Emergency care in a sudden individually significant blood pressure increase without clinically overt target organ damage: rationale for captopril use. Expert Council opinion

Терещенко, С Н; Арутюнов, Г. П.; Галявич, А. С.; Гапонова, Н. И.; Гиляревский, С. Р.; Дупляков, Д. В.; Жиров, И. В.; Скибицкий, В. В.; Ткачева, О. Н.; Шапошник, И. И.

doi:10.15829/1560-4071-2020-2-3748

Cited by 5 publications

(3 citation statements)

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“…Так, самые частые неотложные состояния связаны именно с повышением АД: на их долю приходится ~20% обращений в службу скорой медицинской помощи [8]. Общее число вызовов скорой медицинской помощи в Москве в связи с АГ превышает 400 тыс., при этом >20% из них связаны с ГК [9]. Высокая частота обращений за медицинской помощью пациентов с выраженным повышением АД без поражения органов-мишеней связана с тем, что резкое повышение АД, как правило, сопровождается субъективными симптомами (головной болью, головокружением, тошнотой и вегетативными симптомами), которые снижают качество жизни и работоспособность пациента [10].…”

Section: подходы к лечению неконтролируемой артериальной гипертензии место препарата физиотенз ®unclassified

Approaches to the treatment of uncontrolled hypertension. Place of the Physiotens®

et al. 2021

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The paper discusses the issues of managing uncontrolled hypertension. It is noted that in the International Classification of Diseases, 10th revision (ICD-10), there is no diagnosis “hypertensive crisis”, which complicates the epidemiological estimates. In the new Russian Society of Cardiology guidelines, instead of using the term “uncomplicated hypertensive crisis”, the term “sudden pronounced individually relevant blood pressure (BP) increase” was proposed to describe pronounced BP increase without target organ damage. Since the term “uncomplicated hypertensive crisis” is not recommended for use, but this condition is often diagnosed in practice, it is advisable to replace this term with “sharp BP increase not accompanied by target organ damage” or “sudden pronounced individually relevant BP increase”. At the same time, there is no evidence that in patients with uncomplicated hypertensive crisis, a more rapid BP decrease is more effective over the standard antihypertensive therapy in relation to the risk of complications. The drug Physiotens® lowers BP smoothly and without sudden falls, while having favorable pharmacokinetics. The issues of revising the current approaches to antihypertensive therapy in patients with frequent BP increases, as well as the use of original drugs and generics are considered.

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Section: подходы к лечению неконтролируемой артериальной гипертензии место препарата физиотенз ®unclassified

Approaches to the treatment of uncontrolled hypertension. Place of the Physiotens®

et al. 2021

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“…Моксонидин, обладая обширной доказательной базой, остается препаратом выбора для купирования приступов неконтролируемой артериальной гипертензии, в особенности, у пациентов с метаболическим синдромом и сахарным диабетом II типа, а также в ситуациях, когда назначение других препаратов (в частности, каптоприла) является нерациональным, Так, установлено, что назначение каптоприла при внезапном выраженном повышении АД может быть безусловно рекомендовано лишь пациентам, не получающим другие блокаторы ренин-ангиотензин-альдостероновой системы (РААС), поскольку длительная терапия комбинациями препаратов-блокаторов РААС сопряжена с увеличением риска нарушения почечной функции [1].…”

Section: заключениеunclassified

“…у пациентов, постоянно принимающих антигипертензивную терапию. Таким образом, термин «неконтролируемая артериальная гипертензия» правомерно использовать в ситуациях недостижения целевых значений АД, а также наличии соответствующей клинической симптоматики [1].…”

Section: Introductionunclassified

Clinical and Pharmacological Approaches to the Prescription of Centrally Acting Antihypertensive Drugs for Uncontrolled Arterial Hypertension

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Tolkachev

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et al. 2020

Racionalʹnaâ farmakoterapiâ v kardiologii

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Episodes of rapid increase in blood pressure due to uncontrolled arterial hypertension, previously known as a hypertensive urgency, is common clinical condition which many of practicing physicians are encountered daily. As a rule, these conditions are not life-threatening, however they could lead to target-organs damage if not promptly relieved. Therefore, clear evidence-based recommendations of optimal antihypertensive drug administration in these situations would provide more safe and effective therapy. Despite that, definite expert consensus regarding optimal choice of antihypertensive drugs to manage these patients have not been reached so far. The aim of the current review was to assess the results obtained from clinical trials regarding the safety and efficacy of moxonidine for urgent hypertensive therapy in patients with uncontrolled arterial hypertension admitted to emergency healthcare units as well as in those at the prehospital stage. Performed literature-based analysis revealed enough evidences proving that moxonidine can be administered in a single dose of 0.4 mg as a drug of choice in situations where prompt and stable hypotensive effect is desired. Results of comparative studies designed to closely match real clinical settings indicate that more adequate and sustainable therapeutic effect is achieved after moxonidine administration in comparison to other frequently used antihypertensive drugs.

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Self-help for uncontrolled arterial hypertension

2021

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The results of the study showed that during 3 years (2012–2014), the number of cases of uncontrolled arterial hypertension in two adjacent (control and main) emergency departments increased by 15.7% and 19.3%, respectively, and amounted to 95.2 and 95.4% of cases, respectively. It was proved that the increase in calls for emergency medical care in connection with uncontrolled arterial hypertension was due to an increase in multiple calls (23.5% and 26.4%, respectively) to the same patients, mainly of elderly senile age with comorbid pathology (78.4% and 84.2%, respectively). In the final comparative 3-year (2015–2017) study in two adjacent (control and main) emergency departments, it was shown that individually selected self-help with two-component combinations of antihypertensive agents was associated with a decrease in emergency medical care by 18.2%, due to uncontrolled arterial hypertension. The main indications, contraindications and methods of prescribing personalized self-help are proposed.

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Emergency care in a sudden individually significant blood pressure increase without clinically overt target organ damage: rationale for captopril use. Expert Council opinion

Cited by 5 publications

References 22 publications

Approaches to the treatment of uncontrolled hypertension. Place of the Physiotens®

Approaches to the treatment of uncontrolled hypertension. Place of the Physiotens®

Clinical and Pharmacological Approaches to the Prescription of Centrally Acting Antihypertensive Drugs for Uncontrolled Arterial Hypertension

Self-help for uncontrolled arterial hypertension

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