Saratov JOURNAL of Medical and Scientific Research

arterial hypertension

Issues on optimization of primary health care for working patients with diagnosed hypertension

Year: 2017, volume 13 Issue: №1 Pages: 007-009
Heading: Health Service Organization Article type: Original article
Authors: Shulpina N.Yu., Erugina M.V, Sazanova G.Yu, Krom I.L.
Organization: Saratov State Medical University
Summary:

Aim: to justify the ways of optimization of availability of primary health care for working-age patients with arterial hypertension. Material and Methods. The study of the availability of drug treatment of working-age patients with arterial hypertension was based on a survey of 409 patients and calculated the average cost of treatment of this group of patients for 1 month in accordance with the care standards. Results. On 01.06.2016, the cost of treatment for a patient with stage 1 hypertension amounted to 316.89 rubles per month, with 2 stage 652.68 rubles per month. 67% of patients of working age are unable to follow the doctor's recommendations and take the prescribed medicines. Conclusion. Provision of free medicines to patients with arterial hypertension of stages 1 and 2 and the formation of their commitment to preventive treatment causes a direct economic effect, which will be 7915979 rubles per year, and indirect economic effect of the decreased mortality from cardiovascular diseases, disability, reduce in disability days and increase of the gross domestic product.

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Evaluation of treatment of patients with essential hypertension at primary care units using structured questionnaires (a polyclinic of the Saratov region as an example)

Year: 2016, volume 12 Issue: №4 Pages: 560-565
Heading: Internal Diseases Article type: Original article
Authors: Gerasimov S.N., Korotin A.S., Alexandrova I.N., Popova Yu.V.
Organization: Saratov Institute of Cardiology, Russia, Krasnoarmeysk Regional Hospital, Engels City Polyclinic №4
Summary:

The aim of the article is to assess patients' view on the treatment of hypertension in polyclinic located in the Saratov region using structured questionnaires. Material and Methods. 83 patients (aged 64.6±9.6 years, males 30%) with the diagnosis of essential hypertension who referred to the polyclinic of workers settlement of the Saratov region during the period from July 1, 2015 to July 7, 2015 were interviewed. The questionnaire for patients with elevated blood pressure (BP) developed by S. N. Gerasimov et al. (2015) was used. The questionnaire included 16 questions organized in the following panels: awareness of hypertension and risk factors, BP self-monitoring, conducted treatment, compliance to therapy, referrals to medical care. Results. 90% of the interviewed patients have known previously about BP elevation; 90% of respondents have had a tonometer; 84% of hypertensives measured BP no rare then once a week, and 54% did it daily; 88% of enrollers regularly take antihypertensive drugs. Only 36% of patients could be classified as compliant to therapy according the Morisky — Green scale (had 4 points). 92% of respondents have received one or more advice on lifestyle modification: 82% — advice on eating, 66% — advice on weight reduction, 55% — advice on physical activity, 28% — advice on smoking cessation, 26% — advice on alcohol consumption. 62.7% of patients were interested in organization of special follow-up program. Conclusion. High frequency of BP self-measurement was identified together with low compliance of patients to antihypertensive therapy, good knowledge on non-pharmacologic treatment interventions.

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Gender features of risk factors and clinical course of arterial hypertension

Year: 2015, volume 11 Issue: №4 Pages: 542-547
Heading: cardiac surgery Article type: Original article
Authors: Shkatova E.Yu., Bakshaev I.N., Korolkova G.S.
Organization: Igevsk State Medical Academy
Summary:

The aim of the article is to reveal the risk factors and features of the clinical course of hypertension in men and women. Material and Methods: A prospective study of 204 patients was carried out. The survey included a sociological survey, with the use of special socio-sanitary profiles, matters which concern lifestyle characteristics of respondents, hereditary risk factors, peculiarities of hypertension. Results: Men often have a hidden crisis-free for hypertension with a great number of complications; women have a longer duration of the disease, with a more severe clinical picture. Conclusion: The differences of social and health behavior with the existing risk factors and the clinical course of hypertension according to the gender of the patient have been revealed.

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Perspectives for the analysis of arterial hypertension morbidity in Saratov region

Year: 2015, volume 11 Issue: №2 Pages: 97-100
Heading: Health Service Organization Article type: Original article
Authors: Zhuzhlova N.Y., Sazanova G.Y., Dolgova E.M.
Organization: Saratov State Medical University
Summary:

Purpose: the study of trends in overall morbidity and primary hypertension in the Saratov region over the period from 2002 to 2013. Materials and methods. The official statistics Ministry of Health and the Federal State Statistics Service were used, which is processed using analytical and statistical methods. Results. The article has been providing the analysis of total and primary arterial hypertension morbidity of the population of the Saratov region, which is in accordance with the degree of the Government of the Russian Federation from December 1, 2004, N 715 to the group of socially significant diseases. During the period from 2002 to 2013 in the Saratov region, as well as in the Russian Federation in Volga Federal district, the tendency of growth of the overall incidence and the decrease in the primary incidence of arterial hypertension. Conclusion. The dynamics of incidence of hypertension suggests the need for careful analysis and optimization of medical care for patients with hypertension

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Relationship of daily arterial blood pressure monitoring readings and arterial stiffness profile in male patients with chronic obstructive pulmonary disease combined with arterial hypertension

Year: 2013, volume 9 Issue: №2 Pages: 247-252
Heading: Internal Diseases Article type: Original article
Authors: Karoli N.A., Dolishnyaya G.R., Borodkin A.M., Rebrov A.P.
Organization: Saratov State Medical University
Summary:

The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD) and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM) and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation). Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

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Association of polymorphism of CYP2D6 and CYP2C9 genes encoding P-450 proteins of cytochrome with arterial hypertension

Year: 2012, volume 8 Issue: №4 Pages: 933-937
Heading: Internal Diseases Article type: Original article
Authors: Borodulin V.B., Shevchenko O.V., Bychkov E.N., Kiselev A.R., Reshetko O.V., Posnenkova O.M., Saratsev A.V., Losev O.E.
Organization: Saratov State Medical University
Summary:

Gene polymorphisms of cytochrome P-450 CYP2 encoding proteins of cytochrome P-450 are essential forantihy-pertensive drugs metabolism. Purpose: We study the associations of functionally defective allele variants of CYP2D6 gene and CYP2C9 gene with the degree of arterial hypertension (AH). Materials and methods: Samples of DNA of leukocytes of blood of 150 patients with AH without the associated clinical conditions (56% of women) at the age of 20-59
years have been investigated. For the study of polymorphism of genes the pharmacogenetic biochip developed in the Institute of Molecular Biology n.a. V. A. Engelgardt has been used. Comparison of frequencies of occurrence of signs has been carried out on the basis of chi-square criterion. Results: It has been revealed that homozygotes by mutant A1075C, C430T alleles of CYP2C9gene and G1934A of CYP2D6 gene have been significantly more common among patients with hypertension III (p=0.01). Conclusion: The research works on genes of system of P-450 cytochrome have important clinical value for rationalization of pharmacotherapy of hypertension. The increased frequency of occurrence of mutant allele of CYP2D6 and CYP2C9 genes in patients with hypertension III requires special attention to the problem of efficiency and safety of application of hypotensive drugs for the patients.

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The role of genetic mutations in development of metabolic disturbances in patients with arterial hypertension

Year: 2012, volume 8 Issue: №3 Pages: 751-756
Heading: Internal Diseases Article type: Original article
Authors: Borodulin V.B., Shevchenko O.V., Bychkov E.N., Reshetko O.V., Kiselev A.R., Posnenkova O.M., Zhelezinskaja N.V., Sarattsev A.V., Losev O.E.
Organization: Saratov State Medical University, Saratov Institute of Cardiology, Russia, First Moscow State Medical University n.a. I.M. Sechenov, Clinical Hospital of Ministry of Internal Affairs of the Russian Federation
Summary:

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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Dynamic regulation of cerebral blood flow and it's clinical, and laboratory markers in elderly patients with arterial hypertension

Year: 2011, volume 7 Issue: №4 Pages: 842-845
Heading: Internal Diseases Article type: Original article
Authors: Malinova L.I., Sadjaya L.A., Tikhonova L.A.
Organization: Saratov Road Clinical Hospital, Saratov Institute of Cardiology, Russia
Summary:

Aim: to estimate the dynamic regulation of cerebral blood flow (CBF) and significance of clinical, and laboratory parameters as a possible markers of CBF violations. Material. 179 elderly patients with arterial hypertension were involved in the study. Transcranial Doppler ultrasonography (Philips Envisor HD, USA) was used for CBF parameters dynamics during orthostatic hypotension. Results. Main directions of CBF parameters changings (Friedman ANOVA p 0,0091 ... 0,012, coeff. of concordance 0,308 ... 0,691) were detected. Gender differences of CBF parameters, as well as blood pressure level influence upon CBF regulation during orthostatic hypertension were studied. Conclusion. Received data allow us to consider gender, controlled or uncontrolled hypertension, cytomorphological parameters of peripheral blood, diuretics usage as clinical, and laboratory markers of dynamic regulation of CBF in elderly patients with arterial hypertension

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Renal dysfunction and state of metabolic and hemodynamic factors in patients with arterial hypertension

Year: 2011, volume 7 Issue: №4 Pages: 837-842
Heading: Internal Diseases Article type: Original article
Authors: Kurkina T.V., Bogoslovskaya S.I., Svistunov А.А., Kodochigova A.L, Glybochko G.Kh., Klochkov V.A.
Organization: Saratov State Medical University, Saratov Regional Hospital for Veterans of Wars, Saratov Institute of Cardiology, Russia, First Moscow State Medical University n.a. I.M. Sechenov
Summary:

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

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Age dependent dynamics of intima-media complex thickness in elderly patients with arterial hypertension

Year: 2011, volume 7 Issue: №3 Pages: 611-614
Heading: Internal Diseases Article type: Original article
Authors: Sadjaya L.A., Tikhonova LA., Malinova L.I.
Organization: Saratov Road Clinical Hospital, Saratov Institute of Cardiology, Russia
Summary:

Aim: To estimate the dynamics of intima-media complex in elderly patients with arterial hypertension. Materials: 179 elderly patients with arterial hypertension were involved in the study. Mean intima-media wall thickness (IMT) of common carotid arteries in plaque-free sites and prevalence of plaques were evaluated by B-mode ultrasound investigation (Philips Envisor HD, USA). Results: IMT changing was of nonlinear character, remained stable up to 74 years. Mean rate of the following IMT augmentation was 0.157 mm per year. Frequency of atherosclerotic plaque revealing was significantly increased since the 7th decade. Significant correlation between IMT and systolic, diastolic, mean blood pressure levels or medication spectrum was not revealed. Conclusion: Received data proved significant influence of aging upon IMT enlargement

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