Update on interventional approaches to treatment of hypertension

Эдвиновна, Звартау Надежда; Олеговна, Конради Александра

doi:10.18705/1607-419x-2015-21-5-450-458

Cited by 6 publications

(2 citation statements)

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“…Мы не имели возможности установить, какова роль нарушений эндотелиальной дисфункции при рефрактерной аГ, являются ли они ее этиологическими факторами или служат маркерами симпатической гиперактивации и следствием более тяжелого течения аГ, однако эти вопросы могут стать предметом будущих исследований. кроме того, поскольку рефрактерная аГ предположительно имеет нейрогенную этиологию, а проведение симпатической ренальной денервации рассматривается в качестве эффективного способа снижения симпатической активности и лечения раГ [34][35][36][37][38][39][40], дальнейшие исследования помогут установить, имеют ли больные рефрактерной аГ преимущества от ренальной денервации по сравнению с пациентами с неконтролируемой раГ.…”

Section: показательunclassified

Refractory and resistant hypertension in patients with type 2 diabetes mellitus: differences in metabolic profile and endothelial function

Falkovskaya

Mordovin

Pekarskiy

et al. 2021

Terapevticheskii arkhiv

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Aim. To determine the prevalence of refractory hypertension (RfH) in patients with and without type 2 diabetes mellitus (DM), as well as to evaluate whether diabetic patients with RfH significant differ from those with uncontrolled resistant hypertension (RH) in clinical phenotype, metabolic profile and endothelial function. Materials and methods. The study included 193 patients with RH: RH 74 patients with diabetes and 119 patients without DM. Uncontrolled RH and RfH were defined by the presence of uncontrolled blood pressure BP (140 and/or 90 mm Hg) despite the use of 3 but 5 antihypertensive drugs (for RH) and 5 antihypertensive drugs, including a mineralocorticoid receptor antagonist (for RfH). Clinical examination, lab tests were performed. Flow-mediated dilation (FMD) and vasoreactivity of middle cerebral artery (MCA) using both breath-holding and hyperventilation test were measured by high-resolution ultrasound. Results. The prevalence of refractory hypertension in patients with and without DM was similar (30% vs 28%, respectively). No differences in BP levels, data of echocardiography and clinical phenotype were found between the diabetic groups, but value of HOMA index, plasma resistin level and postprandial glycaemia were higher in patients with RfH. FMD and MCA reactivity to the breath-holding test were worse in patients with RfH, and they had a more pronounced vasoconstrictor response of MCA to the hyperventilation test compared to patients with RH. Conclusion. The prevalence of RfH is the same in patients with and without diabetes. Diabetic patients with refractory hypertension have a more unfavorable metabolic profile and greater impairment of endothelial function than patients with uncontrolled resistant hypertension.

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Section: показательunclassified

Refractory and resistant hypertension in patients with type 2 diabetes mellitus: differences in metabolic profile and endothelial function

Falkovskaya

Mordovin

Pekarskiy

et al. 2021

Terapevticheskii arkhiv

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“…Среди патофизиологических факторов, опосредующих развитие и поддержание АГ, существенная роль принадлежит высокому тонусу симпатической нервной системы (СНС), запускающему порочный круг целого ряда патологических изменений -активацию РААС, метаболические нарушения, воспаление, гиперкоагуляцию и каскад опосредованных периферических эффектов [10]. Возможности подавления избыточной активности СНС при АГ активно изучаются с помощью современных электрофизиологических методов нейромодуляции, имплантации специальных устройств, ренальной денервации [11], нефармакологических вмешательств и лекарственной терапии [12].…”

Section: Introductionunclassified

Features of antihypertensive therapy and real-world prescription of selective imidazoline receptor agonists in Russia vs other countries: STRAIGHT study data analysis

Конради

Олеговна²,

Звартау

et al. 2021

Terapevticheskii arkhiv

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Analysis of routine clinical practice of hypertensive patient management represents one of the important tools in the search for further ways to minimize hypertension-associated cardiovascular and renal adverse outcomes. Aim. To compare the strategies for hypertension management and features of clinical use of I1-imidazoline receptor (I1-IR) agonists in the Russian Federation and other countries where the STRAIGHT (Selective imidazoline receptor agonists Treatment Recommendation and Action In Global management of HyperTension) study was conducted. Materials and methods. It was a cross-sectional online study involving physicians of various specializations. The study was conducted from January 18 to July 1, 2019, in seven countries with a high rate of I1-IR agonist prescription, including Russia. Results. A total of 125 (4.5%) responders filled out the survey in the Russian Federation, which was somewhat lower than in other countries (6.8%). The participants were mostly general practitioners (54.0%) and cardiologists (42.0%), while in other countries greater diversity was seen. Most Russian physicians (83.0%) seemed to rely on national clinical guidelines in their routine practice, while in other countries the US guidelines were more popular (66.0%). The majority of responders stated that they took into account the traditional risk factors of hypertension when initiating the therapy; every second responder noted if sleep apnea was present. Awareness of I1-IR agonists, their prescription rate and their preference were higher in Russia. The main reported benefits of I1-IR agonists were their efficacy, including in resistant hypertension, and their metabolic effects (in Russia). Most participants preferred I1-IR agonists as third-line therapy (65.0% in Russia vs 60.0% in other countries) and in combination with an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin II receptor blockers (ARB) (55.0% in Russia vs 54.0% in other countries). Compared to responders from other countries, Russian physicians prescribe I1-IR agonists as first-line (15.0% vs 5.0%) and second-line (48.0% vs 21.0%) therapy more often. Conclusion. Russian physicians were the most aware of I1-IR agonists and tended to prescribe drugs of this class for hypertension management more often, and I1-IR agonist combination with ACEi was preferable compared to physician responders from other countries. Antihypertensive efficacy and metabolic effects were reported as the major benefits of I1-IR agonist therapy.

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A multicenter study on the influence of different kinds of carotidal endarterectomy on the course of resistant arterial hypertension

Виноградов

Chernykh

Chernyavsky

et al. 2021

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Update on interventional approaches to treatment of hypertension

Cited by 6 publications

References 0 publications

Refractory and resistant hypertension in patients with type 2 diabetes mellitus: differences in metabolic profile and endothelial function

Refractory and resistant hypertension in patients with type 2 diabetes mellitus: differences in metabolic profile and endothelial function

Features of antihypertensive therapy and real-world prescription of selective imidazoline receptor agonists in Russia vs other countries: STRAIGHT study data analysis

A multicenter study on the influence of different kinds of carotidal endarterectomy on the course of resistant arterial hypertension

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