE inhibitors (27.8%), -adrenergic receptor blocking agents (21.7%), diuretics (15.7%), calcium antagonists (11.3%) and angiotensin II receptor blockers (10.7%), fixed combination - 10.8%. Additional proportion of classes: central-acting agents - 2.3% and b-adrenoceptor blocking agents - 0.1%. Among the ACE inhibitors the main share had 3 drugs: enalapril (33.6%), perindopril (16%), and lisinopril (13%). In b-blockers class the main share had 2 drugs - bisoprolol (64.4%), and usual form of release and modified release dosage form of metoprolol (the total share 21,4%). Indapamide of standard and retard form took the first place in the structure of diuretics (the total share 75%). In calcium antagonists class the main share had amlodipine (55.8%). The main drug in ARBs II was losartan (55.4%). Central-acting agent class was consisted of moxonidine (66%), methyldopa (17%) and clonidine (5%). For about 76% of cases were presented by combinations containing diuretics and 24% - by combinations containing calcium antagonists among the fixed combinations. The proportion of original drugs in the structure of AHD was 38.3%. The average BP level in patients was 140.4/86.4 mm Hg and the blood pressure targets were determined in 50.2% of cases. A high degree of compliance according to the Morisky-Green test indicated in 32%, low compliance - in 49% of cases.Conclusions. We noted the reduction of ACE inhibitors proportion and increase of ARBs II proportion, increase of fixed combinations in the structure of AHD. However, we noticed the decrease of the treatment efficacy in patients with AH using average BP level and achievement of the target BP, as well as the average number of AHD.

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