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Search Results: 1 - 10 of 582462 matches for " A.D. Deev "
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How to describe the results of observational epidemiological studies
S.A. Shal'nova,A.D. Deev
Rational Pharmacotherapy in Cardiology , 2011,
Abstract: Principles and fundamentals of proper presentation of observational epidemiological study results are focused. Principles of observational study publication developed by expert epidemiologists (STROBE statement) are explained in detail.
Pharmacoeconomic analysis of carvedilol therapy in patients with arterial hypertension and metabolic risk factors (according to the CAMELLIA study)
S.Y. Martsevich,N.P. Kutishenko,A.D. Deev,S.A. Shalnova
Rational Pharmacotherapy in Cardiology , 2010,
Abstract: Aim. To perform cost-effectiveness analysis of 24 weeks antihypertensive therapy based on carvedilol or metoprolol in patients with arterial hypertension (HT) 1-2 degrees and overweight/obesity. To assess effects of carvedilol therapy on 10-year expected risk of cardiovascular complications (CVC).Material and methods. Patients with HT and overweight/obesity (n=320) were included into the study and randomly split in two groups. Patients of the first group (n=160) received carvedilol as a basic therapy and patients of the second group (n=160) — metoprolol. Both groups of the patients were comparable on key clinical characteristics.Results. In 24 weeks of treatment systolic and diastolic blood pressure (BP) decreased significantly in comparison with the baseline level (p<0.0001). Dose doubling of beta-blockers was required more often in patients treated with carvedilol. At the same time a combined antihypertensive therapy of the patients treated with carvedilol was required less (p>0.05). Target BP levels were achieved in carvedilol and metoprolol groups in 96.2and 95.5% of patients respectively (p=0.85). Carvedilol had better effect on plasma metabolic indicators such as glucose (p<0.01), lipid profile, uric acid level. Reduction in expected 10-year risk of death was more pronounced in 24 weeks carvedilol treatment. Cost of target BP level achievement was approximately 2.5 times higher in carvedilol group than this in metoprolol group. However cost of additional therapy was higher in metoprolol group. 1% reduction of the 10-year expected risk of CVC death cost 1 847 rubles in carvedilol therapy.Conclusion. Carvedilol therapy (vs metoprolol one) has a higher cost under comparable efficacy. Additional expenses are compensated with the favorable effect on metabolic indices and a more pronounced effect on reduction in the 10-year expected risk of CCO death. That is why carvedilol can be recommended to patients with HT and metabolic risk factors. Longer studies are necessary to assess an effect of carvedilol therapy on prognosis in patients with HT and concomitant metabolic disorders.
Arterial hypertension in Russia: PROLOG study as a proof method of contemporary therapy opportunities.
S.A. Shalnova,S.Y. Martsevich,A.D. Deev,N.P. Kutishenko
Rational Pharmacotherapy in Cardiology , 2005,
Abstract: Aim. To prove the advantage of the long-term controlled antihypertensive therapy compared with the real usual standard therapy in patients with mild to moderate arterial hypertension.Material and methods. It was multicenter, randomized, prospective parallel-group study in patients with mild to moderate hypertension. One part of patients (treatment group) received the strongly regulated stepped antihypertensive therapy based on ACE-inhibitor spirapril, the second one (control group) continued their usual standard therapy prescribed by doctors of polyclinics or other patient care institutions. The study lasted one year.Results. 1742 patients were enrolled in the study, 854 patients were included in the treatment group and 888 — in the control group. 220 patients dropped out of the study by different reasons, and 1552 patients finished the study. There were 651 (37,6%) men and 1081 (62,4%) women. It was substantial decrease in blood pressure in both group, but distinctions between systolic and diastolic blood pressure in the treatment and control group during the study were significant.The target levels of blood pressure (systolic < 140 mm Hg and diastolic < 90 mm Hg) were registered substantially more frequent in the patients of treatment group than in control group (69,4% и 39,3% after three months and 83,6% и 66,9% after 12 months of the treatment correspondingly).Conclusion. Controlled stepped antihypertensive therapy resulted into more significant decrease in systolic and diastolic blood pressure and more frequent achievement of target levels of blood pressure in comparison with control group. It supposes better prognosis of patients.
Comparative controlled study of antihypertensive efficacy and safety of carvedilol in patients with hypertension and obesity or diabetes 2 type (based on results of multicenter trial ACCORD)
Yu.V. Lukina,S.Yu. Martsevich,A.D. Deev,S.A. Shalnova
Rational Pharmacotherapy in Cardiology , 2009,
Abstract: Aim. To study efficacy and safety of beta-blocker with vasodilating properties carvedilol (Acridilole, Akrihin, Russia) as a part of the combined therapy of patients with arterial hypertension (HT) and diabetes mellitus 2 type (DM2) and/or obesity.Material and methods. 592 patients: 176 men (29,7%) and 416 women (70,3%) with HT were examined. 194 patients had D2 and 398 patients had obesity. Patients were randomized for carvedilol therapy (n=291) or control group (n=301). Carvedilol was prescribed additionally to current therapy in dose of 6,25 mg BID, in 2 weeks the dose was increased to 12,5 mg BID if it was necessary. Blood pressure (BP) and heart rate, number of angina attacks were registered at visits. ECG, laboratory analysis (plasma lipide profile, serum glucose, glycolised haemoglobin, serum K+ and Na+), evaluation of depression and anxiety status (according to special questionnaires) were performed on the first and the last visits.Results. 582 patients completed the study. 7 patients dropped out from carvedilol group and 3 patients - from control group. The levels of systolic BP (SBP) and diastolic BP (DBP) were decreased during study, more significantly in carvedilol group (р<0,0001). SBP decreased on 24,8 mm Hg in patients of carvedilol group and on 21,4 mm Hg in patients of control group. DBP decreased on 12,5 mm Hg and 11 mm Hg respectively. Angina attacks were registered less often in patients of carvedilol group (р=0,001). Serum glucose and lipid spectrum did not change in both groups. Depression level decreased in patients receiving carvedilol. 17 side effects were registered in carvedilol group and 15 - in control group (р=0,575)Conclusion. High antihypertensive efficacy of carvedilol is confirmed in hypertensive patients with DM2 and/or obesity. Good tolerability and metabolic neutrality of carvedilol is also observed.
Comparative analysis of arterial hypertension treatment in men and women based on the results of ACCORD study (ACridilole in Combination therapy in patients with arterial hypertension and Obesity of type 2 Diabetes)
S.A. Shalnova,S.Yu. Martsevich,A.D. Deev,Yu.V. Lukina
Rational Pharmacotherapy in Cardiology , 2011,
Abstract: Aim. To compare the efficacy and safety of carvedilol in men and women with mild to moderate arterial hypertension, associated with obesity and/or compensated diabetes type 2.Material and methods. Hypertensive patients (n=592, 176 men and 416 women) with obesity and/or diabetes were involved into randomized comparative open-label study in parallel groups. Patients were randomized into two groups. Patients of group A (n=291: 90 men and 201 women) kept on to receive previous antihypertensive drugs except beta-blockers which were withdrawn and replaced with carvedilol (Acridilole , PLC “Akrikhin”, Russia). Patients of control group (n=301: 86 men and 215 women) kept on to receive only previous antihypertensive drugs. Efficacy of antihypertensive therapy was assessed at every 2-week visits during 24-week observation. Biochemical parameters of glucose and lipid metabolism, 12-lead ECG were evaluated at baseline and at the end of the study. Target blood pressure (BP) achievement and safety was assessed in 24 weeks of treatment.Results. Women had more severe metabolic abnormalities compared with men. By the 24th week of treatment significant reduction in systolic BP, diastolic BP, and heart rate was found in the both groups of patients regardless of gender, intergroup differences were significant (p<0,05). By the end of the study target BP level was achieved in 96.3% of men and 96,8% of women in group A and 85.9% and 88.8%, respectively, in the control group (p<0,001). The number of hospital admissions decreased in 4.8 times in men (p<0.0001) and 12 times - in women (p<0.05) in group A, and in 2.7 and 3.3 times, respectively, — in the control group (p<0.0001). Mild to moderate side effects were observed in 32 patients: 19 and 13 patients in group A and control group, respectively (p=0.58). Adverse event rate was not distinguished significantly between men and women.Conclusion: The results show comparable high efficacy and safety of carvedilol in hypertensive men and women with concomitant diseases and high metabolic and cardiovascular risk.
Tobacco dependence treatment with nicotine replacement therapy as one of the methods for cardiovascular disease risk reduction
O.V. Vikhireva,S.A. Shalnova,A.D. Deev
Rational Pharmacotherapy in Cardiology , 2005,
Abstract: Aim. To investigate efficacy and safety of nicotine chewing gum and inhaler in individuals trying to quit smoking. To assess expected reduction of cardiovascular disease (CVD) and total mortality relative risks (RR).Material and methods. In this open, parallel study, 169 relatively healthy male smokers aged 18-60 years were randomly assigned to free choice vs admission of Nicorette gum (2/4 mg) or inhaler (10 mg). At baseline, all participants smoked ≥15 cig/d, for ≥3 years. The intervention phase lasted 3 months; follow-up evaluations were made at 3, 6 and 12 months after nicotine replacement therapy (NRT) initiation.Results. Twelve-month results were obtained for 152 subjects (response rate 89.9%). Point prevalence abstinence and reduction (smoking ≤50% of basic daily cigarette amount) rates were 19.7% and 35.5%, respectively. Neither abstinence, nor reduction rates depended on Nicorette form (gum vs inhaler), or on choice vs admission factor. The main predictors of long-term efficacy were nicotine dependence severity and contacts with other smokers. NRT was not associated with negative dynamics in objective health parameters (blood pressure, heart rate, ECG parameters, body weight, and body mass index) or self-evaluation of health. Both Nicorette forms seemed to be safe and well-tolerated. At 12 months, the expected mean RR reduction for CVD mortality reached 19%, for total mortality — 21%.Conclusion. In Russian clinical settings, NRT efficacy and safety are similar to that demonstrated in numerous international trials. NRT can be recommended as one of the methods of assistance to quit smoking and, therefore, for CVD risk reduction.
The choice of the drug amlodipine for the hypertension treatment from the standpoint of economic feasibility
S.Yu. Martsevich,N.A. Dmitrieva,A.D. Deev,Yu.V. Lukina
Rational Pharmacotherapy in Cardiology , 2011,
Abstract: Aim. Тo compare the cost-effectiveness of antihypertensive therapy based on a generic and original drugs of amlodipine in patients with arterial hypertension (HT) degree 1-2 in NORST study.Material and methods. Patients (n=60) with HT degree 1-2 were involved in NORST study. After wash-out period they were randomized to receive generic (Group 1) or original (Group 2) amlodipine in the initial dose of 5 mg daily. In case of insufficient antihypertensive effect dose of amlodipine was increased to 10 mg per day and then successively lisinopril 10 mg daily and hydrochlorothiazide 12.5 mg one time per day were added. The total duration of treatment was 10 weeks (70 days). Achieving target blood pressure (BP) (<140/90 mm Hg) was the criterion of the effectiveness of therapy. Cost-effectiveness analysis of treatments in all patients was performed after individual analysis of the target BP achieving.Results. The target BP level was achieved in 25 (89%) patients of Group 1 and in 27 (96%) patients of Group 2. Total direct costs over 10 weeks amounted to 21 206 rubles in group 1, and 80 073 rubles in group 2. The cost-effectiveness ratio (CER) for group 1 was: CER=21 206/0.89=23 827 rubles. For Group 2, CER=80 073/0.96=83 409 rubles. Costs for achieving target BP in 1 patient of Group 1 were 3,5 times lower than these in group 2.Conclusion. The use of generic amlodipine (Stamlo M) has opportunity to draw in the healing process more hypertensive patients due to reducing the cost of treatment.
Estimation of antihypertensive effect equability for two presentations of nifedipine with daily blood pressure monitoring
V.M. Gorbunov,E.V. Alimova,A.D. Deev
Rational Pharmacotherapy in Cardiology , 2005,
Abstract: Aim. To compare information value of antihypertensive effect equability parameters for two drug formulations of nifedipine: long-acting one (nifedipine-XL) and short-acting one (nifedipine-sa).Material and methods. 147 patients with arterial hypertension (age 53,8±12,5 years) were included into multicenter, cross over design study. Duration of wash-out period was 2 weeks; duration of each treatment course — 4 weeks; interval between courses — 1 week. The following doses of drugs were used: nifedipine-XL — 30-60 mg once daily, nifedipine-sa — 10-20 mg three times a day. Daily blood pressure monitoring (DBPM — Schiller BR-102) was made initially, at the end of each treatment course and at the end of interval between courses. To assess the equability of drug antihypertensive effect “smoothness index” (SI) and coefficient trough effect/peak effect were used (COTP). Information value of these indexes (treatment vs. initial) was assessed by the logical regress analysis.Results. Nifedipine-XL and nifedipine-sa had significant antihypertensive effect according to DBPM data and clinical measurements. Equability of both drugs was similar. χ2 Wald range was 14,7-18,7 (p<0,0001) for SI and 12,7-22,8 for COTP (p<0,001-0,0001).Conclusion. Similar information value of SI and COTP can be explained by the homogeneity of studied patients. Usage both of these indexes for estimation of antihypertensive effect equability is connected with same methodical limits.
Assessment of therapeutical equivalency of original and generic indapamide in hypertensive patients by randomized cross-over study
N.P. Kutishenko,V.V. Yakusevich,A.D. Deev,S.Y. Martsevich
Rational Pharmacotherapy in Cardiology , 2007,
Abstract: Aim. To develop a protocol for comparison of efficacy and safety of original drugs with generic ones and to apply this protocol for comparison of generic indapamide (Indap) with original indapamide in two presentations: short acting (Arifon) and long acting (Arifon Retard).Materials and methods: 64 patients with arterial hypertension of 1-2 degree took part in open cross-over randomized study. All patients were treated with Indap as well as with Arifon (half of patients) or Arifon Retard (another half) for comparison. Each kind of therapy lasted for 6 weeks; sequence of drug administration was randomized. The effect of treatment was assessed by resting blood pressure (BP) dynamics. If antihypertensive effect was not sufficient after 3 weeks of treatment, lisinopryl (Dapril) 10 mg/d was added.Results. There were no differences between basic clinical characteristics in groups of patients initially treated with different indapamide medications. Systolic and diastolic BP significantly reduced after 3 weeks of treatment without difference between tested indapamide medications. Combined therapy led to additional decrease in BP without significant difference between the patients groups. There was no significant difference in groups on the rates of side effects caused by therapy with tested indapamide medications.Conclusion. The proposed protocol of study showed that there were no significant differences in efficacy and safety of two presentations of original indapamide and tested generic indapamide in hypertension treatment.
Assessment of amlodipine antihypertensive effect homogeneity in controlled trial
V.M. Gorbunov,M.I. Smirnova,A.D. Deev
Rational Pharmacotherapy in Cardiology , 2009,
Abstract: Aim. To compare influence of amlodipine and spirapril on ambulatory blood pressure profile, including antihypertensive effect smoothness in patients with arterial hypertension (HT).Methods. 39 patients (aged 53,7±10,0 y.o.) with HT were included in the open, randomized, cross-over study, 30 patients completed study. The duration of every therapies was 4 weeks, initial control period and wash-out period between therapies lasted 1 week. The initial daily dose of amlodipine was 5 mg, standard dose of spirapril (6 mg/daily) was not changed during the trial. After 1-2 weeks of treatment amlodipine dose was increased up to 10 mg/daily as well as dihydrochlorothiazide was added, if necessary. Ambulatory blood pressure monitoring (ABPM) was performed initially and at the end of both therapies.Results. Both drugs demonstrated good antihypertensive effect according to ABPM data. Decrease of systolic/diastolic blood pressure was 11,2±1,8/7,6±1,2 mm Hg in amlodipine therapy and 10,0±1,8/7,1±1,2 in spirapril therapy (p<0,0001). The smoothness indexes (SI) were 0,65/0,45 and 0,55/0,45, respectively, differences between two therapies were not significant. However the individual analysis of the SI distribution (with SI=0,5 as a satisfactory criterion), showed that antihypertensive effect smoothness is better in amlodipine therapy than this in spirapril one.Conclusion. Amlodipine has prominent as well as smooth antihypertensive effect, that gives it advantages in the long-term antihypertensive therapy.
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