Treatment of hypertension in children and adolescents

Леонтьева, И. В.

doi:10.21508/1027-4065-2019-64-1-15-24

Cited by 7 publications

(2 citation statements)

References 52 publications

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“…Нарастание эпидемии ожирения среди детей приводит к раннему старту и распространению артериальной гипертензии (АГ) с сохранением этого тренда во взрослую жизнь. [1][2][3]. АГ среди детей и подростков с ожирением диагностируется с частотой 24,8-40 % случаев [4][5][6][7].…”

Section: фармакогенетика введениеunclassified

“…Данный аргумент позволяет персонализировано и патогенетически обосновано оценивать риски сохранения артериальной гипертензии, учитывая имеющийся генетический полиморфизм и обосновывать рекомендации по дальнейшей тактике ведения детей, в том числе и решение вопроса о назначении и выборе антигипертензивной терапии. Актуальность этого вопроса разделяют ведущие российские детские кардиологи, которые считают необходимым «расширение показаний к использованию в педиатрии основных групп гипотензивных лекарственных средств, применяемых у взрослых и необходимость выведения этих препаратов из категории «off -label», то есть необходимо внесение соответствующих изменений в инструкции по медицинскому применению» [3].…”

Section: фармакогенетикаunclassified

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Polymorphism of genes of arterial hypertension among children with obesity and arterial hypertension

Маскова¹,

Хохлов²,

Сироткина³

2021

GCP

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Arterial hypertension (АH) among obese children and adolescents is diagnosed with a frequency of 24,8 — 40 % of cases. The pathogenesis high blood pressure (HB) among childhood obesity continues to be studied in connection with the identification of new genetic and epigenetic factors that determine its course. Polymorphism of genes of arterial hypertension can serve as a reason for maintaining increased vascular tone, even if the nutritional status of the child is optimized. The objective was to study polymorphisms of genes of arterial hypertension AGT: 704, AGТ: 521; AGTR2: 1675; еNOS3:786 among children with obesity and arterial hypertension, depending from the dynamics of blood pressure after courses of diet and physical rehabilitation. Materials and methods. The study has included 50 obese and hypertensive children aged 11—14 years who were prescribed diet and courses of special physical exercises for 6 months. We have compared 2 groups of children: children who have had arterial hypertension after treatment («АH6 month +») and children who had no arterial hypertension after treatment («АH6 month -»). The comparison group has consisted of 34 healthy children with normal body mass index and blood pressure. We have performed clinical and instrumental, laboratory examination, anamnestic assessment of heredity, laboratory analysis of genotypic variants AGT: 704, AGТ: 521; AGTR2: 1675; еNOS3:786 among the studied population of children. Results. Comparative analysis of genotypic variants has showed a disproportionate distribution of alleles depending on the dynamics of blood pressure. Among children o «АH 6 month +» there were a predominance of mutant homozygous alleles of the gene AGTR2 AA (A) 45 % (22 %) and a decrease in the frequency a normal homozygous allele GG 9,0 % (9,6 %). We found a greater affinity of the CC homozygote for AGT 704, the CT heterozygote for AGT521 and the CC homozygote for the eNOS gene for the group of children «АH 6 month +» than among children «AH 6 months -» and healthy children. Conclusion. The revealing of causal polymorphisms of genes of arterial hypertension in obese children will allow predicting the risk of developing stable hypertension and determining treatment.

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Section: фармакогенетика введениеunclassified

Section: фармакогенетикаunclassified

Polymorphism of genes of arterial hypertension among children with obesity and arterial hypertension

Маскова¹,

Хохлов²,

Сироткина³

2021

GCP

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Morphofunctional State of the Periodontal Tissues in Humans and Rats with Arterial Hypertension

et al. 2020

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Pharmacoeconomic study of the treatment of arterial hypertension in children and adolescents using cost-of-illness analysis

Mikhaylova

Krikova

2022

Farmakoèkonomika

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Background. The cost-of-illness (COI) analysis allows to estimate and plan costs for calculations between the subjects of the health care system and medical insurance organizations. The primary morbidity of the population with diseases of the circulatory system increased from 4,784 thousand people in 2018 to 5,136 thousand in 2019. A growth in the number of cases resulted in an increase in the demand for drugs for the treatment of cardiovascular diseases.Objective: to perform a pharmacoeconomic study of the treatment of arterial hypertension in children and adolescents by COI-analysis.Material and methods. The source of information for COI-analysis was the real clinical practice – medical records of sick children and adolescents. A pharmacoeconomic study using COI-analysis was carried out at the inpatient and outpatient stages of care and included the calculation of direct medical costs (the costs of laboratory, instrumental medical services, non-drug and drug antihypertensive therapy). The study included 102 children diagnosed with arterial hypertension. The average stay of patients in the hospital was 10 (10.4±0.35) bed-days and treatment on an outpatient basis varied from 3 months to 1 year.Results. The leading place in the structure of costs for antihypertensive therapy is occupied by the beta-blockers pharmacological group (35%). The total cost of arterial hypertension in children and adolescents in inpatient and outpatient settings was 4,459.00 and 29,638.90 rubles, respectively.Conclusion. The COI-analysis of arterial hypertension confirms the need for timely diagnosis and treatment and preventive measures for high blood pressure in children and adolescents to reduce the development of risk factors for such serious cardiovascular complications as stroke and myocardial infarction in adulthood, the treatment of which requires large cash costs.

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Treatment of hypertension in children and adolescents

Cited by 7 publications

References 52 publications

Polymorphism of genes of arterial hypertension among children with obesity and arterial hypertension

Polymorphism of genes of arterial hypertension among children with obesity and arterial hypertension

Morphofunctional State of the Periodontal Tissues in Humans and Rats with Arterial Hypertension

Pharmacoeconomic study of the treatment of arterial hypertension in children and adolescents using cost-of-illness analysis

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