IPAH is a severe heart disease with non-specific signs and symptoms. Screening for IPAH is transthoracic colour Doppler echocardiography shows high correlation with cardiac catheterization.

Approximately 30-50% of the world's adult population suffer from arterial hypertension, and only 30-35% is successfully treated. A large number of patients with arterial hypertension require a combination of antihypertensive medications to achieve target blood pressure. The ESH/ESC recommendations suggest the use of fixed dose combinations for treatment simplification and improved adherence to treatment.The aim of this study was to evaluate efficacy and safety of fixed ramipril + felodipine combination in therapy of essential arterial hypertension.This multicentric, cross-sectional, non-interventional study evaluated 1.341 adult patients with essential arterial hypertension, defined by systolic and diastolic blood pressure increase (BP≥140/90 mmHg), only systolic blood pressure increase or antihypertensive therapy usage. All patients were treated with fixed-dose combination therapy ramipril + felodipine (5+5mg and 2.5+2.5mg) (Triapin® and Triapin mite®) therapy for at least two months. Efficacy was evaluated by proportion of patients who achieved target blood pressure values (<140/90 mmHg and <130/80 mmHg in diabetics) or defined blood pressure reduction (≥15/10mmHg). Safety of ramipril + felodipine therapy was evaluated based on the incidence of adverse events (AE) and therapy discontinuation rate during observational period. Therapy prescription was based on physician decision according to everyday clinical practice and 15 consecutive eligible patients were enrolled by each physician from the cohort of hypertensive patients treated in ambulatory setting.Patient population consisted of 647 (48.4%) males and 690 (51.7%) females (mean age 60.15±11.84 and mean duration of hypertension 9.5±7.34 years). Males were significantly younger (58.74±15.5 vs. 61.45±11.04, p<0.01) without difference in body mass index. There were 47.5% of patients with stage II, 29.2% with stage I and 23.3% with stage III. There was a significant reduction of systolic/diastolic BP and heart rate in patients with ramipril + felodipine combination (162.6±17/97.2±9 mmHg and 79.4±12/min) compared to baseline values prior to treatment (136.9±17/84.2±9 mmHg and 73.2±10 /min, p<0.01). Group with Triapin mite had lower reduction of systolic/diastolic BP compared to Triapin 21.4±15.9/11.6±9.8 vs. 28.9±19.2/14.1±11.0 mmHg and lower reduction of heart rate 6.1 vs. 6.3 /min (p<0.01). In total, 39.3% of patients reached target BP with or without target BP reduction, 30.0% reached only BP reduction and 30.7% did not reach target values. More patients reached target BP (48.4 vs 32.%) and less achieved defined BP reduction (18.8 vs. 38.9%) on Triapin mite therapy compared to Triapin (p<0.01). The proportion of patients who failed to reach any of these endpoints is similar in both treatment modalities. AEs were present in 34 patients (2.5%): headache in 9 (0.7%), lower leg swelling in 8 (0.6%) and dry cough in 4 (0.2%) cases -these were reported as the most frequent. None of reported adverse events was serious. Therapy continuation was reported in 92.6% of pa...

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Introduction. Adherence to proposed lifestyle changes and prescribed medication in patients with stable coronary artery disease (SCAD) is poor. Objective. We sought to investigate the influence of adjusting guideline proposed medications on relief of angina in a large group of patients with SCAD in Serbia. Methods. The study included a total of 3,490 patients from 15 cardiology clinics with symptoms of stable angina and at least one of the following criteria: abnormal electrocardiogram (ECG), history of myocardial infarction (MI), positive stress test, significant coronary artery disease on coronary angiogram or previous revascularization. All the patients underwent comprehensive evaluation at initial visit and after two months. The relief of angina was study end-point defined as any reduction in Canadian Cardiology Society (CCS) class, number of angina attacks per week and/or number of tablets of short-acting nitrates per week. Results. Most patients were included based on abnormal ECG (48.4%). At Visit 1, the average number of prescribed classes of medications to a single patient increased from 4.16 ? 1.29 to 4.63 ? 1.57 (p < 0.001). At the follow-up, the patients had significantly lower blood pressure (141 ? 19 / 85 ? 11 vs. 130 ? 12 / 80 ? 8 mmHg; p < 0.001) and most of them reported CCS class I (63.3%). The average weekly number of angina attacks was reduced from 2.82 ? 2.50 at Visit 1 to 1.72 0 ? 1.66 at Visit 2, as well as average weekly use of short-acting nitrates to treat these attacks (2.69 ? 2.53 to 1.74 ? 1.47 tablets; p < 0.001 for all). Conclusion. Adjustment of prescribed medications to guideline recommendations in a large Serbian patient population with prevalent risk factors led to significant relief of angina.