Pub Date : 2023-05-14DOI: 10.18705/1607-419x-2023-29-2-138-149
A. Semenkin, I. Druk, V. V. Potapov, V. S. Sapronenko, A. V. Zakharova
Objective. The purpose of this review is to highlight the pathophysiological mechanisms of the sequential formation of left ventricular hypertrophy (LVH), left ventricular dysfunction and chronic heart failure (CHF) in patients with hypertension (HTN), diagnostic and therapeutical issues of CHF with both reduced and preserved ejection fraction (EF). HTN is the main risk factor for cardiovascular diseases and is accompanied by damage of target organs, among which LVH is of particular importance. On the one hand, development of LVH is the consequence of increased load on the heart muscle and neurohumoral stimuli, and on the other hand, it is an independent risk factor for myocardial infarction, stroke, cardiac arrhythmias and CHF. HTN precedes newly developed heart failure in 91 % of patients with a predominance of CHF with a preserved EF according to the Framingham Heart Study. To date, different drugs can improve the prognosis of patients with HTN, CHF with reduced EF and to induce LVH regression. However, the issues of effective treatment of patients with CHF with preserved EF are still insufficiently studied.
{"title":"Hypertensive heart: from left ventricular hypertrophy to chronic heart failure","authors":"A. Semenkin, I. Druk, V. V. Potapov, V. S. Sapronenko, A. V. Zakharova","doi":"10.18705/1607-419x-2023-29-2-138-149","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-2-138-149","url":null,"abstract":"Objective. The purpose of this review is to highlight the pathophysiological mechanisms of the sequential formation of left ventricular hypertrophy (LVH), left ventricular dysfunction and chronic heart failure (CHF) in patients with hypertension (HTN), diagnostic and therapeutical issues of CHF with both reduced and preserved ejection fraction (EF). HTN is the main risk factor for cardiovascular diseases and is accompanied by damage of target organs, among which LVH is of particular importance. On the one hand, development of LVH is the consequence of increased load on the heart muscle and neurohumoral stimuli, and on the other hand, it is an independent risk factor for myocardial infarction, stroke, cardiac arrhythmias and CHF. HTN precedes newly developed heart failure in 91 % of patients with a predominance of CHF with a preserved EF according to the Framingham Heart Study. To date, different drugs can improve the prognosis of patients with HTN, CHF with reduced EF and to induce LVH regression. However, the issues of effective treatment of patients with CHF with preserved EF are still insufficiently studied.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87158171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-14DOI: 10.18705/1607-419x-2023-29-2-201-210
K. M. Shubina, S. V. Vorobev, S. Yanishevskiy
Background. Acute disorders of cerebral circulation are one of the most urgent problems of modern clinical neurology. Its significance is due to both the high frequency of occurrence and a large number of unsatisfactory outcomes, as well as the significant impact on the quality of life. Cognitive disorders are one of the main syndromes that manifest in post-stroke period and are associated with the rehabilitation potential, as well as opportunities for social and household adaptation. Our objective was to study the profile of cognitive impairment in a continuous sample of patients with cardioembolic stroke in the acute period of stroke, as well as to determine the correlations between their occurrence and the factors determining the course of the disease. Design and methods. The study involved 46 patients of both sexes in the acute stage of ischemic stroke (average age was 69 ± 11 years). The selection of patients was carried out in accordance with the diagnostic criteria of the International Association of Vascular Behavioral and Cognitive Disorders VASCOG. The results of the Hachinski scale were also considered. All patients underwent interview for history, complaints, as well as the assessment of the neurological status. Risk factors for stroke were evaluated. We also assessed the results of computer and magnetic resonance imaging, standard “stroke” scales and performed a neuropsychological examination aimed at a comprehensive study of cognitive functions. All studies were conducted at the end of 10-14 days from the development of focal neurological symptoms. Results. Cognitive disorders in patients with cardioembolic ischemic stroke turned out to be quite heterogeneous. Their severity in the majority of our patients was considered as mild cognitive impairment. Changes at dementia level were much less common and were characteristic of patients with extensive lesions or in the case of disorders in the field of cognitively significant “strategic” foci. Neurodynamic disorders predominated in the profile of disorders of higher cortical functions. Memory impairment was expressed slightly and was of a secondary nature. With the aggravation of cognitive disorders, mnestic disorders progressed. In addition, regulatory disorders began to be detected. The most significant correlations were found between the results of neurocognitive tests on the one hand and the assessment on the Bartel scales, the assessment of changes in white matter, as well as the volume of the necrosis focus, the presence of heart failure and dyscirculatory encephalopathy in the anamnesis. Conclusions. Cognitive impairment is a significant component of the clinical picture of cardioembolic stroke. Their severity is largely determined by the volume and topical localization of the ischemic focus, as well as the presence and severity of previous chronic cerebrovascular pathology. This determines the need to develop methods to assess the state of cognitive functions before the developm
{"title":"Cognitive impairment in the acute period of cardioembolic stroke","authors":"K. M. Shubina, S. V. Vorobev, S. Yanishevskiy","doi":"10.18705/1607-419x-2023-29-2-201-210","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-2-201-210","url":null,"abstract":"Background. Acute disorders of cerebral circulation are one of the most urgent problems of modern clinical neurology. Its significance is due to both the high frequency of occurrence and a large number of unsatisfactory outcomes, as well as the significant impact on the quality of life. Cognitive disorders are one of the main syndromes that manifest in post-stroke period and are associated with the rehabilitation potential, as well as opportunities for social and household adaptation. Our objective was to study the profile of cognitive impairment in a continuous sample of patients with cardioembolic stroke in the acute period of stroke, as well as to determine the correlations between their occurrence and the factors determining the course of the disease. Design and methods. The study involved 46 patients of both sexes in the acute stage of ischemic stroke (average age was 69 ± 11 years). The selection of patients was carried out in accordance with the diagnostic criteria of the International Association of Vascular Behavioral and Cognitive Disorders VASCOG. The results of the Hachinski scale were also considered. All patients underwent interview for history, complaints, as well as the assessment of the neurological status. Risk factors for stroke were evaluated. We also assessed the results of computer and magnetic resonance imaging, standard “stroke” scales and performed a neuropsychological examination aimed at a comprehensive study of cognitive functions. All studies were conducted at the end of 10-14 days from the development of focal neurological symptoms. Results. Cognitive disorders in patients with cardioembolic ischemic stroke turned out to be quite heterogeneous. Their severity in the majority of our patients was considered as mild cognitive impairment. Changes at dementia level were much less common and were characteristic of patients with extensive lesions or in the case of disorders in the field of cognitively significant “strategic” foci. Neurodynamic disorders predominated in the profile of disorders of higher cortical functions. Memory impairment was expressed slightly and was of a secondary nature. With the aggravation of cognitive disorders, mnestic disorders progressed. In addition, regulatory disorders began to be detected. The most significant correlations were found between the results of neurocognitive tests on the one hand and the assessment on the Bartel scales, the assessment of changes in white matter, as well as the volume of the necrosis focus, the presence of heart failure and dyscirculatory encephalopathy in the anamnesis. Conclusions. Cognitive impairment is a significant component of the clinical picture of cardioembolic stroke. Their severity is largely determined by the volume and topical localization of the ischemic focus, as well as the presence and severity of previous chronic cerebrovascular pathology. This determines the need to develop methods to assess the state of cognitive functions before the developm","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79192633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-14DOI: 10.18705/1607-419x-2023-29-2-231-240
A. Konradi
The article describes the current situation in hypertension awareness and treatment, the role of treatment adherence and fixed-dose combinations in its improvement. The real world data form recent studies concerning adherence and outcome on the triple combination of amlodipine/indapamide/perindopril are demonstrated.
{"title":"ACE-inhibitor, calcium antagonist and diuretic as three major components of antihypertensive therapy. Potential advantages of fixed triple combinations","authors":"A. Konradi","doi":"10.18705/1607-419x-2023-29-2-231-240","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-2-231-240","url":null,"abstract":"The article describes the current situation in hypertension awareness and treatment, the role of treatment adherence and fixed-dose combinations in its improvement. The real world data form recent studies concerning adherence and outcome on the triple combination of amlodipine/indapamide/perindopril are demonstrated.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87947972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-12DOI: 10.18705/1607-419x-2023-29-4-402-410
E. V. Akimova, M. M. Kayumova, V. V. Gafarov, M. I. Bessonova, A. M. Akimov, E. I. Gakova, A. A. Gakova, T. I. Petelina
Objective . The aim of the study was to determine the associations of a high level of personal anxiety (PA) with stress at work among women in an open urban population. Design and methods . A cross-sectional epidemiological study was conducted on a representative sample of 1000 women aged 25-64, formed from the electoral lists of citizens of the city of Tyumen, the response rate was 70,3 %. PA and stress at work was assessed by the standard WHO MONICA-MOPSY questionnaire. Results . Among women of the open population of a medium urbanized city of Western Siberia, PA is rather prevalent with the prevalence of its high level over a low level in the age range and the achievement of an absolute maximum in a high level of PA in the fifth decade of life. Stress at work during the previous twelve months was manifested as following: more than a third of respondents began to perform additional work, by the sixth decade of life, the workload had stabilized. Responsibility at the workplace was reported as high by more than half of the population, about 40 % of women denied the possibility of a good rest after a working day. In women with a high level of PA, stress at work was associated with the increase in responsibility at the workplace and the lack of opportunities for rest after a working day. Conclusions . Thus, the results of the study obtained on an open urban population identified the most vulnerable age categories of women with a high level of PA, as well as the relationships between PA and work-related stress. Our results can serve as a scientific basis for the development of preventive programs to reduce the risks of cardiovascular diseases in female populations of medium urbanized cities of Western Siberia.
{"title":"Personal anxiety and its associations with work stress in open urban population","authors":"E. V. Akimova, M. M. Kayumova, V. V. Gafarov, M. I. Bessonova, A. M. Akimov, E. I. Gakova, A. A. Gakova, T. I. Petelina","doi":"10.18705/1607-419x-2023-29-4-402-410","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-4-402-410","url":null,"abstract":"Objective . The aim of the study was to determine the associations of a high level of personal anxiety (PA) with stress at work among women in an open urban population. Design and methods . A cross-sectional epidemiological study was conducted on a representative sample of 1000 women aged 25-64, formed from the electoral lists of citizens of the city of Tyumen, the response rate was 70,3 %. PA and stress at work was assessed by the standard WHO MONICA-MOPSY questionnaire. Results . Among women of the open population of a medium urbanized city of Western Siberia, PA is rather prevalent with the prevalence of its high level over a low level in the age range and the achievement of an absolute maximum in a high level of PA in the fifth decade of life. Stress at work during the previous twelve months was manifested as following: more than a third of respondents began to perform additional work, by the sixth decade of life, the workload had stabilized. Responsibility at the workplace was reported as high by more than half of the population, about 40 % of women denied the possibility of a good rest after a working day. In women with a high level of PA, stress at work was associated with the increase in responsibility at the workplace and the lack of opportunities for rest after a working day. Conclusions . Thus, the results of the study obtained on an open urban population identified the most vulnerable age categories of women with a high level of PA, as well as the relationships between PA and work-related stress. Our results can serve as a scientific basis for the development of preventive programs to reduce the risks of cardiovascular diseases in female populations of medium urbanized cities of Western Siberia.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135423162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-02DOI: 10.18705/1607-419x-2023-29-3-286-298
M. Fedin, N. Vorobyeva, A. Izyumov, K. Eruslanova, Y. Kotovskaya, O. Tkacheva
Objective. In persons aged ≥ 65 years, to estimate the prevalence of chronic heart failure (CHF), assess geriatric status and analyze associations of CHF with geriatric syndromes (GS).Design and methods. The study included 4308 people (30 % men) aged 65 to 107 years (mean age 78 ± 8 years) living in 11 regions of the Russian Federation, who were divided into 3 age subgroups (65–74 years, 75–84 years and ≥ 85 years). All participants underwent a comprehensive geriatric assessment, which consisted of two stages: 1) questioning according to a specially designed questionnaire; 2) objective examination. The presence of 15 GS was assessed. The presence of CHF was judged on the basis of the submitted medical documentation.Results. The frequency of CHF in all subjects was 57,8 %, including 44,2 % in persons aged 65–74 years, 60,2 % in 75–84 years, 72,6 % in ≥ 85 years (p for a trend < 0,001). In patients with CHF, the frequency of 13 out of 15 GS was higher (except for orthostatic hypotension and malnutrition). One-way regression analysis showed that the presence of CHF is associated with an increase in the chances of having these GS by 1,3–1,9 times. Multivariate regression analysis adjusted for age and sex found that age was independently associated with the presence of CHF (odds ratio (OR) 1,06 for every 1 year; 95 % confidence interval (CI) 1,05–1,07; p < 0,001), basic dependence in everyday life (OR 1,22; 95 % CI 1,04–1,42; p = 0,015), probable depression (OR 1,35; 95 % CI 1,16–1,56; p < 0,001), fecal incontinence (OR 1,80; 95 % CI 1,21–2,69; p = 0,004) and chronic pain syndrome (OR 1,97; 95 % CI 1,58–2,45; p < 0,001).Conclusions. In the EUCALYPTUS study, for the first time, national data on the prevalence of CHF in people aged ≥ 65 years were obtained and associations between CHF and 15 GS were studied.
{"title":"Peculiarities of geriatric status in patients with chronic heart failure over the age of 65: data from the EUCALYPTUS study","authors":"M. Fedin, N. Vorobyeva, A. Izyumov, K. Eruslanova, Y. Kotovskaya, O. Tkacheva","doi":"10.18705/1607-419x-2023-29-3-286-298","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-286-298","url":null,"abstract":"Objective. In persons aged ≥ 65 years, to estimate the prevalence of chronic heart failure (CHF), assess geriatric status and analyze associations of CHF with geriatric syndromes (GS).Design and methods. The study included 4308 people (30 % men) aged 65 to 107 years (mean age 78 ± 8 years) living in 11 regions of the Russian Federation, who were divided into 3 age subgroups (65–74 years, 75–84 years and ≥ 85 years). All participants underwent a comprehensive geriatric assessment, which consisted of two stages: 1) questioning according to a specially designed questionnaire; 2) objective examination. The presence of 15 GS was assessed. The presence of CHF was judged on the basis of the submitted medical documentation.Results. The frequency of CHF in all subjects was 57,8 %, including 44,2 % in persons aged 65–74 years, 60,2 % in 75–84 years, 72,6 % in ≥ 85 years (p for a trend < 0,001). In patients with CHF, the frequency of 13 out of 15 GS was higher (except for orthostatic hypotension and malnutrition). One-way regression analysis showed that the presence of CHF is associated with an increase in the chances of having these GS by 1,3–1,9 times. Multivariate regression analysis adjusted for age and sex found that age was independently associated with the presence of CHF (odds ratio (OR) 1,06 for every 1 year; 95 % confidence interval (CI) 1,05–1,07; p < 0,001), basic dependence in everyday life (OR 1,22; 95 % CI 1,04–1,42; p = 0,015), probable depression (OR 1,35; 95 % CI 1,16–1,56; p < 0,001), fecal incontinence (OR 1,80; 95 % CI 1,21–2,69; p = 0,004) and chronic pain syndrome (OR 1,97; 95 % CI 1,58–2,45; p < 0,001).Conclusions. In the EUCALYPTUS study, for the first time, national data on the prevalence of CHF in people aged ≥ 65 years were obtained and associations between CHF and 15 GS were studied.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"47 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72479855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-02DOI: 10.18705/1607-419x-2023-29-3-275-285
A. Izyumov, N. M. Vorobyova, H. A. Mkhitaryan, K. Eruslanova, Y. Kotovskaya, O. Tkacheva
Objective. The aim of the study was to study the prevalence of cognitive impairment (CI) and chronic heart failure (CHF) in people aged ≥ 65 years, as well as to analyze the relationship between them.Design and methods. In the subanalysis of the multicenter EUCALYPTUS study, 3537 patients aged 65 to 107 years (average age 78,7 ± 8,4 years) were selected who had information about the presence/absence of CHF and who underwent a Mini- Cog test. All patients were stratified into 2 groups: with the presence (n = 2111) and absence (n = 1426) of CHF.Results. The prevalence of CHF in this sample was 59,7 %, CI — 60,8 %. With increasing age, the prevalence of both CHF and CI increased significantly. Patients with CHF were on average 4 years older than patients without CHF, but did not differ by gender. In general, the frequency of probable CI (≤ 3 points in the Mini-Cog test) in patients with CHF was significantly higher than without CHF (64,5 % против 55,4 %; p < 0,001). One-factor regression analysis demonstrated that an increase in the sum of points in the Mini-Cog test for every 1 point reduces the chances of having CHF by 14 %, and the presence of probable CI is associated with an increase in the chances of having CHF by 46 %. Univariate regression analysis showed that compared with the absence of CI (reference category; odds ratio = 1,0), patients with CI had a 72 % higher chance of having CHF, whereas the presence of a moderate risk of CI was not associated with an increased chance of having CHF. However, when adjusting for age and gender in the model, all of the above associations lost their significance due to the fact that age is significantly associated with both CHF and CI.Conclusions. Thus, the results of a multicenter study of EUCALYPTUS demonstrate a high prevalence of both probable CI and CHF among the elderly and senile in the Russian population and their relationship.
{"title":"Associations between cognitive impairment and chronic heart failure in people over the age of 65: data from the Russian multicenter study EUCALYPTUS","authors":"A. Izyumov, N. M. Vorobyova, H. A. Mkhitaryan, K. Eruslanova, Y. Kotovskaya, O. Tkacheva","doi":"10.18705/1607-419x-2023-29-3-275-285","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-275-285","url":null,"abstract":"Objective. The aim of the study was to study the prevalence of cognitive impairment (CI) and chronic heart failure (CHF) in people aged ≥ 65 years, as well as to analyze the relationship between them.Design and methods. In the subanalysis of the multicenter EUCALYPTUS study, 3537 patients aged 65 to 107 years (average age 78,7 ± 8,4 years) were selected who had information about the presence/absence of CHF and who underwent a Mini- Cog test. All patients were stratified into 2 groups: with the presence (n = 2111) and absence (n = 1426) of CHF.Results. The prevalence of CHF in this sample was 59,7 %, CI — 60,8 %. With increasing age, the prevalence of both CHF and CI increased significantly. Patients with CHF were on average 4 years older than patients without CHF, but did not differ by gender. In general, the frequency of probable CI (≤ 3 points in the Mini-Cog test) in patients with CHF was significantly higher than without CHF (64,5 % против 55,4 %; p < 0,001). One-factor regression analysis demonstrated that an increase in the sum of points in the Mini-Cog test for every 1 point reduces the chances of having CHF by 14 %, and the presence of probable CI is associated with an increase in the chances of having CHF by 46 %. Univariate regression analysis showed that compared with the absence of CI (reference category; odds ratio = 1,0), patients with CI had a 72 % higher chance of having CHF, whereas the presence of a moderate risk of CI was not associated with an increased chance of having CHF. However, when adjusting for age and gender in the model, all of the above associations lost their significance due to the fact that age is significantly associated with both CHF and CI.Conclusions. Thus, the results of a multicenter study of EUCALYPTUS demonstrate a high prevalence of both probable CI and CHF among the elderly and senile in the Russian population and their relationship.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82296879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-21DOI: 10.18705/1607-419x-2023-29-3-330-336
E. Solonskaya, A. Falkovskaya, S. Pekarskiy, A. Baev, V. Mordovin
Traditionally an iodine-containing contrast agent is used for renal arteries angiography. However, patients with chronic kidney disease (CKD) and allergic reaction to iodine, despite infusion and desensitization therapy, have a very high risk of developing complications after procedure. We present a clinical case of successful and safe use of carboxyangiography for renal artery denervation in a patient with resistant arterial hypertension (HTN) in combination with type 2 diabetes mellitus and CKD against the background of an allergic reaction to iodine contrast agents in the form of an anaphylactoid reaction in anamnesis (angioedema). An alternative type of angiography allowed us to carry out successful endovascular treatment of HTN resulting in the achievement of target blood pressure levels without intervention-related complications at early- and long-term follow-up.
{"title":"The first experience of using carboxyangiography in renal denervation in a patient with resistant arterial hypertension, chronic kidney disease and iodine contrast allergy","authors":"E. Solonskaya, A. Falkovskaya, S. Pekarskiy, A. Baev, V. Mordovin","doi":"10.18705/1607-419x-2023-29-3-330-336","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-330-336","url":null,"abstract":"Traditionally an iodine-containing contrast agent is used for renal arteries angiography. However, patients with chronic kidney disease (CKD) and allergic reaction to iodine, despite infusion and desensitization therapy, have a very high risk of developing complications after procedure. We present a clinical case of successful and safe use of carboxyangiography for renal artery denervation in a patient with resistant arterial hypertension (HTN) in combination with type 2 diabetes mellitus and CKD against the background of an allergic reaction to iodine contrast agents in the form of an anaphylactoid reaction in anamnesis (angioedema). An alternative type of angiography allowed us to carry out successful endovascular treatment of HTN resulting in the achievement of target blood pressure levels without intervention-related complications at early- and long-term follow-up.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80367270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-21DOI: 10.18705/1607-419x-2023-29-3-266-274
А. V. Turusheva, E. Frolova
Background. No increase or decrease in heart rate (HR) after transition to the upright position during orthostatic test is an important criterion for identifying older adults at risk of falls, but its relationship with other geriatric syndromes is unknown. Objective. To investigate the relationship between no increase or decrease of HR after transition to the upright position during orthostatic test and the prevalence of other geriatric syndromes.Design and methods. A cross-sectional cohort epidemiological study of EUCALYPTUS. Sample: random sample of community-dwelling older adults aged 65 years and older (n = 396). Methods: orthostatic test, analysis of medication therapy, comorbid chronic diseases, laboratory tests, comprehensive geriatric assessment.Results. No increase/ decrease in HR in the first minute after transition to the upright position during orthostatic test was associated with increased prevalence of frailty, as well as other geriatric syndromes, of which low level of physical function was the most significant. After adjusting for sex and age, atrial fibrillation, cognitive impairment, malnutrition, autonomy decline, and anemia, study participants with low physical function were 3,6 times more likely to find no increase or decrease in HR in the first minute after transition to the upright position during orthostatic test [odds ratio (95 % confidence interval) 3,620 (1,499 to 8,742)].Conclusions. The use of the marker “no increase/ decrease of HR in the first minute after transition to the upright position during” orthostatic test in older adults can serve as one of the important components of cardiovascular system reserve assessment and diagnosis of patients with decreased functional status and frailty.
{"title":"Heart rate, orthostatic test as markers of pathological aging","authors":"А. V. Turusheva, E. Frolova","doi":"10.18705/1607-419x-2023-29-3-266-274","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-3-266-274","url":null,"abstract":"Background. No increase or decrease in heart rate (HR) after transition to the upright position during orthostatic test is an important criterion for identifying older adults at risk of falls, but its relationship with other geriatric syndromes is unknown. Objective. To investigate the relationship between no increase or decrease of HR after transition to the upright position during orthostatic test and the prevalence of other geriatric syndromes.Design and methods. A cross-sectional cohort epidemiological study of EUCALYPTUS. Sample: random sample of community-dwelling older adults aged 65 years and older (n = 396). Methods: orthostatic test, analysis of medication therapy, comorbid chronic diseases, laboratory tests, comprehensive geriatric assessment.Results. No increase/ decrease in HR in the first minute after transition to the upright position during orthostatic test was associated with increased prevalence of frailty, as well as other geriatric syndromes, of which low level of physical function was the most significant. After adjusting for sex and age, atrial fibrillation, cognitive impairment, malnutrition, autonomy decline, and anemia, study participants with low physical function were 3,6 times more likely to find no increase or decrease in HR in the first minute after transition to the upright position during orthostatic test [odds ratio (95 % confidence interval) 3,620 (1,499 to 8,742)].Conclusions. The use of the marker “no increase/ decrease of HR in the first minute after transition to the upright position during” orthostatic test in older adults can serve as one of the important components of cardiovascular system reserve assessment and diagnosis of patients with decreased functional status and frailty.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91315020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-17DOI: 10.18705/1607-419x-2023-29-2-246-252
Y. Kotovskaya, O. Tkacheva
Frailty is a state of increased vulnerability to endo- and exogenous stress factors when the physiological reserve is decreased due to ageing. Frailty poses challenges for the management of arterial hypertension (HTN) and other chronic cardiovascular and non-cardiovascular diseases in older adultst. Although many Russian and international clinical guidelines on HTN frailty recommended to consider it in decision making process on antihypertensive therapy tactics, the optimal criteria and instruments are still uncertain. HTN is common in patients with frailty, but the direct impact of HTN on frailty development has not been fully established. Blood pressure (BP) control is important for reducing the risk of cardiovascular events and maintaining quality of life in patients with HTN and frailty. BP decreases in later life and in patients who are completely dependent in daily activity. Mortality in patients with frailty and low BP is higher than in patients with high BP, which raises the question of the optimal BP level in this vulnerable category of patients. Cognitive decline is one of the domains of frailty that is closely associated with loss of autonomy, self-care ability, and reduced quality of life. It remains controversial whether antihypertensive therapy has beneficial effects on cognition in very old patients.
{"title":"Frailty and arterial hypertension: clinical practice issues","authors":"Y. Kotovskaya, O. Tkacheva","doi":"10.18705/1607-419x-2023-29-2-246-252","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-2-246-252","url":null,"abstract":"Frailty is a state of increased vulnerability to endo- and exogenous stress factors when the physiological reserve is decreased due to ageing. Frailty poses challenges for the management of arterial hypertension (HTN) and other chronic cardiovascular and non-cardiovascular diseases in older adultst. Although many Russian and international clinical guidelines on HTN frailty recommended to consider it in decision making process on antihypertensive therapy tactics, the optimal criteria and instruments are still uncertain. HTN is common in patients with frailty, but the direct impact of HTN on frailty development has not been fully established. Blood pressure (BP) control is important for reducing the risk of cardiovascular events and maintaining quality of life in patients with HTN and frailty. BP decreases in later life and in patients who are completely dependent in daily activity. Mortality in patients with frailty and low BP is higher than in patients with high BP, which raises the question of the optimal BP level in this vulnerable category of patients. Cognitive decline is one of the domains of frailty that is closely associated with loss of autonomy, self-care ability, and reduced quality of life. It remains controversial whether antihypertensive therapy has beneficial effects on cognition in very old patients.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81474461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-17DOI: 10.18705/1607-419x-2023-29-4-342-352
A. P. Gurevich, I. V. Emelyanov, M. V. Ionov, A. G. Vanyurkin, M. A. Chernyavskiy, A. O. Konradi
Aortic aneurysm (AA) is one of the most formidable cardiovascular diseases, characterized by subtle clinical manifestations and a high risk of complications. Predisposing factors in the development of AA are age, arterial hypertension (HTN), atherosclerosis, and inflammatory aortic diseases. Those are associated with changes in vascular stiffness. HTN causes increased tension in the aortic wall when the pulse wave of blood pressure (BP) rises in patients with AA. Indicators of central BP and vascular stiffness are of particular interest. They present as independent risk factors for cardiovascular events but are poorly studied among patients with AA. The purpose of the review is to summarize the ideas about the relationship of AA with the indicators of vascular stiffness and central hemodynamics in patients with non-operated AA, as well as after endovascular AA repair. Here we discuss the predictive accuracy and applicability of individual markers concerning AA progression and surgical treatment outcomes, as well as unresolved issues and prospects for further research.
{"title":"Central aortic blood pressure and pulse wave characteristics in patients with decscending thoracic and abdominal aortic aneurysm: features, dynamics, and prognostic significance","authors":"A. P. Gurevich, I. V. Emelyanov, M. V. Ionov, A. G. Vanyurkin, M. A. Chernyavskiy, A. O. Konradi","doi":"10.18705/1607-419x-2023-29-4-342-352","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-4-342-352","url":null,"abstract":"Aortic aneurysm (AA) is one of the most formidable cardiovascular diseases, characterized by subtle clinical manifestations and a high risk of complications. Predisposing factors in the development of AA are age, arterial hypertension (HTN), atherosclerosis, and inflammatory aortic diseases. Those are associated with changes in vascular stiffness. HTN causes increased tension in the aortic wall when the pulse wave of blood pressure (BP) rises in patients with AA. Indicators of central BP and vascular stiffness are of particular interest. They present as independent risk factors for cardiovascular events but are poorly studied among patients with AA. The purpose of the review is to summarize the ideas about the relationship of AA with the indicators of vascular stiffness and central hemodynamics in patients with non-operated AA, as well as after endovascular AA repair. Here we discuss the predictive accuracy and applicability of individual markers concerning AA progression and surgical treatment outcomes, as well as unresolved issues and prospects for further research.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"8 10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136244414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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