Arterial Hypertension (Russian Federation)最新文献

{"title":"Orthostatic hypotension and its associations with geriatric syndromes in subjects over 65 years old: data from EVKALIPT study","authors":"N. Vorobyeva, A. V. Luzina, I. Malaya, Y. Kotovskaya, O. Tkacheva","doi":"10.18705/1607-419x-2023-29-3-253-265","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-253-265","url":null,"abstract":"Objective. To estimate the prevalence of orthostatic hypotension (OH) and analyze its associations with geriatric syndromes (GS) in subjects aged ≥ 65 years.Design and methods. In total, 4308 subjects (30 % males) aged 65 to 107 years (mean age 78 ± 8 years) living in 11 regions of the Russian Federation were examined, who were divided into 3 age subgroups (65–74 years, 75–84 years and ≥ 85 years). All participants underwent a comprehensive geriatric assessment, which consisted of two stages: 1) questionnaire on a specially developed questionnaire; 2) objective examination. Orthostatic test was performed in 3982 (92,4 %) patients. OH was diagnosed with a decrease in systolic blood pressure (BP) by ≥ 20 mm Hg or diastolic BP — by ≥ 10 mm Hg (or a decrease in both parameters) within 3 minutes after switching to orthostasis.Results. The frequency of OH in all subjects was 7,9 %, including 6,7 % in subjects aged 65–74 years, 8,4 % — 75–84 years, 8,8 % — ≥ 85 years (p for trend = 0,093). Univariate regression analysis showed that with an age increase per every 1 year, the odds of OH increased by 1,4 % (odds ratio [OR] 1,014; 95 % confidence interval [CI] 1,001–1,028; p = 0,042). Univariate regression analysis also demonstrated that 5 of the 15 studied GSs were associated with the presence of OH: urinary (OR 1,41; 95 % CI 1,12–1,77; p = 0,004) and fecal (OR 1,61; 95 % CI 1,01–2,58; p = 0,046) incontinence, malnutrition (OR 1,77; 95 % CI 1,15–2,72; p = 0,009), visual deficit (OR 2,23; 95 % CI 1,47–3,40; p < 0,001) and falls in the previous year (OR 1,37; 95 % CI 1,08–1,75; p = 0,010). Multivariate regression analysis adjusted for age and sex found that only 2 GSs were independently associated with the presence of OH: urinary incontinence (OR 1,36; 95 % CI 1,08–1,72; p = 0,009) and visual deficit (OR 2,01; 95 % CI 1,37–3,19; p = 0,001).Conclusions. The EVKALIPT study first obtained domestic data on the prevalence of OH in subjects aged ≥ 65 years and studied the associations between OH and GSs.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86631762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiotensin-converting enzyme: a well-known stranger. Part I","authors":"E. O. Nalesnik","doi":"10.18705/1607-419x-2023-29-4-353-370","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-4-353-370","url":null,"abstract":"The angiotensin-converting enzyme (ACE) was discovered in 1956 and has been actively studied to date. It has a unique structure of two homologous domains, each containing a catalytic zinc ion. Domains have different substrate specificity. In terms of function, ACE is a zinc metallopeptidase widely present on the surface of endothelial and epithelial cells. The gene encoding ACE is located on the long arm of chromosome 17 (17q23) and is 21 kb long, including 26 exons and 25 introns. The structure of ACE may be the result of an ancient gene duplication that occurred approximately 700 million years ago. The main function of ACE is the conversion of AngI to the vasoconstrictor AngII, which is the main active product. In addition, ACE metabolizes bradykinin, which is a potent vasodilator. ACE is involved in the metabolism of other angiotensins, in particular Ang(1–7), forming, together with ACE 2 and other components of the renin-angiotensin-aldosterone system (RAAS), a complex balanced system for maintaining blood pressure, water and electrolyte balance, and many other components of systemic, tissue and cellular homeostasis that have not yet been fully studied. More data are accumulating confirming the role of ACE for the renal development, early hematopoiesis, normal male fertility, erythropoiesis, myelopoiesis. ACE plays important roles in the immune response, intracellular signaling.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135836653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary embolism: options for interventional treatment in the intermediate-high risk group","authors":"S. I. Parkhomenko, K. B. Lapshin, T. Glebovskaya, K. Malikov, N. Marukyan, D. D. Zubarev, D. Alekseeva, O. Moiseeva, M. Simakova","doi":"10.18705/1607-419x-2023-29-3-306-319","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-306-319","url":null,"abstract":"Selective transcatheter thrombolysis (STT) in patients with pulmonary embolism (PE) with an intermediatehigh risk of 30-day mortality is an option for rapid lung reperfusion with a decrease in right ventricular (RV) afterload, which largely determines the prognosis of patients.Objective. Comparison of the efficacy of STT using reduced doses of alteplase and routine conservative treatment of patients with PE with an intermediate-high risk of 30-day mortality using a retrospective analysis of the data from Almazov National Medical Research Centre.Design and methods. The retrospective single-center study included 45 patients (18 men (40 %) and 27 women (60 %)) admitted to the anaesthesiology and resuscitation department of the Almazov National Medical Research Centre from January 1, 2021 to May 1, 2022 with the confirmed diagnosis of acute PE. Intermediate-high risk patients (22 people (57,9 %)) were divided into two groups according to the treatment strategy: the group receiving standard anticoagulant therapy (n = 15 (68,2 %)) and the group with STT by alteplase at a total dose of 50 mg (n = 7 (31,8 %)). In order to assess the effectiveness of treatment, the main laboratory and instrumental indicators were compared based on data from the medical information system.Results. Baseline clinical characteristics of the compared groups did not differ. Systolic pressure in the pulmonary artery (SPPA) in the transcatheter treatment group decreased from 59 [50; 82] to 35 [30; 65] mmHg; in the conservative treatment group: from 65 [50; 70] to 52 [40; 59] mmHg. In the selective thrombolysis group, there was a significant trend for a greater decrease SPPA compared to the anticoagulant therapy group: –25 [–29; –3] versus — 10 [–23; –6] mmHg, р = 0,047. There was a significant change in the level of leukocytes and platelets in the group of transcatheter treatment versus anticoagulant therapy: –5,0 [6,1; 4,1] × 109/l vs –2,8 [4,3; 1,8] × 109/l (p = 0,017) and 130 [32; 181] × 1012/l vs 31 [2; 56] × 1012/l (р = 0,044). There were no significant differences in the change in the RV size between the groups. The groups did not differ in the total number of hemorrhagic complications. When bleeding was divided by severity (according to the TIMI classification), moderate bleeding was more common in the selective thrombolysis group (2 cases versus 0 with a conservative approach, p = 0,014). There were no differences in the duration of treatment in the anaesthesiology and resuscitation department and the terms of inpatient treatment.Conclusions. A single center retrospective study demonstrated the high quality of approaches to the diagnosis and treatment of PE in terms of current guidelines. The STT with reduced doses of alteplase was associated with a more significant decrease SPPA and normalization of hemogram parameters when compared to the standard treatment approach. At the same time, selective thrombolysis was associated with a higher risk of hemorrhagic complications.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"148 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77987556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of effective lipid-lowering therapy on the prognosis in patients who have suffered ST-segment elevation myocardial infarction","authors":"V. Oleynikov, L. Salyamova, O. Kvasova, V. A. Shmeleva, Y. Tomashevskaya, N. Borisova","doi":"10.18705/1607-419x-2023-29-3-320-329","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-320-329","url":null,"abstract":"Objective. To study the dynamics of quality of life, exercise tolerance, parameters of central and peripheral blood pressure, adverse cardiovascular events depending on the achievement and maintenance of the target level (TL) of low-density lipoprotein cholesterol (LDL) against the background of 48-week high-dose therapy with atorvastatin.Design and methods. In total, 141 patients with acute myocardial infarction with ST-segment elevation were included. Within 48 weeks patients received atorvastatin 40–80 mg/day. A comprehensive examination was performed on days 7–9, after 24 and 48 weeks. After 192 weeks the endpoints were assessed.Results. The study was completed by 125 people (88,7 %). The patients were divided into groups: “А” (n = 41) — with achieved TL of LDL after 24 and 48 weeks; “PA” (n = 35) — partially achieved TL of LDL — on one of two visits; “NA” (n = 49) — not achieved TL. According to the Minnesota questionnaire, the symptoms of chronic heart failure increased in the groups “PA” (+53,5 %; p = 0,009) and “NA” (+75 %; p = 0,001). During applanation tonometry in the “PA” group, the number of people with elevated pulse pressure in the aorta increased. In the “NA” group, an increase in cases of normal and elevated central aortic systolic, pulse pressure was diagnosed. After 192 weeks the frequency of endpoints in the “PA” and “NA” groups was 38,1 % vs 17,1 % in the “А” group (p = 0,017); the odds ratio was 3,0 (95 % confidence interval 1,2–7,5).Conclusions. Our study demonstrated the most favorable clinical profile and prognosis in patients who achieved and maintained LDL for 48 weeks treatment.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87491454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Target organ damage in people with chronic heart failure infected with human immunodeficiency virus depending on blood pressure control","authors":"O. G. Goryacheva","doi":"10.18705/1607-419x-2023-29-4-380-391","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-4-380-391","url":null,"abstract":"Objective . To study target organ damage in patients with chronic heart failure (CHF) infected with the human immunodeficiency virus (HIV), depending on the control of blood pressure (BP) in a single-stage clinical study. Design and methods . We examined 240 patients with HIV infection in a multidisciplinary hospital. The diagnosis of CHF was confirmed by the plasma level of the N-terminal fragment of the brain natriuretic peptide (NT-proBNP), echocardiographic criteria, and clinical signs. Subsequently, patients with CHF and elevated BP ≥ 140/90 mm Hg (40 people) and with BP from 91/61 to 139/89 mm Hg (76 people) were selected. In all patients we assessed serum levels of tissue inhibitor of metalloproteinases-1 (TIMP-1) and cystatin C to assess renal filtration function. We also performed non-invasive arteriography with the determination of daytime BP for 3 hours using TensioMed ArterioGraph 24 (Great Britain). The data were processed using the Statistica 13.0 program. Results . In patients with CHF and HIV infection BP ≥ 140/90 mm Hg was associated with subclinical arterial disease, manifested by an increase in augmentation indices and pulse wave velocity, as well as an increase in serum level of TIMP-1. It was also accompanied by a decrease in the renal filtration function, which was confirmed by a higher serum level of cystatin C and a lower glomerular filtration rate calculated on the basis of cystatin C using the CKD-EPIcys. Myocardial remodeling in patients with CHF, HIV and elevated BP ≥ 140/90 mm Hg is presented by a more frequent left ventricular diastolic dysfunction, left ventricular hypertrophy (LVH), and left atrial dilatation. In patients with CHF and HIV infection, BP ≥ 140/90 mm Hg is associated with a higher incidence of heart failure, thrombocytopenia and a history of serum iron deficiency, as well as the intake of protease inhibitors and nucleoside reverse transcriptase inhibitors. Conclusions . In patients with HIV infection and CHF, an increase in BP ≥ 140/90 mm Hg is associated with the subclinical damage of arterial wall, kidneys and myocardium (mainly diastolic dysfunction, LVH and left atrial dilatation). The use of protease inhibitors and nucleoside reverse transcriptase inhibitors is more common in individuals with elevated BP ≥ 140/90 mm Hg.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135951897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of adverse vascular events after carotid endarterectomy: a ten-year follow-up","authors":"L. F. Bikbulatova, I. A. Lakman, L. R. Akhmadeeva, N. Sh. Zagidullin, V. V. Plechev, Yu. O. Urazbakhtina","doi":"10.18705/1607-419x-2023-29-4-392-401","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-4-392-401","url":null,"abstract":"Significant atherosclerotic stenosis of the carotid arteries can provoke ischemic stroke and is one of the factors considered when assessing eligibility for carotid endarterectomy (CEE). Objective . To identify risk factors for the development of adverse vascular events (AVE) after undergoing CEA in the medium-term (5 and 7 years) and long-term (10 years) follow-up. Design and methods . In total, 257 patients underwent reconstructive surgery on the carotid arteries in the period from 2007 to 2010, and at 1–1,5-year follow-up after the operation, we assessed the regularity of taking prescribed medications, vital activity according to the Barthel index, FIM scale, scales of anxiety, depression and mental status assessment (MMSE); and lipid profile. Long-term endpoints (death or acute cerebrovascular accident) were registered for 5-10 years after surgery. During follow-up, 129 patients dropped out at different stages of the study, 47 died during the study period (30 died from cardiovascular disease), 37 had a stroke. Cox’s proportional hazards model was used as a tool for survival analysis. Results . Older age (over 60 years) at the time of surgery increases the risk of death and the onset of AVE in the period up to 5, 7 and 10 years after surgery by 1,106 (1,245) times, 1,137 (1,247) and 1,182 (1,182) times, respectively; smoking increases the risk of death within 5, 7 and 10 years by 2,963, 2,419 and 2,44 times; the presence of diagnosed depression in accordance with the HADS scale (part II) increases the risk of death after CEE in the period up to 5 years by 1,176 times. An increase in the atherogenicity coefficient by each unit relative to the average value (3,0) leads to an increase in the risk of death or the onset of AVE in the period of 5 years after the operation by 1,915 (2,159) times, in the period of 7 years — by 1,966 (2,183), and in 10 years — by 1,991 (2,264) times. Each additional point of the Barthel index relative to the mean value (95 points) reduced the risk of death or the onset of AVE in a 5-year period by 7 (9,5) % compared to the baseline, in 7 and 10-year periods by 4,5 (9) and 10 (10,5) %, respectively. A decrease in adherence to drug therapy increases the risk of death in the period up to 7 years — by 1,406 times, in 10 years — by 1,426 times. The lack of regular intake of acetylsalicylic acid increases the risk of AVE in the 5-year period after the operation by 3,278 times, in 7 years — by 2,892 times, in 10 years — by 2,837 times; each additional point of the MMSE scale from the mean value (28 points) reduces the risk of death in the period up to 10 years after CEE compared with the baseline risk by 1,51 times, the female gender increases the risk of AVE in the period up to 5, 7 and 10 years by 4,762, 3,952 and 3,484 times, respectively. Conclusions . Risk factors for the development of AVE after long-term follow-up after CEE have been identified, which can be used for the personalized preventive measures.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135951896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between folate cycle genes polymorphisms and development of chronic heart failure in patients with hypertension and type 2 diabetes mellitus","authors":"T. Sveklina, S. N. Kolyubaeva, S. Shustov, A. Kuchmin, V. A. Kozlov, M. Y. Yaroslavtsev, V. V. Konyaev, P. D. Oktysyuk","doi":"10.18705/1607-419x-2023-29-3-299-305","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-299-305","url":null,"abstract":"Limited studies have been performed on the association of distorted folates metabolism genetic markers with progression of clinically manifesting chronic heart failure with preserved ejection fraction (CHF-pEF) in patients with arterial hypertension (HTN) and type 2 diabetes mellitus (DM2).Objective. To identify folate cycle genes polymorphisms in patients with HTN, DM2 and CHF-pEF.Design and methods. We have identified the occurrence frequency of several MTHFR genes polymorphisms: 677 C > T (rs1801133), MTHFR: 1298 A > C (rs1801131), MTR: 2756 A > G (rs1805087), MTRR: 66 A > G (rs1801394) in patients with CHF-pEF and DM2 (n = 52), chronic heart failure with reduced ejection fraction (CHF-rEF) and DM2 (n = 49) and control patients without CHF or DM2 (n = 66). Mean aged was 69,9 ± 10,1 years old.Results. In comparison to the controls, the CHF-pEF group showed higher frequencies of rs1801133: CHF-pEF group — 61,54 % vs. 28,57 % (odds ratio (OR) — 4,0, confidence interval (CI) — 1,788–8,948, p < 0,002); rs1805087–75,0 % vs. 25,0 % (OR — 9,0, CI — 3,573–22,673, p < 0,001), rs1801394–90,38 % vs. 69,39 % (OR — 4,2, CI — 1,375–12,510, p < 0,017). Compared to the CHF-rFV group, the following frequencies were found: CHF-rFV — rs1805087–75,0 % against 36,96 % (OR — 5,2, CI — 2,110–12,414, p < 0,001), rs1801394–90,38 % vs. 68,75 % (OR — 4,3, CI — 1,414–12,909, p < 0,011). The polymorphism frequencies in CHF-rFV were generally comparable with such of the controls. Conclusions. Higher frequencies of rs1801133, rs1805087 and rs1801394 polymorphisms were detected in patients with HTN, DM2 and those with CHF-pEF, as compared to either helthy patients and those with reduced ejection fraction. There is also high rate of rs1801394 polymorphism in patients with HTN, DM2, regardless of the ejection fraction.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79510260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NOS 3 gene polymorphism –786T&gt;S (rs2070744) as the risk factor of hemodynamic disorders in Northerners","authors":"I. V. Averyanova, I. N. Bezmenova","doi":"10.18705/1607-419x-2023-29-4-411-418","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-4-411-418","url":null,"abstract":"Objective . This research assessed the influence of polymorphism –786T&gt;C (rs2070744) of the NOS3 gene on the hemodynamic impairments in the Northern residents. Design and methods . One hundred and one volunteers of Magadan region, mainly Caucasians by ethnicity, underwent molecular genetic examination, and a continuous method was used to form the study sample. DNA was isolated by phenol-chloroform extraction followed by polymorphism genotyping by the polymerase chain reaction. Results . In male Northerners, the following percentage variation in the genotype frequencies by the eNOS locus (rs2070744) was found: –786ТТ — 42,57 %, –786ТС — 43,56 %, –786СС — 13,87 %. The concentration of the eNOS *C allele was 35,64 %, the ancestral eNOS *T allele occurred with the frequency of 64,36 %. The observed distribution of frequencies of alleles and genotypes corresponded to the Hardy-Weinberg equilibrium (χ 2 (HWE) = 0.26, p &gt; 0.05). The presence of even one eNOS *C allele in the genotype causes a significant increase in diastolic blood pressure level. The lowest blood pressure (80,3 ± 5,9 mmHg) was found in male homozygotes by the ancestral eNOS *T allele, while the T/C heterozygotes and the C/C homozygotes showed significantly higher blood pressure (83,2 ± 7,3 and 82,9 ± 3,7 mmHg, respectively). The individuals with the C/C genotype showed lower cardiovascular adaptabilities, in particular lower indicators of stroke volume (SV, 43,6 ± 3,7 mL) and cardiac output (CO, 2836,3 ± 182,4 mL/min) with a significant increase in total peripheral vascular resistance (TPVR, 3028,3 ± 252,7 dyn 2 s cm -5 ) compared to the T/T homozygotes (SV, 49,6 ± 7,9 mL; CO, 3393,1 ± 546,8 mL/min; TPVR, 2572,8 ± 559,4 dyn 2 s cm -5 ). Conclusions . This study showed that the eNOS *C allele is associated with the hemodynamic disorders. These results can be used to calculate the risk of cardiovascular pathologies at younger ages, which can develop under the North extremes.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of adherence to therapy in comorbid patients","authors":"L. Khidirova, D. Yakhontov, P. G. Madonov","doi":"10.18705/1607-419x-2022-28-6-109-118","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-109-118","url":null,"abstract":"Objective. To evaluate adherence to therapy in patients with hypertension (HTN) and atrial fibrillation (AF) in combination with extracardiac comorbid pathology. Design and methods. In an observational cohort study, 884 patients aged 45–65 years with AF (paroxysmal and persistent form) and HTN were observed, in combination with extracardiac comorbid diseases: diabetes mellitus (DM), n = 123; abdominal obesity (AO), n = 171; chronic obstructive pulmonary disease (COPD), n = 137, hypothyroidism, n = 156; thyrotoxicosis, n = 112. The comparison group consisted of 185 patients with AF and HTN, without concomitant extracardiac pathology. Clinical, anthropometric parameters, the Morischi–Green adherence test were evaluated in the work. To assess the social aspects of low adherence, special questionnaires were developed. All statistical calculations were performed using the Rstudio program. Results. Among patients with AF and HTN, 66 % had concomitant extracardiac comorbid pathology, 20 % of them with DM; COPD was detected in 22 % of patients, and AO was observed in 44 % of patients, 6 % patients had thyroid disease. 15,2 % patients were insufficiently adherent (ADH), 37,2 % were not adherent to therapy (NADH), and only 47,8 % respondents were adherent to therapy. The duration of HTN was not a significant motivation for adherence, because the NADH group had a significantly longer duration of arterial hypertension compared with the ADH group (12.3 vs 10.5 years; p < 0.03); patients with the permanent form of AF were more than ADH (p = 0,001), and the adherence did not differ between groups depending on extracardiac diseases. The blockers of the renin-angiotensin-aldosterone system showed the greatest use — up to 66 %, while adherent patients were more likely to take single-pill combination (SPC) of perindopril (SPC indapamide/perindopril and SPC amlodipine/indapamide/perindopril) (p = 0,003; p = 0,01). Based on the analysis, it was found that the presence of a family, higher education, income level, motivation and trust in doctors are significant factors that increase adherence to treatment. Conclusions. The problem of non-commitment has been and remains one of the most complex and difficult to solve. The main reason for low adherence among patients with AF with concomitant extracardiac diseases was polypharmacy, and it is associated with the use of a large number of drugs and a complex treatment regimen. Thus, the limitation of the use of fixed combinations is one of the main reasons for the lack of adherence and needs to be addressed soon.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74572046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac troponin I in a representative sample of the Kyrgyz Republic population: distribution, ethnic differences, and association with risk factors","authors":"А. V. Kontsevaya, A. Polupanov, D. Mukaneeva, V. Kutsenko, E. Yarovaya, M. T. Duishenalieva, A. V. Belinova, Zh.A. Mamasaidov, O. Drapkina","doi":"10.18705/1607-419x-2022-28-6-79-90","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-79-90","url":null,"abstract":"Objective. To assess the distribution of cardiac troponin I (cTnI) in a sample of the Kyrgyz Republic population, to study its associations with risk factors and to identify the possible ethnic differences. Design and methods. This observational cross-sectional study includes a representative sample of the Kyrgyz Republic population aged 20–64 years (n = 1256). The analysis of cTnI levels in the population and associations of cTnI levels with socio-demographic parameters (sex, age, education, etc.), risk factors (smoking, obesity, hypertension, etc.), blood biochemical parameters (triglycerides, lipid profile, glucose) and an anamnesis of cardiovascular diseases and total cardiovascular risk according to the SCORE scale. The statistical significance level was considered equal to 0,05. Results. The median cTnI level in the Kyrgyz sample was 0,90 pg/ml [0,40; 1,80]. The 99th percentile for the entire sample was 21,4 pg/ml in men and 12,2 pg/ml in women. The median cTnI in the Slavs sample was 1,40 pg/ml [0,60; 2,20]. The 99th percentile for the entire sample was 21,2 pg/ml in men and 25,2 pg/ml in women. The cTnI level log increases significantly with age in both men and women. At the age of 20-30 years, the cTnI level in men is higher than in women in both ethnic groups. However, with age, the increase rate of cTnI in women is higher than in men in both ethnic groups. In a multivariate analysis, significant associations of cTnI levels with sex, age, hypertension, stroke, blood levels of total cholesterol and triglycerides were obtained. Insufficient accuracy of classification of study participants by SCORE risk was revealed. Conclusions. cTnI is a potential strong biomarker that complements traditional risk scales and is applicable in the framework of cardiovascular diseases primary prevention strategies, which was confirmed in this study on the Kyrgyz Republic population.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80407277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}