The coronavirus pandemic showed not only an increase in levels of excess morbidity and mortality in the acute phase, but also persisting symptoms 4 weeks after the onset of the disease. A review of international studies on the prevalence and diversity of the manifestations of postcoid syndrome is presented. The data on such a manifestation of post-COVID syndrome as postural orthostatic tachycardia syndrome (POTS) are accumulating. Pathogenetic mechanisms, modern diagnostic criteria and research data on the prevalence of this syndrome are presented in the article. The Canadian Cardiovascular Society has proposed medications as a treatment for POTS, including the sinus node If channel inhibitor ivabradine. Data from several studies showing the effectiveness of this drug for POTS, including after suffering COVID-19, are presented in the article. Clinical data on the prevalence of tachycardia among patients admitted to the Sechenov University hospital are presented. About 18% of patients with hypertension and 21% of patients with normal blood pressure had a high heart rate. A clinical example of the use of ivabradine in a patient after a coronavirus infection is presented. Drug interactions and individual tolerance of ivabradine in patients after coronavirus infection are being discussed. The authors put forward the hypothesis about the further prospect of using ivabradine in the treatment of clinical manifestations of postcoid syndrome on the basis of literature data and their own experience.
Introduction/Objective: Tobacco smoking is a well-known risk factor for cardiovascular and renal diseases. In recent years, alternative types of smoking, including vaping, have been becoming popular. The contribution of vape to vascular and renal injury is not known. We studied the relation between smoking of traditional/electronic cigarettes and arterial stiffness and albuminuria, which is also a vascular dysfunction marker. Methods: We examined 270 young volunteers without significant clinical cardiovascular diseases (mean age: 21.2 ± 2.3 years). Twenty-seven percent of the subjects in the study group were smokers; 69.9% of them smoked traditional cigarettes and 30.1% smoked electronic cigarettes. The urine albumin level was assessed by a dipstick test, and the augmentation index was determined by photoplethysmography. A linear correlation test and multiple regression analysis were applied. Results: The study groups did not differ in basic characteristics. The smokers demonstrated generally higher blood pressure levels and were overweight. Most of the smokers were male. In the groups of smokers, albuminuria was more frequent, especially among vapers (94 vs. 79% in tobacco smokers and 29% in nonsmokers). AU values (median [quartile 25; quartile 75]) were significantly higher in vapers (160 mg/L [150; 207.5]) vs. tobacco smokers (115 mg/L [60; 200]) and vs. nonsmokers (20 mg/L [10; 50]) (р < 0.05). Photoplethysmographic results showed relevant higher augmentation indices among tobacco smokers (-4, [-6.6; -1.9]) and vapers (-5.05 [-13.4; -3.3]) compared to nonsmokers (-16.2 [-23.9; -7]) (р < 0.05). Results of multiple regres-sion analysis demonstrate that smoking of both traditional and electronic cigarettes is related to an increase in the albuminuria level and the augmentation index. Conclusions: Smoking of both traditional and electronic cigarettes is related to albuminuria and an increase in the augmentation index, which is a noninvasive marker for arterial stiffness.
The paper discusses specific features of arterial hypertension (AH) in women: age-related aspects of AH incidence, pathogenetic and clinical AH variants, and optimal pharmacotherapy approaches.
In Russia, target blood pressure (BP) levels are achieved in only 14.4% of men and in 30.9% of women. The need for combination therapy of hypertension is as high as 70.7%. There are well-known benefits of combined antihypertensive therapy allowing for higher efficiency and better tolerability. One of the current combinations is a combination of an angiotensin-converting enzyme inhibitor and a calcium antagonist, which have pronounced protective activity and metabolic neutrality. Fixed-dose combinations have substantial advantages over free ones, contributing to improving patient compliance with the used treatment regimen. Dyslipidemia is present in 60.7% of the hypertensive patients. Nonetheless, only 9.7% of Russian patients with coronary heart disease take statins and control of lipid levels remains very poor. The review discusses whether the use of the triple combination lisinopril + amlodipine + rosuvastatin is reasonable from the standpoint of evidence-based medicine. There are literature data suggesting the high value of this fixed-dose combination in the context of organ protection and the reduced risk of cardiovascular events.
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