Saratov JOURNAL of Medical and Scientific Research

arterial hypertension

Clinical and diagnostic significance of arterial stiffness in the early post-stroke period

Year: 2019, volume 15 Issue: №3 Pages: 769-773
Heading: Cardiology Article type: Original article
Authors: Mayorova S.V., Lipatova Т.Е., Haibekova T.V.
Organization: Saratov State Medical University
Summary:

The purpose of the study is the analysis of neurological functions' restoration in patients with hypertension in the early post-stroke period after ischemic stroke, depending on the parameters of vascular wall rigidity. Materials and Methods. The study included 50 patients with hypertension in the acute phase of ischemic stroke. Clinical, laboratory and instrumental studies were carried out on patients. Vascular wall rigidity was defined using the ankle-brachial index and stiffness index, as well as deficit neurological functions — using the NIHSS, MRS scales. Results. It is shown that high levels vascular wall rigidity is associated with marked shortage of neurological function in hypertensive patients in the early post-stroke period. Conclusion. Accounting indicators of vascular stiffness allow more accurate assessment of prognosis and help to develop personalized treatment strategy in patients with hypertension in the early post-stroke period after ischemic stroke.

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Frailty and arterial hypertension (lecture)

Year: 2019, volume 15 Issue: №3 Pages: 757-763
Heading: Cardiology Article type: Lecture
Authors: Lipatova Т.Е., Tyultyaeva L.A., Denisova Т.Р., Shulpina N.Yu.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

The lecture analyses reference data on the problem of combination of senile asthenia and hypertension in elderly and senile patients. It discusses modern views on the possibilities and problems of diagnosis and treatment of patients with a combination of senile asthenia and hypertension.

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Progression of chronic heart failure in atrial fibrillation in patients with arterial hypertension in combination with extracardial pathology

Summary:

Purpose: to study the features of the course of atrial fibrillation (AF) in patients with arterial hypertension (AH) and chronic heart failure (CHF) in combination with concomitant extracardial pathology and to assess the effect of AF on the progression of chronic heart failure. Material and Methods. In an observational cohort study was observed in 308 patients 45-60 years with AF in hypertension and CHF in combination with noncardiac pathology: diabetes mel-litus (DM) (n=40); diffuse toxic goiter (DTG) (n=42); hypothyroidism (GT) (n=59); abdominal obesity (АО) (n=64); and chronic obstructive pulmonary disease (COPD) (n=47). The comparison group consisted of 56 patients with AF and CHF hypertension, without concomitant noncardiac disease. When comparing groups, the unpaired Mann — Whitney U- test for numerical variables and the exact two-way Fisher test for categorical variables were used. Differences were considered significant at a level of p <0.05. The calculations were carried out in the program Rstudio. Results. In all the presented clinical groups there were no differences in the frequency of the permanent form of AF, paroxysmal form was more often recorded in thyroid and АО pathology, and persistent form in COPD, DTZ and DM. Transformation of paroxysmal AF into chronic AF occurred in groups of patients with DTZ (p<0.001), DM (p=0.041) and АО (p=0.004). Progression of CHF was revealed in groups of patients with DTZ (p<0.004), DM (p<0.008), АО (p<0.001) and COPD (p=0.05). Conclusion. Significant progression of AF and CHF is observed in patients with SSD, COPD, АО and DTZ. The most pronounced indicators of left ventricular diastolic dysfunction were found in patients with DM, GT and АО.

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Issues on optimization of primary health care for working patients with diagnosed hypertension

Year: 2017, volume 13 Issue: №1 Pages: 007-009
Heading: Health Service Organization Article type: Original article
Authors: Shulpina N.Yu., Erugina M.V, Sazanova G.Yu, Krom I.L.
Organization: Saratov State Medical University
Summary:

Aim: to justify the ways of optimization of availability of primary health care for working-age patients with arterial hypertension. Material and Methods. The study of the availability of drug treatment of working-age patients with arterial hypertension was based on a survey of 409 patients and calculated the average cost of treatment of this group of patients for 1 month in accordance with the care standards. Results. On 01.06.2016, the cost of treatment for a patient with stage 1 hypertension amounted to 316.89 rubles per month, with 2 stage 652.68 rubles per month. 67% of patients of working age are unable to follow the doctor's recommendations and take the prescribed medicines. Conclusion. Provision of free medicines to patients with arterial hypertension of stages 1 and 2 and the formation of their commitment to preventive treatment causes a direct economic effect, which will be 7915979 rubles per year, and indirect economic effect of the decreased mortality from cardiovascular diseases, disability, reduce in disability days and increase of the gross domestic product.

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Evaluation of treatment of patients with essential hypertension at primary care units using structured questionnaires (a polyclinic of the Saratov region as an example)

Year: 2016, volume 12 Issue: №4 Pages: 560-565
Heading: Internal Diseases Article type: Original article
Authors: Gerasimov S.N., Korotin A.S., Alexandrova I.N., Popova Yu.V.
Organization: Saratov Institute of Cardiology, Russia, Krasnoarmeysk Regional Hospital, Engels City Polyclinic №4
Summary:

The aim of the article is to assess patients' view on the treatment of hypertension in polyclinic located in the Saratov region using structured questionnaires. Material and Methods. 83 patients (aged 64.6±9.6 years, males 30%) with the diagnosis of essential hypertension who referred to the polyclinic of workers settlement of the Saratov region during the period from July 1, 2015 to July 7, 2015 were interviewed. The questionnaire for patients with elevated blood pressure (BP) developed by S. N. Gerasimov et al. (2015) was used. The questionnaire included 16 questions organized in the following panels: awareness of hypertension and risk factors, BP self-monitoring, conducted treatment, compliance to therapy, referrals to medical care. Results. 90% of the interviewed patients have known previously about BP elevation; 90% of respondents have had a tonometer; 84% of hypertensives measured BP no rare then once a week, and 54% did it daily; 88% of enrollers regularly take antihypertensive drugs. Only 36% of patients could be classified as compliant to therapy according the Morisky — Green scale (had 4 points). 92% of respondents have received one or more advice on lifestyle modification: 82% — advice on eating, 66% — advice on weight reduction, 55% — advice on physical activity, 28% — advice on smoking cessation, 26% — advice on alcohol consumption. 62.7% of patients were interested in organization of special follow-up program. Conclusion. High frequency of BP self-measurement was identified together with low compliance of patients to antihypertensive therapy, good knowledge on non-pharmacologic treatment interventions.

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Gender features of risk factors and clinical course of arterial hypertension

Year: 2015, volume 11 Issue: №4 Pages: 542-547
Heading: cardiac surgery Article type: Original article
Authors: Shkatova E.Yu., Bakshaev I.N., Korolkova G.S.
Organization: Igevsk State Medical Academy
Summary:

The aim of the article is to reveal the risk factors and features of the clinical course of hypertension in men and women. Material and Methods: A prospective study of 204 patients was carried out. The survey included a sociological survey, with the use of special socio-sanitary profiles, matters which concern lifestyle characteristics of respondents, hereditary risk factors, peculiarities of hypertension. Results: Men often have a hidden crisis-free for hypertension with a great number of complications; women have a longer duration of the disease, with a more severe clinical picture. Conclusion: The differences of social and health behavior with the existing risk factors and the clinical course of hypertension according to the gender of the patient have been revealed.

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Perspectives for the analysis of arterial hypertension morbidity in Saratov region

Year: 2015, volume 11 Issue: №2 Pages: 97-100
Heading: Health Service Organization Article type: Original article
Authors: Zhuzhlova N.Y., Sazanova G.Y., Dolgova E.M.
Organization: Saratov State Medical University
Summary:

Purpose: the study of trends in overall morbidity and primary hypertension in the Saratov region over the period from 2002 to 2013. Materials and methods. The official statistics Ministry of Health and the Federal State Statistics Service were used, which is processed using analytical and statistical methods. Results. The article has been providing the analysis of total and primary arterial hypertension morbidity of the population of the Saratov region, which is in accordance with the degree of the Government of the Russian Federation from December 1, 2004, N 715 to the group of socially significant diseases. During the period from 2002 to 2013 in the Saratov region, as well as in the Russian Federation in Volga Federal district, the tendency of growth of the overall incidence and the decrease in the primary incidence of arterial hypertension. Conclusion. The dynamics of incidence of hypertension suggests the need for careful analysis and optimization of medical care for patients with hypertension

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Relationship of daily arterial blood pressure monitoring readings and arterial stiffness profile in male patients with chronic obstructive pulmonary disease combined with arterial hypertension

Year: 2013, volume 9 Issue: №2 Pages: 247-252
Heading: Internal Diseases Article type: Original article
Authors: Karoli N.A., Dolishnyaya G.R., Borodkin A.M., Rebrov A.P.
Organization: Saratov State Medical University
Summary:

The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD) and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM) and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation). Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

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Association of polymorphism of CYP2D6 and CYP2C9 genes encoding P-450 proteins of cytochrome with arterial hypertension

Year: 2012, volume 8 Issue: №4 Pages: 933-937
Heading: Internal Diseases Article type: Original article
Authors: Borodulin V.B., Shevchenko O.V., Bychkov E.N., Kiselev A.R., Reshetko O.V., Posnenkova O.M., Saratsev A.V., Losev O.E.
Organization: Saratov State Medical University
Summary:

Gene polymorphisms of cytochrome P-450 CYP2 encoding proteins of cytochrome P-450 are essential forantihy-pertensive drugs metabolism. Purpose: We study the associations of functionally defective allele variants of CYP2D6 gene and CYP2C9 gene with the degree of arterial hypertension (AH). Materials and methods: Samples of DNA of leukocytes of blood of 150 patients with AH without the associated clinical conditions (56% of women) at the age of 20-59
years have been investigated. For the study of polymorphism of genes the pharmacogenetic biochip developed in the Institute of Molecular Biology n.a. V. A. Engelgardt has been used. Comparison of frequencies of occurrence of signs has been carried out on the basis of chi-square criterion. Results: It has been revealed that homozygotes by mutant A1075C, C430T alleles of CYP2C9gene and G1934A of CYP2D6 gene have been significantly more common among patients with hypertension III (p=0.01). Conclusion: The research works on genes of system of P-450 cytochrome have important clinical value for rationalization of pharmacotherapy of hypertension. The increased frequency of occurrence of mutant allele of CYP2D6 and CYP2C9 genes in patients with hypertension III requires special attention to the problem of efficiency and safety of application of hypotensive drugs for the patients.

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The role of genetic mutations in development of metabolic disturbances in patients with arterial hypertension

Year: 2012, volume 8 Issue: №3 Pages: 751-756
Heading: Internal Diseases Article type: Original article
Authors: Borodulin V.B., Shevchenko O.V., Bychkov E.N., Reshetko O.V., Kiselev A.R., Posnenkova O.M., Zhelezinskaja N.V., Sarattsev A.V., Losev O.E.
Organization: Saratov State Medical University, Saratov Institute of Cardiology, Russia, First Moscow State Medical University n.a. I.M. Sechenov, Clinical Hospital of Ministry of Internal Affairs of the Russian Federation
Summary:

The article stresses on the study of molecular markers of essential arterial hypertension providing insight into the pathological mechanisms underlying the disease and creation of «genetic passport» for every patient in the future. Objective: To study genetic markers of 5,10-methylenetetrahydrofolate reductase (MTHFR), involved in the metabolism of homocysteine, and N-acetyltransferase 2 (NAT2), ensuring the process of transformation of acetyl-CoAto acetoacetyl-coenzyme A. Methods: The study involved 160 patients with essential hypertension l-lll stages Caucasian (57.5% female.) aged 20-59 years. MTHFR gene polymorphisms and NAT2 in DNA of peripheral blood leukocytes were studied using a set of Wizard Genomic DNA Purification Kit (Promega, USA). Results: It was shown that «slow acetylators» (homozygous for a mutant version of the gene NAT2) were more frequently (p <0.05) determined among patients with hypertension stage 1. It was also revealed the dependence on the presence of hypertension stage mutant allele T (hetero-and homozygous variants) in 677 nucleotide gene MTHFR (r = 0,40, p <0.001). Conclusions: The regularities of the distribution of polymorphic variants of MTHFR and NAT2 gene were found out in hypertensive patients according to the stage of the disease.

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