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Bisoprolol and metformin in patients with arterial hypertension and metabolic syndrome  [cached]
V.A. Nevzorova,N.V. Zakcharchuk,O.V. Nastradin,O.G. Pomogalova
Rational Pharmacotherapy in Cardiology , 2007,
Abstract: Aim. To compare efficacy of bisoprolol and bisoprolol+metformin combination in patients with arterial hypertension (AH) and metabolic syndrome (MS).Material and methods. 20 patients with AH and MS were involved in the study. They were randomized in 2 groups, 10 patients in each group. Patients of the 1st group received bisoprolol. Patients of the 2nd group received combination of bisoprolol and metformin. Blood pressure (BP), body mass index (BMI), carbohydrate metabolism, lipid profile, microalbuminuria (МАU) level was determined before, within and at the end of 24-week treatment.Results. Both treatments resulted in similar reduction in BP. Reduction of BMI and insulin plasma concentration was more significant in patients received combined therapy. Both treatments improved lipid profile and reduced MAU.Conclusion. Bisoprolol has positive effect on pathogenic mechanisms of AH and MS. Metformin additionally improves carbohydrate and lipid metabolism.
Tratamiento no farmacológico de la hipertensión arterial Non-pharmacologic therapy for hypertension: a review
Iván Villegas
Iatreia , 1992,
Abstract: El manejo no farmacológico se recomienda como terapia inicial en todo paciente con hipertensión arterial pero ha sido ampliamente desplazado por el tratamiento farmacológico. Los avances recientes permiten concluir que la reducción de peso, la restricción moderada de sal y el ejercicio son las modalidades que mayores beneficios producen en el hipertenso. Los resultados del manejo del estrés, de la modificación de la dieta y de los suplementos de calcio, magnesio, potasio, vitamina D y ácido gama amino Iinolénico son más controvertidos. Despite the fact that non-pharmacologic therapy has been recommended as the initial step in hypertension treatment, it has been largely displaced by the pharmacologic approach. Recent findings of hypertension research show that weight reduction, moderate salt restriction and exercise are the most beneficial modalities for the hypertensive patient. Measures Iike stress management, diet modification and dietary supplementation of calcium, potassium, magnesium, vitamin D or gamma-amino- Iinolenic acid provide controversial results.
Danijela Cvetkovic,Marina Deljanin Ilic,Maja Nikolic
Acta Facultatis Medicae Naissensis , 2006,
Abstract: The metabolic syndrome encompasses a group of clinical entities which point to an increased risk of development of cardiovascular disease and diabetes.Guided by highly predictive value of the metabolic syndrome (MS) in patients with arterial hypertension, the aim of the study was to examine the prevalence of MS in the patients of both sexes within the Municipality of Nis.The study involved 140 hypertensive patients, 70 men with mean age of 67.47 years and 70 women with mean age of 67.06 years.Antropometric values were measured in all the patients. Functional measurements, blood biochemistry and analysis of their medical records were also done. Events of cardiac death were evaluated in the course of a three-year follow-up.The existence of MS was diagnosed in a high percent, in both males (70%) and females (71.43%).Arterial hypertension and MS sufferers are more affected by dyslipidemia, angina pectoris and myocardial infarction, and also are at higher risk of lethal outcome, compared to the arterial hypertension sufferers with no MS, regardless of sex.
Renal dysfunction and state of metabolic and hemodynamic factors in patients with arterial hypertension  [PDF]
Kurkina T.V.,Bogoslovskaya S.I.,Svistunov А.А.,Kodochigova A.L
Saratov Journal of Medical Scientific Research , 2011,
Abstract: The aim of the investigation is to carry out comparative evaluation of metabolic and hemodynamic indices in patients with arterial hypertension (AH) and renal dysfunction; to study the interrelation between arterial blood pressure level normalization and the presence or lack of microalbuminuria (MAU) in the morning urine portion of patients with AH after therapy with antihypertensive preparations (APs) of various groups. Methods. 121 persons have been investigated, 91 out — patients of both sexes, aged 33-55, with the diagnosis of arterial hypertension of stage II risk III, who have been taking Perindopril, Telmisartan and Bisoprolol for3 months. The control of arterial pressure level, biochemical analysis of metabolic indices and morning urine portion test for microalbuminuria has been carried out. Results. MAU has been revealed in 17,6% patients, occurring more frequently in men than in women. Microalbuminuria is accompanied by reliable decrease of total and ionized calcium and magnesium concentrations, an increase of potassium level in blood plasma, increase of cholesterol, triglycerides, glucose and levels. Patients with AH and renal dysfunction reliably demonstrate higher levels of systolic and diastolic arterial pressure in the morning and evening hours, their normalization effect after APs intake is significantly interconnected with MAU presence. Conclusion. In patients with AH and MAU the main risk factors of cardio-vascular diseases development are more expressed. Microalbuminuria is a risk factor in patients with arterial hypertension and may influence on the basic blood electrolyte balance. While carrying out antihypertensive therapy the presence of MAU should be taken into consideration
Optimization of regular medical examination of patients with arterial hypertension and metabolic disorders  [PDF]
V.V. Blinova,Yu.I. Skvortsov,A.G. Martynova,E. Yu. Ryzhkova
Saratov Journal of Medical Scientific Research , 2010,
Abstract: The scientific work is devoted to examination of 180 patients with arterial hypertension in case of metabolic syndrome during the period of 12 months. By the end of initial examination patients were divided into 3 groups. The first group (72 men and women) was regularly checked by cardiologist once in 3 months, the second one (60 patients) -once in 6 months, the third group (48 patients) was observed once a year. Accordingly regular clinical examination provides more effective conditions for observation and treatment, improvement of health state and hemodynamic indices allowing to cosider the given way of clinical examination as a rational and effective method
Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review  [PDF]
Vasilios G. Athyros,Andromachi Reklou,Antonis Lazarides,Eudoxia Mitsiou,Asterios Karagiannis
Diseases , 2013, DOI: 10.3390/diseases1010051
Abstract: The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS) or not, substantially increases the risk of cardiovascular disease (CVD) and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS), and in high central aortic blood pressure (CABP), which are significant and independent CVD risk factors. Arterial hypertension was connected to AS long ago; however, other MetS components (obesity, dyslipidaemia, dysglycaemia) or MetS associated abnormalities not included in MetS diagnostic criteria (renal dysfunction, hyperuricaemia, hypercoaglutability, menopause, non alcoholic fatty liver disease, and obstructive sleep apnea) have been implicated too. We discuss the evidence connecting these cardio-metabolic risk factors, which negatively affect AS and finally increase CVD risk. Furthermore, we discuss the impact of possible lifestyle and pharmacological interventions on all these cardio-metabolic risk factors, in an effort to reduce CVD risk and identify features that should be taken into consideration when treating MetS patients with or without arterial hypertension.
Investigation Of Arterial Blood Pressure Level And Metabolic Indices In Patients With Arterial Hypertension At Pharmacotherapy With Antihypertensive Medicines Of Various Chemical Structure  [PDF]
T.V. Kurkina,A.A. Svistunov,S.I. Bogoslovskaya,V.A. Klochkov
Saratov Journal of Medical Scientific Research , 2009,
Abstract: The research goal is to carry on the comparative analysis of medicines of various chemical structure, Telmisar-tan and Bisoprolol, and to reveal their effect on the arterial blood pressure level and the indices of various metabolic processes in patients with arterial hypertension. 60 out-patients with arterial hypertension (stage II risk III) both males and females aged 33-55 have been under study taking Telmisartan and Bisoprolol for 3 months. While treating the patients the arterial blood pressure level control and biochemical investigations for determination the indices of metabolic processes have been carried out. The investigated medications have provided the decrease of systolic and diastolic arterial pressure parameters, the increase of concentration of total and ionized calcium, chlorine ions, urea and total bilirubin in blood plasma. Therapy with Telmisartan has shown more significant increase of potassium level in erythro-cytes, decrease of levels of natrium, glucose, glycolized hemoglobin and triglycerides and increased contents of alani-naminotransferase and aspartataminotransferase. The course of therapy with Bisoprolol has restored the normal level of magnesium in blood plasma, has not have any influence on carbohydrate and lipid metabolism, increased the level of alaninaminotransferase and significantly increased the contents of total and ionized calcium, urea and creatinine. 3-months therapy with Telmisartan and Bisoprolol has proved the decrease of systolic and diastolic arterial pressure in patients with arterial hypertension. The medications under study have had active and variable effects on metabolic indices
Shiftwork as one of risk factors of arterial hypertension and metabolic disorders  [cached]
I.S. Dzherieva,N.I. Volkova,S.I. Rapoport
Rational Pharmacotherapy in Cardiology , 2012,
Abstract: Background. Shiftwork is considered as one of risk factors of arterial hypertension (HT) and metabolic disorders.Aim. To study effects of different types of shift plan on HT and the metabolic disorders development.Material and methods. 1091 men were included in the study. Patients were split into subgroups according to age (20–29, 30–39, 40–49, 50–59 years old) and shift plan (steady or shiftable work schedule). HT (blood pressure >130/85 mm Hg), abdominal obesity (waist circumference >94 cm), disorders of glucose metabolism were revealed.Results. HT prevalence in patients with shiftwork was significantly higher than that in employees with steady work schedule (34.4 vs 27.4%, respectively; р<0.01). In patients with shift and steady work schedule significant differences in abdominal obesity (69.2 vs. 19.3%, respectively; p<0.001) and glucose metabolism disorders rates (19.0 vs. 10.6%, respectively; p<0.001) were also found. Differences between groups in prevalence of hypercholesterolemia and metabolic disorders cluster were not significant. HT associated with metabolic disorders dominated among steady work patients aged 40-49 years (56.7%) in comparison with shiftable work patients (20.0%), p<0.01.Conclusion. Shiftwork may be considered as a risk factor of HT and metabolic disorders in males.
Antihypertensive, organ protective, and metabolic efficiency of spirapril in patients with arterial hypertension  [cached]
M.V. Leonova,M.A. Demidova,A.V. Tarasov,Y.V. Belousov
Rational Pharmacotherapy in Cardiology , 2005,
Abstract: Aim. To estimate antihypertensive, organ protective and metabolic efficiency of angiotensin converting enzyme (ACE) inhibitor spirapril in patients with arterial hypertension (AH).Material and methods. 30 patients with AH of I-II grade with different cardiovascular risk were included into the study. Spirapril was prescribed in the dose of 3 mg once daily. If necessary, daily dose could be increased to 6 mg after two weeks, and after next 4 weeks hydrochlorothiazide in daily dose 12,5-25 mg could be added. Treatment lasted 16 weeks. Before and after 16-week treatment ambulatory blood pressure monitoring (ABPM) was carried out. At the same time vasodilatation tests for reactive hyperemia and nitroglycerin were held, microalbuminuria and β2-microglobulinuria levels were defined, figures of lipid and glucose metabolism were studied, questionnaires for quality of life were filled in.Results. 27 patients with AH finished the study according to protocol. Treatment with spirapril within 16 weeks caused normalization of blood pressure in 60% of patients, decreased levels of microalbuminuria (p<0,05) and β2-microglobulinuria (p<0,05), recovered significantly disrupted endothelial function according to the results of vasodilatation tests (p<0,01), improved patients quality of life (p<0,05). Spirapril didn’t change lipid and glucose metabolism, regardless that in 1/3 of cases it was used in combination with hydrochlorothiazide.Conclusion. Spirapril is a highly efficient antihypertensive drug with organ protective effect and metabolic neutrality. According to the revealed qualities it can be recommended to patients with AH with high cardiovascular risk.
The role of genetic mutations in development of metabolic disturbances in patients with arterial hypertension
Borodulin V.B.,Shevchenko O.V.,Bychkov E.N.,Reshetko O.V.
Saratov Journal of Medical Scientific Research , 2012,
Abstract: The article stresses on the study of molecular markers of essential arterial hypertension providing insight into the pathological mechanisms underlying the disease and creation of genetic passport for every patient in the future. Objective: To study genetic markers of 5,10-methylenetetrahydrofolate reductase (MTHFR), involved in the metabolism of homocysteine, and N-acetyltransferase 2 (NAT2), ensuring the process of transformation of acetyl-CoAto acetoacetyl-coenzyme A. Methods: The study involved 160 patients with essential hypertension l-lll stages Caucasian (57.5% female.) aged 20-59 years. MTHFR gene polymorphisms and NAT2 in DNA of peripheral blood leukocytes were studied using a set of Wizard Genomic DNA Purification Kit (Promega, USA). Results: It was shown that slow acetylators (homozygous for a mutant version of the gene NAT2) were more frequently (p <0.05) determined among patients with hypertension stage 1. It was also revealed the dependence on the presence of hypertension stage mutant allele T (hetero-and homozygous variants) in 677 nucleotide gene MTHFR (r = 0,40, p <0.001). Conclusions: The regularities of the distribution of polymorphic variants of MTHFR and NAT2 gene were found out in hypertensive patients according to the stage of the disease.
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