The effect of hemodynamically-guided hypotensive therapy in one-year observation: Randomized, prospective and controlled trial (FINEPATH study)

Krzesiński, Paweł; Gielerak, Grzegorz; Stańczyk, Adam; Piotrowicz, Katarzyna; Uziębło‐Życzkowska, Beata; Banak, Małgorzata; Kurpaska, Małgorzata; Michalczyk, Łukasz; Jurek, Agnieszka; Wolszczak, Kalina; Galas, Agata; Wójcik, A; Skrobowski, Andrzej

doi:10.5603/cj.a2016.0009

Cited by 11 publications

(10 citation statements)

References 13 publications

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“…The FINEPATH study enrolled 144 patients with uncontrolled HTN, defined as elevated blood pressure (≧140/90 mmHg) for at least 3 months prior to study enrollment, without pharmacotherapy at baseline. The key patient characteristics were presented in one of the earlier publications by our team [ 19 ]. The FINEPATH study was a prospective, randomized, controlled study to assess a novel HTN treatment.…”

Section: Methodsmentioning

confidence: 99%

Heart Rate Variability in Patients with Hypertension: the Effect of Metabolic Syndrome and Antihypertensive Treatment

Maciorowska

Krzesiński

Wierzbowski

et al. 2020

Cardiovascular Therapeutics

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Metabolic syndrome (MetS) is a combination of factors which, collectively, increase cardiovascular risk to a greater extent than each of them separately. Previous studies showed high cardiovascular risk to be associated with autonomic nervous system dysfunction. The purpose of this study was to assess the effects of antihypertensive treatment on heart rate variability (HRV) in patients with hypertension (HTN), depending on cooccurrence of MetS. 118 patients with uncontrolled HTN were enrolled to the study. HRV was compared among patients with and without MetS (MetS [+], n = 70 ) at baseline and following 12 months antihypertensive treatment. The HRV indices measured from RR intervals recorded form using 24-hour ambulatory electrocardiography. The measured HRV domains were the standard deviation of the average of NN intervals [SDNN], square root of the mean of the sum of the squares of differences between adjacent NN intervals [rMSSD], percentage of NN50 [pNN50], low frequency [LF], high frequency [HF], total power of variance of all NN intervals [TP], and LF/HF ratio. Baseline parameters: SDNN, rMSSD, pNN50, and HF were significantly lower in the MetS[+] compared to the MetS[-] subgroup ( p < 0.05 ). After a 12-month antihypertensive treatment, MetS[+] patients achieved a significant improvement in parameters: SDNN, rMSSD, pNN50, and TP ( p < 0.05 ), while the changes in HRV observed in the MetS[-] subgroup were not statistically significant. The cooccurrence of HTN and other components of MetS is associated with disturbances of the autonomic balance. HTN control has a beneficial effect on HRV, with the effect being more evident in patients with MetS.

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Section: Methodsmentioning

confidence: 99%

Heart Rate Variability in Patients with Hypertension: the Effect of Metabolic Syndrome and Antihypertensive Treatment

Maciorowska

Krzesiński

Wierzbowski

et al. 2020

Cardiovascular Therapeutics

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“…The effectiveness of ICG in the development of targeted hypertension treatment has been proven to be superior when compared to standard treatment guidelines in two studies performed by Krzesiński et al In one study, increased vascular resistance seemed to be the dominant mechanism of hypertension [20,24]. Smith et al evaluated 164 patients with essential hypertension and obtained better office BP control in their ICG-guided group [25].…”

Section: Discussionmentioning

confidence: 99%

Non-invasive haemodynamic assessments among hypertensive patients in a routine family doctor’s office

Trzeciak¹,

Gutknecht²,

Marek-Trzonkowska³

et al. 2021

Ann Agric Environ Med.

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Introduction and objective. Difficult-to-control blood pressure can be attributed to a mismatch between the haemodynamic type of hypertension and the drug class used in treatment. Impedance cardiography may be a useful tool for enabling the individualization of antihypertensive therapy. The aim was to investigate the distribution of haemodynamic types of HT among hypertensive patients in an outpatient clinic. Materials and method. This was a prospective, observational study of patients with primary hypertension at an outpatient clinic. A 10-minute ICG examination was performed in 189 consecutive, patients (118 men and 71 women). Patients were divided into groups based on whether their hypertension was well-controlled (140/90 mmHg, n=95). They were also stratified according to haemodynamic states. Results. Patients with poorly controlled blood pressure compared to patients with well controlled blood pressure had a high haemodynamic output in 6.3% vs. 2.1% (p=0.153), and high vascular resistance in 41.1% vs. 27.7% (p=0.037), and balanced haemodynamic states in 52.6% vs. 70.2% (0 80 beats/min) and fluid retention (p<0.01). Conclusions. Half of the examined patients did not achieve the therapeutic goals for hypertension treatment. Differences in haemodynamic state of well and poor controlled hypertension groups suggests the usefulness of impedance cardiographytargeted hypertension treatment.

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“…The study enrolled a total of 144 patients with untreated AH defined as elevated blood pressure (BP) values -≥140/90 mm Hg -persisting for at least 3 months. The basic characteristics of the study subjects are presented in one of the authors' earlier publications (10) . It was a prospective randomised controlled trial aimed primarily at assessing a new treatment for AH patients.…”

Section: Methodsmentioning

confidence: 99%

Assessment of heart rate variability parameters in the age subgroups of patients with arterial hypertension

Maciorowska¹,

Krzesiński²,

Gielerak³

et al. 2020

Pediatr Med Rodz

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Age is one of the main known risk factors for cardiovascular diseases. The ageing of the body and arterial hypertension are associated with progressive dysfunction of the autonomic nervous system, which may be one of the mechanisms underlying an increased cardiovascular risk. The aim of the paper was to assess heart rate variability parameters in the age subgroups of patients with arterial hypertension. The heart rate variability parameters were compared in a total of 139 patients with untreated arterial hypertension (mean age 45.2 ± 10.5 years, men – 69% of the study group) in the following subgroups distinguished by age: ≥45 years (n = 72) and <45 years (n = 67). A temporal analysis of the heart rate variability parameters in 24-hour Holter ECG (SDNN, rMSSD, pNN50) was conducted for 24 hours, and for the day and night periods. In addition, a spectral analysis (LF, HF, TP, LF/HF ratio) was performed. The recorded values of SDNN, rMSSD, pNN50, TP as well as night-time HF were lower in the group of patients aged ≥45 years compared to the younger group. The results confirm that in patients with arterial hypertension older age is associated with a shift of the autonomic balance towards sympathetic activity, which may translate into an additional increase in cardiovascular risk.

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The effect of hemodynamically-guided hypotensive therapy in one-year observation: Randomized, prospective and controlled trial (FINEPATH study)

Abstract: BP (27.3% vs. 12.1%; p = 0.013). More pronounced improvement in the left ventricular diastolic dysfunction (delta E/A 0.34 vs. 0.12, p = 0.017) (Cardiol J 2016; 23, 2: 132-140)

Cited by 11 publications

References 13 publications

Heart Rate Variability in Patients with Hypertension: the Effect of Metabolic Syndrome and Antihypertensive Treatment

Heart Rate Variability in Patients with Hypertension: the Effect of Metabolic Syndrome and Antihypertensive Treatment

Non-invasive haemodynamic assessments among hypertensive patients in a routine family doctor’s office

Assessment of heart rate variability parameters in the age subgroups of patients with arterial hypertension

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