Arterial Hypertension (Russian Federation)最新文献

{"title":"The possibilities of the new START indicator in the assessment of vascular stiffness in healthy individuals","authors":"","doi":"10.18705/1607-419x-2023-29-1-38-50","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-1-38-50","url":null,"abstract":"Objective. To study the possibility of using the new arterial stiffness index START in healthy individuals of different ages. Design and methods. The study included data from healthy individuals without any medical history (n = 190), 121 men and 69 women aged 25–64 years. Arterial stiffness was assessed for all subjects on the VaSera VS-1000 device (Fukuda Denshi, Japan). As an additional parameter, the new domestic stiffness index START was analyzed retrospectively. Results. The average age of the participants was 37,0 ± 8,1 years, 63,7 % men. The median of the CAVI index was 6,6 on the right, 6,7 on the left. The median of the START index was 5,02 on the right, 5,3 on the left. A strong correlation between CAVI and START indicators was found (r = 0,829, p < 0,001). The relationship of age with the CAVI and START indices was established (CAVI r = 0,469, p < 0,001, START r = 0,49, p < 0,001). The dependence of vascular wall stiffness indicators on smoking experience (CAVI r = 0,458, p < 0,001, START r = 0,466, p < 0,001), glomerular filtration rate (GFR) (CAVI r = –0,265, p < 0,001, START r = –0,282, p < 0,001) was found. The gender features of the dependence of vascular wall stiffness on the level of high-density lipoproteins (HDL) (in women, CAVI r = 0,241, p = 0,048; START r = 0,358, p = 0,003) and body mass index (BMI) (in women, CAVI r = 0,411, p = 0,027, START r = 0,374, p = 0,046). Conclusions. When examining healthy individuals, a high correlation of the new START index with the CAVI index was shown both in the whole sample and in men and women separately. The START index had a statistically significant correlation with age, smoking experience and GFR among all surveyed, as well as with HDL and BMI in women.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87587616","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":"Dynamics of structural and functional characteristics of the heart in patients after myocardial infarction with ST segment elevation as a marker of progression of chronic heart failure","authors":"V. Karetnikova, S. Berns, E. A. Shmidt, T. P. Artemova, R. Shepel, O. Barbarash","doi":"10.18705/1607-419x-2022-28-6-681-688","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-681-688","url":null,"abstract":"Objective. To identify the association of a number of clinical features and structural and functional characteristics of the heart with the progression of chronic heart failure (CHF) in patients one year after ST-segment elevation myocardial infarction (MI) (STEMI) with preserved and reduced left ventricular ejection fraction (EF) (LVEF).Design and methods. 120 patients with STEMI were included in a prospective study. During the study, all patients underwent an echocardiographic study using a Sonos 2500 device (Hewlett Packard, USA) on the 1st day (point I), on the 12th day (point II) of hospitalization, and also after 1 year (point III). Depending on the parameters of EF on the 1st day of the disease, the total sample of patients was divided into two: the 1st group — with preserved LVEF was represented by 86 (71,7 %), the 2nd group — with a reduced LVEF was represented by 34 (28,3 %) patients.Results. A total of 19 (15,8 %) adverse events were registered. In two cases, a fatal outcome (1,7 %) was recorded, the cause of which was repeated MI, in five (4,2 %) patients decompensation of СHF was noted, in eight (6,7 %) patients a clinic of progressive angina was traced, in four (3, 3 %) of patients were diagnosed recurrent MI. Deterioration of systolic and diastolic function was established one year after STEMI with preserved (≥ 50 %) LVEF: 17,6 % of patients began to correspond to the intermediate range of EF (40-49 %), the number of patients with diastolic dysfunction increased by 10 % compared to with acute study.Conclusions. Within a year after a STEMI with initially preserved LVEF, there is a deterioration in myocardial function in the form of a decrease in myocardial contractility and an increase in the number of patients with diastolic dysfunction.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83918088","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":"Blood pressure target achievement in older adults with hypertension and chronic heart failure with preserved ejection fraction: the impact of adipose tissue function","authors":"L. I. Malinova, S. Tolstov, T. S. Silina, T. Denisova, T. Lipatova","doi":"10.18705/1607-419x-2022-28-6-669-680","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-669-680","url":null,"abstract":"Objective. To assess the impact of adipose tissue dysfunction for target blood pressure levels achieving in arterial hypertension (AH) and chronic heart failure with preserved left ventricular ejection fraction (HFpEF) in real clinical practice.Materials and methods. We examined 91 elderly patients (> 75 y.o.) with AH and HFpEF during hospital admission. The mass and mass fraction of adipose tissue, serum levels of adipokines (adiponectin, leptin) and proinflammatory cytokines (TNFa and IL6) were assessed. Steady normotension at discharge was used as a marker of the target blood pressure level achievement possibility.Results. By the time of the planned discharge, stable normotension was recorded in 24.2% of patients. In senile patients with failure to achieve normotension, isolated systolic AH was most common - 55.1%. Patients with persistent hypertension at the time of the planned discharge were characterized by a low ability of adipose tissue to secrete adiponectin: 0.05 (0.03; 0.12) vs 0.37 (0.12; 0.5) μg/mL/kg (p = 0.037 ). The minimum values of adiponectin (corrected for adipose tissue mass) were in patients with systolic-diastolic AH (0.04 (0.03; 0.06) μg/ml/kg, Jonkhier-Terpstra test, p = 0.033). A regression model for achieving normotension in senile patients with HFpEF was built with a total percentage of correct classifications of 93.8% before bootstrap and 95.8% after: the maximum values of the Wald statistics were achieved with respect to the predictors \"adiponectin\", \"TNF-a\" and \"heart rate\".Conclusion. The development of adipose tissue dysfunction, accompanied by a decrease in the “rescue hormone” adiponectin synthesis, is associated with the failure to achieve normotension during medication of the inpatient treatment in senile patients with AH and HFpEF.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75748361","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 role of the rs2297518 of NOS 2 gene as a genetic biomarker of arterial hypertension and “arterial hypertension and tension-type headache” phenotype (the pilot study in East Siberia)","authors":"P. V. Alyabyeva, P. A. Reznichenko, N. A. Shnayder, D. S. Kaskaeva, M. M. Petrova","doi":"10.18705/1607-419x-2022-28-6-699-709","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-699-709","url":null,"abstract":"Nitric oxide (NO) plays an important pathogenetic role in vascular relaxation and is a candidate molecule of a common pathogenetic link in the development of arterial hypertension (AH) and tension-type headache (TTH).Objective of the study was to study the association of the single nucleotide variant (SNV) rs2297518 of the NOS 2 gene with the risk of developing AH and clinical “AH + TTH” phenotype in adults living in a large industrial city of Eastern Siberia.Design and methods. All participants (N = 91) were divided into two groups: group 1 (patients with AH) — 60 people, including the main subgroup (patients with AH without headache) — 30 people and a comparable subgroup (patients with clinical phenotype “AH + TTH”) — 30 people; group 2 (control — healthy volunteers) — 31 people. Carriage of the SNV rs2297518 gene NOS 2 (locus 17q11.2) was determined using real-time polymerase chain reaction.Results. The minor allele A rs2297518 of the NOS 2 gene was statistically significantly associated with a high risk of developing AH (odds ratio (OR) = 8,43 [95 % confidence interval (CI): 2,33–30,46], p = 0,000223) and phenotype “AH + TTH” (OR = 5,44 [95 % CI: 1,46–20,21], p = 0,006) compared with the control group. The heterozygous genotype GA rs2297518 of the NOS 2 gene also was statistically significantly associated with a high risk of developing AH (OR = 8,17 [95 % CI: 2,03–32,79], p = 0,001).Conclusions. The study demonstrated that the minor allele A of the SNV rs2297518 (26096597 G > A) of the NOS 2 gene, which encodes the inducible NO-synthase (iNOS), can be considered as a clinically significant genetic biomarker, first of all, of AH in the Caucasian population of Eastern Siberia. At the same time, future studies may clarify the role of this SNV as a genetic biomarker of the “AH + TTH” phenotype.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85724598","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":"Awareness and readiness to combat risk factors for cardiovascular disease: results of a survey of patients and doctors using open questions","authors":"Y. L. Begrambekova, A. G. Plisyuk, K. Ghazi, E. I. Zimakova, A. G. Armaganov, I. Orlova","doi":"10.18705/1607-419x-2022-28-6-641-649","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-641-649","url":null,"abstract":"Relevance. Assessment of the cardiovascular risk factors (RF) knowledge is important for the development of disease preventive programs. It is shown that awareness of the RF does not guarantee readiness for their correction, and there is a potential gap between intention and behavior. Ample evidence suggests that a physician’s commitment to a healthier lifestyle and RF control increases patient confi        in his recommendations. Assessment of the subjective attitude to RF for the development of cardiovascular diseases (CVD) and the readiness for their correction not only in patients, but also in doctors is an important task both for the health of the doctors themselves and indirectly for their future and current patients.Objective. To assess the subjective attitude to RF for the development of CVD and the readiness for their correction in doctors and patients of one medical organization.Design and methods. The study included 58 doctors and 55 patients who were consecutively hospitalized in different departments of the Medical Research and Education Center of Moscow State University named after M. V. Lomonosov. Doctors and patients of the cardiology department were not included in the study. All questions about CVD RF were open. The number of answers was not limited.Results. The analysis included 58 questionnaires of doctors and 52 questionnaires of patients. The median age of physicians was 37 [31; 48] years, among them 40 % were men. The median age of patients was 61 [49; 71] years, men — 42 %. Physicians expectedly showed higher awareness of various RF for CVD. They called an average of 4,9 ± 2,0 RF, and patients — 3,9 ± 1,6, but the difference was not significant. Physicians were more aware of carbohydrate metabolism disorders, malnutrition, physical inactivity, sleep disturbances, and stress as CVD RF (all p < 0,001), with more frequent patients, than physicians indicated smoking (67,3 % and 27,6 %, respectively, p < 0,001). Female physicians were statistically significantly less likely to report obesity (4,3 % and 25,7 %, respectively, p = 0,013). At the same time, they indicated hypertension more often than men (13,0 % and 2,6 %, respectively, p = 0,018). Physicians named one RF that threatened their own health more (p < 0,001). At the same time, physicians were willing to try to change less than half of these factors, while inpatients were determined to change two-thirds of the factors (45,9 % and 66,1 %, p = 0,012). Conclusions. The level of physicians’ awareness of CVD RF and readiness for change remains relatively low. To combat the growing burden of CVD in Russia, it is necessary to maximize the potential of not only cardiologists, but also doctors of other specialties, as channels of reliable information about health, develop and implement measures to increase awareness of the circumstances that contribute to the development of CVD, as well as tools for self-management of risks, not only among patients, but also among medical worker","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81207260","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":"Association of non-high-density lipoprotein hypercholesterol with metabolic syndrome, diabetes and arterial hypertension in the population of 45–69 years adults","authors":"G. Simonova, S. Mustafina, O. Rymar, C. K. Malyutina, L. Sherbakova, A. P. Kashirina, Y. Nikitin, Y. Ragino","doi":"10.18705/1607-419x-2022-28-5-501-517","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-5-501-517","url":null,"abstract":"Objective. To study the prevalence of non-high-density lipoprotein hypercholesterol (non-HDL–C) and the average levels of non-HDL–C in metabolic syndrome (MS), type 2 diabetes mellitus (DM2), arterial hypertension (AH) and other cardiometabolic risk factors in the Siberian population aged 45–69 years.Design and methods. The evaluation of atherogenic dyslipidemia among persons with AН, MS, T2D was based on the materials of Siberian branch of HAPIEE project in the random sample n = 9360 surveyed in 2003–2005 HAPIEE. The study program included questionnaire survey, blood pressure (BP) measurement, anthropometry, biochemical screening. The value ≥ 3,4 mmol/l was considered as hypercholesterol-non-HDL. AH was diagnosed at systolic BP levels ≥ 140 mm hg. art. or diastolic BP ≥ 90 mm hg. art. and/or taking antihypertensive drugs within the last 2 weeks. Persons with previously diagnosed AH, but with normotonia at screening in cases of taking drugs that reduce BP, were also counted as patients with AH. DM2 was diagnozed — according to WHO criteria, 1999, ADA, 2013 — at fasted plasma glucose level ≥ 7,0 mmol/l and persons with previously diagnosed DM2. MS and its components were diagnosed according to IDF criteria (2005).Results. The mean value of non-HDL cholesterol in the general population of Novosibirsk aged 45–69 were 4,7 ± 1,3 mmol/l and were higher in women than in men — 4,9 ± 1,3 mmol/l and 4,5 ± 1,2 mmol/l, (p < 0,0001). The prevalence of hypercholesterol-non-HDL in women varies from 84,7 to 94,3% — and is significantly higher than in men — 80,6 to 84,1%. The level of non-HDL cholesterol ≥ 3,4 mmol/l was observed in 86,8% of the examined, 11% — in the range of 2,6–3,39 and only 2,2% — less than 2,6 mmol/l. The average values of non-HDL–C in men and women in three cohorts (with DM2, MS and AH) were found to be the highest in DM2, lower in MS than in DM, and lower in AH than in MS and DM2. In the cohort with DM2, non-HDL–C, according to the criterion of non-HDL–C ≥ 3,4 mmol/l, was determined in 89,4% of men and 95,7% of women; in persons with MS, it was found in 92,4% of men and 95,1% of women, with AH — in 85,2% of men and 92,5% of women of the Siberian population aged 45–69 years. The frequencies of AH, MS and DM2 in the 5th quintile of the distribution of non-HDL–C are higher compared to the first quintile (p < 0,0001), with a predominance of these indicators in the female population.Conclusions. According to study, the content of non-HDL–C, and its prevalence of elevated levels in the population is high, especially in people with DM2, MS, AH. In terms of developing a platform for prevention of cardiovascular diseases, MS and DM2, the non-HDL–C ratio deserves attention as a target for further research.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86509439","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 hypertension on mortality and the risk of developing geriatric syndromes","authors":"A. Turusheva, Y. Kotovskaya, E. Frolova, Т. A. Bogdanova, O. Kutznetsova","doi":"10.18705/1607-419x-2022-28-4-419-427","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-4-419-427","url":null,"abstract":"Background. Hypertension (HTN) is a major risk factor for the development of cardiovascular disease in young and middle age, however, data on its effect on cardiovascular risk in older adults are contradictory. Objective. To evaluate the impact of high blood pressure on mortality and the course of major geriatric syndromes in the population aged 65 years and older. Design and methods. The prospective cohort Crystal study (2 examinations, 9 years of follow-up), the cross-sectional cohort Eucalyptus study. Sample: a random sample of community-dwelling older adults aged 65 and older (n = 1007). Main parameters: blood pressure, analysis of drug treatment, medical history, laboratory tests, comprehensive geriatric assessment. Results. HTN has been identified as a risk factor for myocardial infarction, cognitive decline, slow gait speed and low muscle strength. However, in people with frailty and slow gait speed, the presence of HTN was associated with a lower risk of all-cause mortality. The lowest risk of all — cause mortality in participants with a slow gait speed was found with systolic blood pressure 140-159 mm Hg [risk ratio (95 % confidence interval) 0,049 (0,009-0,283)], with frailty — with systolic blood pressure 160-180 mm Hg [risk ratio (95 % confidence interval) = 0,109 (0,016-0,758)]. Conclusions. HTN retains its negative predictive value in older adults and is associated with an increased risk of cardiovascular complications, decreased cognitive and physical functions, but a lower risk of mortality in people with frailty and a low level of physical function. An individual approach and an obligatory assessment of the level of physical function in older patients are required when prescribing antihypertensive therapy.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"245 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83490802","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":"Diagnosis of pheochromocytoma and paraganglioma. Focus on chromogranin A","authors":"E. Kravchuk, U. Tsoy, A. S. Kruk, E. Vasilyeva, E. Grineva","doi":"10.18705/1607-419x-2023-29-1-68-78","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-1-68-78","url":null,"abstract":"Objective. To analyze the results of a laboratory examination for chromogranin A in the blood performed in the laboratory at Almazov National Medical Research Centre in patients with confirmed diagnosis of pheochromocytoma/paraganglioma (PPGL) and in patients with unconfirmed neuroendocrine tumor based on the results of a comprehensive examination and to determine the possibilities of this method in the diagnosis of PPGL. Design and methods. A single-center retrospective cohort study was conducted. Electronic medical histories of patients with valid chromogranin A blood test in the period from 2015 to 2021 were studied. The patients included in the study were divided into 2 groups. Group 1 (study group) included 51 patients with a confirmed diagnosis of PPGL, and Group 2 (control group) included 120 patients, who were examined for suspected neuroendocrine tumor, but the diagnosis was not confirmed. The threshold value of chromogranin A was determined using ROC-analysis, the presence of PPGL was selected as a dependent variable. Results. The median of chromogranin A in the study group was 495,93 µg/l (0–100). According to the ROC-analysis, the optimal point of separation of the chromogranin A value for the diagnosis of PPGL with a test sensitivity of 82,4 %, specificity of 94,2 % (area under curve AUC — 0,939, standard error — 0,024, 95 % confidence interval — 0,892–0,986, p < 0,001) was 97,2 µg/l. After dividing patients with PPGL into 3 subgroups, depending on the size of the adrenal gland formation and the prevalence of the lesion according to computer tomography (less than 5 cm — subgroup 1, 5 cm or more — subgroup 2, multiple lesion — subgroup 3), the sensitivity of the threshold value of chromogranin A 97 µg/l in subgroup 1 was 70 %, in subgroup 2 — 95 % and in subgroup 3 — 82 %. Conclusions. Performing a blood test for chromogranin A can be used as an effective marker of PPGL, complementing the standard methods of laboratory diagnostics. This indicator may be an additional factor in the diagnosis of PPGL, especially in the presence of large formations, but the absence of an increase in chromogranin A should not be used to exclude the diagnosis.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80755599","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":"Prognostic significance of geometric patterns of left ventricular hypertrophy in a 12-year cohort study","authors":"A. Ryabikov, S. Shakhmatov, E. Mazdorova, V. Guseva, G. Simonova, V. Gafarov, E. Verevkin, S. Malyutina","doi":"10.18705/1607-419x-2022-28-5-532-545","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-5-532-545","url":null,"abstract":"Objective. The contribution of left ventricular hypertrophy (LVH) to the risk of cardiovascular disease (CVD) and mortality is well established but the prognostic role of structural LVH patterns in the population is ambiguous. The aim of the work — to study the prognostic value of geometric variants of LVH in a 12-year cohort study.Design and methods. The study design—cross-sectional and cohort studies—based on the material from a series of echocardiographic examinations (Echo) in general population samples in Novosibirsk city. The cohort analysis included 2006 men and women 25–64 years old with special concerns about LVH (according to the criterion of increased myocardial mass index (IMM)) and for geometric variants of LVH. The mean follow-up period was of 12,2 years (SD = 3,2) and 220 endpoints (90 CVD deaths) were registered. The risk of incident fatal and nonfatal CVD and death was assessed by Cox regression analysis.Results. In the studied sample, the prevalence of LVH was of 22,8% (lower in men than in women, p < 0,001). Population-specific criteria for increased IMM were 124 g/m2 (men) and 100 g/m2 (women). LVH independently increased the 12-year risk of myocardial infarction (MI) by 1,8 times, fatal MI — by 2 times, fatal CVD — by 1,8 times and all-cause mortality — by 1,6 times. Concentric and disproportional septal forms of LVH (DS LVH) had the most unfavorable prognosis; 40–80% of the excess-risk of CVD and death in these variants was explained by myocardial mass, but the impact of DS LVH was maintained independently of left ventricle myocardial mass. The pattern of segmental LVH (based on additional 2D measurement of the thickest segment) increased the risk of CVD and mortality by 1,9–2,5 times in men.Conclusions. In a population sample aged 25–64 years (Novosibirsk), LVH independently increased the 12-year risk of MI, fatal CVD and death from all causes by 1,6–2 times. Among the geometric types of LVH, concentric and DS LVH had the most unfavorable prognostic value; the impact of DS LVH to the risk of fatal CVD remained significant independently of myocardial mass. The pattern of segmental LVH based on additional 2D Echo measurements, increased the risk of CVD and death by 2–2,5 times. CVD risk and mortality levels depending on the LVH patterns suggest a number of preventive measures against cardiovascular complications and mortality.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81777857","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":"Hypotensive effects of drug combinations in elderly and old patients with controlled arterial hypertension","authors":"F. A. Kovalenko, S. Kanorskii","doi":"10.18705/1607-419x-2022-28-6-650-658","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-650-658","url":null,"abstract":"Aim. To assess the frequency of arterial hypotension, orthostatic hypotension, low blood pressure (BP) and their clinical manifestations in the group of elderly and senile patients with a controlled course of arterial hypertension (AH), taking combinations of drugs based on an angiotensin-converting enzyme inhibitor (ACE inhibitor).Materials and methods. The study included 171 male and female residents of Krasnodar Territory with drug-controlled AH (blood pressure - BP less than 140/90 mm Hg in the background of previous antihypertensive therapy containing an ACE inhibitor perindopril), and with diseases of atherosclerotic genesis. All patients were questioned, tested for balance control, assessed for the risk of falls according to the Morse scale, hypotension in orthostasis was determined, measured office BP, carried out daily monitoring of BP with the determination of the time indices of hypotension and low BP.Results. Most often patients took a combination of ACE inhibitors with calcium channel blockers (CCB) (28.1% of cases), beta-blockers (BB) (27.1%) or diuretics (29.1%). Assessing the risk of falls on the Morse scale, there was a significantly lower level in patients who took the combination of perindopril with CCB compared with those who received perindopril with BB (15 versus 25 points respectively, p=0.039). Patients receiving perindopril and CCB lost balance in the “legs together” position in 19.3% and in the “tandem” or “semi-tandem” position of the feet in 29.8% of cases, that could be compared to the group taking perindopril and a diuretic (22% and 33.9%, respectively) and significantly lower than in the groups with perindopril and BB therapy (34.5% and 50.9%, respectively, p1=0.037, p2=0.043). The time index of low systolic and diastolic BP during therapy with perindopril and CCB was significantly lower than the corresponding indicator in the groups of patients treated with perindopril and BB (22% and 17% versus 27% and 21%, respectively, p1=0,009, p2=0,024), and the time index of low systolic BP for the combination of perindopril and diuretic is lower than for the combination of perindopril and BB (23% versus 27%, respectively, p=0.023).Conclusion. The data obtained on the frequency of arterial hypotension, orthostatic hypotension and low BP in the group of elderly and senile patients indicate the advisability of further studying the risks of drug hypotension in order to better personalize the treatment of AH.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87267590","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}