scholarly journals Analysis of hemodynamic parameters and quality of life in patients with chronic kidney disease and arterial hypertension

2021 ◽  
Vol 12 (33) ◽  
pp. 274-287
Author(s):  
Tamara Muratovna Khokonova ◽  
Sofiat Khasenovna Sizhazheva ◽  
Zhaneta Huseynovna Sabanchieva ◽  
Marina Tembulatovna Nalchikova ◽  
Jannet Anvarovna Elmurzayeva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Arterial Hypertension ◽  
Vascular Wall ◽  
Vascular Stiffness ◽  
Lipid Lowering ◽  
Hemodynamic Parameters ◽  
Peripheral Hemodynamics ◽  
Wall Stiffness ◽  
Ckd Stage

Purpose. The work is devoted to study the effects of antihypertensive, lipid-lowering and metabolic therapy in office and the average hemodynamic parameters, the parameters of central pressure in the aorta, vascular wall stiffness and quality of life in patients with CKD stage 3 in combination with arterial hypertension of 1-2 degrees, and without it. Materials and methods. Were examined patients with arterial hypertension of 1-2 degrees and CKD stage 3. Measured hemodynamic parameters with the help of a daily BP monitor “BPLab”. The quality of life of patients was assessed by the questionnaire MOS SF36. Results. The greatest changes in the indicators of central hemodynamics and vascular stiffness were noted in the group of patients with comorbidity. Conclusion. The combination of antihypertensive therapy (losartan and diltiazem) with meldonium and rosuvastatin significantly decreases indices of central and peripheral hemodynamics and vascular stiffness. Add meldonium part of therapy significantly improves the quality of life of patients.

scholarly journals Association between H-type arterial hypertension and vascular stiffness (a pilot study)

2021 ◽  
Vol 23 (1) ◽  
pp. 32-41
Author(s):  
Yu. M. Sirenko ◽  
O. L. Rekovets ◽  
O. O. Torbas ◽  
S. M. Kushnir ◽  
O. Yu. Sirenko
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Blood Pressure Level ◽  
Vascular Wall ◽  
Vascular Stiffness ◽  
Wall Stiffness ◽  
Body Weights ◽  
Total Homocysteine ◽  
The Relationship

Increased arterial stiffness is an important determinant of cardiovascular risk. Elevated total homocysteine (HC) levels appeared to be an independent risk factor for cardiovascular disease (CVD). To date, clinical studies on the relationship between HC and pulse wave velocity (PWV) assessment have shown conflicting results. Aim. To estimate the prevalence of hyperhomocystinemia (HHc) among patients with mild to moderate arterial hypertension and the effect of HHc on the vascular wall stiffness. Materials and methods. Our study was carried out as a part of the HYPSTER study in Ukraine. The study included 40 patients with I and II degree of arterial hypertension (AH) (average office systolic blood pressure (SBP)/diastolic (DBP) – 155.88/92.60 ± 1.63/1.43 mm Hg), heart rate – 71.40 ± 1.29 beats/min. The average age of the patients was 55.85 ± 2.09 (26–74) years. Patients with HC levels ≥10 μmol/l were defined as patients with H-type AH (HHc). Arterial stiffness was determined by PWV. Results. We found that at the beginning of the study, 75 % (30 patients with mild and moderate hypertension) had H-type hypertension with an increased level of HC. Patients with H-type AH and AH patients without HHc did not differ in age and AH duration. At the same time, patients with H-type AH had higher body weights and BMI. Office SBP in patients with H-type hypertension was higher compared to patients without HHc (156.45 ± 1.04 mm Hg vs. 152.55 ± 1.41 mm Hg at the beginning (P < 0.05) and 130.65 ± 0.96 mm Hg vs. 126.97 ± 1.08 mm Hg after 6 months (P < 0.05)) of treatment, respectively. BMI in H-type AH was 30.72 ± 0,39 kg/m2 vs. 28.34 ± 0.69 kg/m2 without HHc (P < 0.05) at the beginning of the study. It was difficult to achieve target levels of BP in the patients with H-type hypertension during the treatment and they had high initial blood pressure values. In contrast to the patients without HHc, H-type AH patients had a more pronounced degree of insulin resistance (according to the HOMA index), lower GFR both at the beginning and at the end of the treatment. According to ambulatory BP monitoring, H-type AH patients presented with a significantly higher SBP level before starting the treatment compared to those with AH without HHc. The regression analysis revealed an association between HC and PWVel, regardless of the degree of BP reduction (PWVel (6 months), m/s, β = 0.307, P = 0.001). Conclusions. Hyperhomocystinemia was observed in 75 % of patients with arterial hypertension. Homocysteine levels were associated with vascular stiffness, regardless of the reduction in blood pressure level.

ARTERIAL HYPERTENSION AND COMORBIDITY (REVIEW)

2020 ◽  
Vol 2 (1) ◽  
pp. 9-13
Author(s):  
Irina Agababyan ◽  
◽  
Shukhrat Ziyadullaev ◽  
Jamshid Ismailov
Keyword(s):  
Quality Of Life ◽  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
The Metabolic Syndrome

Today, hypertension is considered by many authors within the framework of the manifestation of the metabolic syndrome. It has been established that in persons with hypertension in 60% of cases, various variants of MS are found. In addition, hypertension is a factor that reduces the quality of life of patients, especially those with comorbid pathology

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

Assessment of the quality of life in the treatment approaches of patients with the comorbid course of arterial hypertension and metabolic disorders aimed at reducing cardiovascular risk

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
V Zlatkina ◽  
V Shkapo ◽  
A Nesen ◽  
T Starchenko
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Arterial Hypertension ◽  
Metabolic Disorders ◽  
Clinical Signs ◽  
Blood Analysis ◽  
Sf 36 ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. Cardiovascular diseases (CVD) remain the leading cause of premature death worldwide. According to epidemiological studies CVD prevention is highly effective. A 50% reduction in mortality from coronary artery disease (CAD) is associated with exposure to risk factors and only 40% with improved treatment. Purpose.  To assess the quality of life (QOL) in patients with arterial hypertension (AH) and metabolic disorders, to establish its impact on therapy effectiveness. We examined 280 patients with AH and comorbidity - 171 women and 109 men aged 45-75 years. Along with AH, all patients had comorbidities: 72.6 % suffered from coronary artery disease (CAD), 10.5% after myocardial infarction (MI), 35 % had clinical signs of heart failure (HF), 22, 1% - type 2 diabetes mellitus (t2DM), 27.4% - chronic kidney disease (CKD). Methods. Anthropometry, blood pressure (BP) measurement, immunoassay (C-reactive protein), biochemical blood analysis (lipid, carbohydrate metabolism parameters, QOL determination (questionnaire Sf-36). Results. In patients with comorbidity of pathologies (presence of AH, t2DM, CKD, CAD, obesity), there was a decrease in assessments in almost all indicators of QOL, and especially significant limitations in the performance of daily activities due to both physical and mental state. Conclusion. The degree of AH in patients with t2DM decreased QOL of physical activity, role-physical functioning, pain and general health, reflecting physical health, as well as mental health, including vitality, social activity, role emotional functioning. T2DM in patients with AH significantly worsens QOL of this category of patients as in physical component summary and mental component summary. The indicators of QOL are significantly affected by the duration of t2DM, as well as the degree of compensation. Achievement of the target BP levels in patients with AH with t2DM shows an improvement in a number of QOL parameters and makes it possible to recommend the Sf-36 questionnaire as a criterion for the effectiveness of the therapy.

scholarly journals EXPRESS: Association of daily physical activity with psychosocial aspects and functional capacity in patients with Pulmonary Arterial Hypertension: a cross-sectional study

2021 ◽  
pp. 204589402199995
Author(s):  
Layse Nakazato Lima ◽  
Felipe Mendes ◽  
Ilma Paschoal ◽  
Daniela Oliveira ◽  
Marcos Mello Moreira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Functional Capacity ◽  
Daily Physical Activity ◽  
Cross Sectional ◽  
Pulmonary Arterial ◽  
The Mean

Pulmonary arterial hypertension (PAH) impairs exercise tolerance and daily physical activity (PA). Aside from the hemodynamic limitations, physical, cognitive and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the PA level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the PA level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable PAH subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the anxiety and depression scale (HADS), and the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Transthoracic echocardiography, the 6-Minute walk test (6MWT), the 1-minute sit-to-stand test (STST), and spirometry were performed. For statistical analysis we used Chi-square tests or Fisher's test as appropriate and the Mann-Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic PAH, and 20% had connective tissue disease . The mean daily step count was 4,280 ± 2,351, and the mean activity time was 41.6 ± 19.3 minutes. The distance covered (6MWT) was 451.5 m, and the number of movements (1-STST) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (HADS). There was a significant correlation between accelerometer data and walking distance (6MWT), number of movements (1-STST), level of daily physical activity (MRADL), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with PAH.

Effect of Pulmonary Arterial Hypertension-Specific Therapies on Health-Related Quality of Life

CHEST Journal ◽  
2014 ◽  
Vol 146 (3) ◽  
pp. 686-708 ◽  
Author(s):  
Gilles Rival ◽  
Yves Lacasse ◽  
Sylvie Martin ◽  
Sébastien Bonnet ◽  
Steeve Provencher
Keyword(s):  
Quality Of Life ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Pulmonary Arterial

scholarly journals A prescribed walking regimen plus arginine supplementation improves function and quality of life for patients with pulmonary arterial hypertension: a pilot study

2017 ◽  
Vol 8 (1) ◽  
pp. 204589321774396 ◽  
Author(s):  
Mary Beth Brown ◽  
Attie Kempf ◽  
Catherine M. Collins ◽  
Gary M. Long ◽  
Matthew Owens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Current Evidence ◽  
Proof Of Concept ◽  
Concept Study ◽  
Sf 36 ◽  
Pulmonary Arterial ◽  
Arginine Supplementation

Current evidence suggests that exercise training is beneficial in pulmonary arterial hypertension (PAH). Unfortunately, the standard supervised, hospital-based programs limit patient accessibility to this important intervention. Our proof-of-concept study aimed to provide insight into the usefulness of a prescribed walking regimen along with arginine supplementation to improve outcomes for patients with PAH. Twelve PAH patients (all women) in New York Heart Association (NYHA) functional class (FC) II (n = 7) or III (n = 5) and in stable condition for ≥ 3 months were enrolled. Patients performed home- and fitness-center- based walking at 65–75% heart rate (HR) reserve for 45 min, six sessions/week for 12 weeks. Concomitant L-arginine supplementation (6000 mg/day) was provided to maximize beneficial endothelial training adaptations. Cardiopulmonary exercise testing, 6-min walk testing (6MWT), echocardiography, laboratory studies, and quality of life (QoL) survey (SF-36) were performed at baseline and 12 weeks. Eleven patients completed the study (72 session adherence rate = 96 ± 3%). Objective improvement was demonstrated by the 6MWT distance (increased by 40 ± 13 m, P = 0.01), VO2max (increased by 2 ± 0.7 mL/kg/min, P = 0.02), time-to-VO2max (increased by 2.5 ± 0.6 min, P = 0.001), VO2 at anaerobic threshold (increased by 1.3 ± 0.5 mL/kg/min, P = 0.04), HR recovery (reduced by 68 ± 23% in slope, P = 0.01), and SF-36 subscales of Physical Functioning and Energy/Fatigue (increased by 70 ± 34% and 74 ± 34%, respectively, P < 0.05). No adverse events occurred, and right ventricular function and brain natriuretic peptide levels remained stable, suggesting safety of the intervention. This proof-of-concept study indicates that a simple walking regimen with arginine supplementation is a safe and efficacious intervention for clinically stable PAH patients, with gains in objective function and QoL measures. Further investigation in a randomized controlled trial is warranted.

scholarly journals Quality of Life in CKD Patients on Low-Protein Diets in a Multiple-Choice Diet System. Comparison between a French and an Italian Experience

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1354
Author(s):  
Antioco Fois ◽  
Massimo Torreggiani ◽  
Tiziana Trabace ◽  
Antoine Chatrenet ◽  
Elisa Longhitano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Choice ◽  
Protein Restriction ◽  
World Health ◽  
Life Questionnaire ◽  
Historical Cohort ◽  
Low Protein ◽  
Ckd Stage ◽  
The Impact

Prescribing a low-protein diet (LPD) is part of the standard management of patients in advanced stages of chronic kidney disease (CKD). However, studies on the quality of life (QoL) of patients on LPDs are lacking, and the impact these diets have on their QoL is often given as a reason for not prescribing one. We, therefore, decided to assess the QoL in a cohort of CKD stage 3–5 patients followed up by a multiple-choice diet approach in an outpatient nephrology clinic in France. To do so, we used the short version of the World Health Organization’s quality of life questionnaire and compared the results with a historical cohort of Italian patients. We enrolled 153 patients, managed with tailored protein restriction in Le Mans, and compared them with 128 patients on similar diets who had been followed in Turin (Italy). We found there were no significant differences in terms of age (median 73 vs. 74 years, respectively), gender, CKD stage, and comorbidities (Charlson’s Comorbidity Index 7 vs. 6). French patients displayed a greater body mass index (29.0 vs. 25.4, p < 0.001) and prevalence of obesity (41.2 vs. 15.0%, p < 0.001). Baseline protein intake was over the target in France (1.2 g/kg of real body weight/day). In both cohorts, the burden of comorbidities was associated with poorer physical health perception while kidney function was inversely correlated to satisfaction with social life, independently of the type of diet. Our study suggests that the type of LPD they follow does not influence QoL in CKD patients and that a personalized approach towards protein restriction is feasible, even in elderly patients.

CLINICAL CASE: STEROID-RESISTANT NEPHROTIC SYNDROME

2021 ◽  
pp. 13-17
Author(s):  
А.Е. Турсын
Keyword(s):  
Quality Of Life ◽  
Nephrotic Syndrome ◽  
Arterial Hypertension ◽  
Clinical Case ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Moderate Severity ◽  
Syndrome Diagnosis ◽  
Pathogenetic Therapy

Описан клинический случай пациент с нефротическим синдромом, стероид резистентный вариант, с артериальной гипертензией, осложненный полисерозитом (гидроторакс, асцит, плеврит). Пациент поступил в клинику в состоянии средней степени тяжести, с массивными отеками, полисерозитом, артериальной гипертензией и выраженным нефротическим синдромом. Диагноз: Гломерулярная болезнь. Нефротический синдром, стероид резистентный вариант. Функция почек снижена (СКФ- 84мл/мин по Шварцу). Двухсторонний экссудативный плеврит. Гидроторакс. Полисерозит (в рамках нефротического синдрома) был установлен на основании выраженного нефротического синдрома. Пациенту была проведена патогенетическая терапия. Отмечено улучшение состояния больного, в виде снижения отеков, нормализаций артериального давления, что в свою очередь поспособствовало сохранению и улучшению качества жизни пациента. A clinical case of a patient with nephrotic syndrome, steroidresistant variant, with arterial hypertension complicated by polyserositis (hydrothorax, ascites, pleurisy) is described. The patient was admitted to the clinic in a state of moderate severity, with massive edema, polyserositis, arterial hypertension, and severe nephrotic syndrome. Diagnosis: Glomerular disease. Nephrotic syndrome, steroidresistant variant. The kidney function is reduced (GFR - 84 ml/min according to Schwartz). Bilateral exudative pleurisy. Hydrothorax. Polyserositis (within the framework of nephrotic syndrome) was established based on the severe nephrotic syndrome. The patient underwent pathogenetic therapy. An improvement in the patient's condition was noted, in the form of a decrease in edema, normalization of blood pressure, which in turn contributed to the preservation and improvement of the patient's quality of life.

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