Treatment of patients with high cardiovascular risk: a modern view on combined therapy

Introduction. Lack of efficacy of treatment with several medications in patients with arterial hypertension (AH) and high cardiovascular disease (CVD) risk is often explained by low compliance to treatment. Using combined therapy (CT) is one of the ways to increase compliance. Objective. To evaluate the influence of CT consisting of amlodipine, lisinopril and rosuvastatin on arterial elastance and serum fibrosis marker levels in patients with high CVD risk. Materials and methods. The study included 66 patients (mean age 66.5 years, 5% male, 95% female) with atherosclerosis of the brachiocephalic arteries. Serum levels of cholesterol and low density lipoprotein (LDL); brachial and central blood pressure (BP); brachial-ankle and carotid-femoral pulse wave velocity (baPWV and cfPWV, respectively); and augmentation index (AI) were determined initially and after 6 months of CT. Results. Against the background of CT statistically significant reduction of levels of LDL from 4.1 (3.6; 4.7) to 2.2 (1.8; 2.5) mmol/L (p<0.01); systolic and diastolic brachial BP from 127 (116; 144) to 122 (115; 132) mm Hg (p<0.01) and from 79 (72; 89) to 75 (70; 83) mm Hg (p<0.01), respectively; systolic and diastolic central BP from 125 (112; 139) to 120 (110; 124) mm Hg (p<0.01) and from 80 (75; 87) to 76 (70; 81) mm Hg (p<0.01), respectively; baPWV from 13.6 (12.5; 15.9) to 12.9 (11.8; 14.2) m/s (p<0.01); cfPWV from 11 (9; 12.2) to 9,4 (8.4; 10.2) m/s (p<0.01); and AI from 31 (25; 35) to 26 (21; 32) (p<0,05) was observed. Conclusion. CT consisting of amlodipine, lisinopril and rosuvastatin resulted in BP and LDL target level achievement and arterial stiffness reduction in patients with AH and high CVD risk. Further research is also necessary to more thoroughly assess efficacy of CT

Rationale for dapagliflozin administration for the prevention of adverse outcomes in patients with heart failure with reduced ejection fraction. Expert consensus statement

[No abstract available

The use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure Society [Экспертное мнение по применению диуретиков при хронической сердечной недостаточности Общество специалистов по сердечной недостаточности]

The document focuses on key issues of diuretic therapy in CHF from the standpoint of current views on the pathogenesis of edema syndrome, its diagnosis, and characteristics of using diuretics in various clinical situations

Management of adherence-based treatment. Consensus document – Clinical guidelines. English version [упРАВЛЕНИЕ ЛЕЧЕНИЕМ НА ОСНОВЕ пРИВЕРЖЕННОСТИ. КОНСЕНСуСНЫй ДОКуМЕНТ – КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ. АНГЛОЯзЫЧНАЯ ВЕРСИЯ]

Consensus Document «Management of adherence-based treatment» developed based on clinical guidelines of Russian Scientific Medical Society of Internal Medicine approved by the XIV National Congress of physicians (Moscow, 20 November 2019). The document is intended primarily to assess adherence to drug therapy, adherence to lifestyle modification, and adherence to medical support for patients who need long-term or permanent treatment. The document’s authors considered the treatment adherence unanimously as the compliance of the patient’s behavior with the recommendations received from the Doctor regarding medication, dieting, and other measures of lifestyle modifications. Insufficient adherence to treatment is a global problem. Assessing adherence as a basis for making medical decisions is an essential element of improving the quality of the healthcare system. Predictions of treatment outcomes cannot be considered effective if individualized levels of adherence are not used to justify project planning and evaluation. In medical practice, quantitative assessment of adherence is preferred, suitable for patients with various diseases, and with the possibility of automated data entry and processing. Therefore, sections on medical interventions based on the assessment of treatment adherence should be reflected in national clinical guidelines. These Joint Recommendations are based on these provisions. © Group of authors, 202

Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors

Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasive measures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different available methods of measurement. How these values were significantly altered by cardiovascular risk factors (CVRFs) was then investigated.AtCor Medical via an unrestricted gran

Treatment management based on adherence: Patient recommendation algorithms. Cross-disciplinary guidelines [УПРАВЛЕНИЕ ЛЕЧЕНИЕМ НА ОСНОВЕ ПРИВЕРЖЕННОСТИ: АЛГОРИТМЫ РЕКОМЕНДАЦИЙ ДЛЯ ПАЦИЕНТОВ. МЕЖДИСЦИПЛИНАРНЫЕ РЕКОМЕНДАЦИИ]

The algorithms (sample templates) of recommendations for patients, which are an integral part of adherence-based treatment management technologies, were developed by an interdisciplinary Working Group coordinated by the Treatment Adherence Section of the Russian Scientific Medical Society of Physicians. The Working Group includes opinion leaders and experts in the therapeutic, gastroenterology, cardiology, preventive medicine, gerontology, oncology, hematology, immunology, phthisiopulmonology, infectious diseases, oncohematology, neurology, intensive care, rehabilitation and other specialties, both involved by the section of RSMSIM, and recommended by the Gastroenterological Scientific Society of Russia, National Association of experts in Thrombosis, Clinical Hemostasiology and Hemorheology, Gerontological Society of the Russian Academy of Sciences, Russian Oncohematologists Society, Russian Society of Phthisiatrists, Society of Evidence-based Neurology. The algorithms are based on the materials of «The First Russian Consensus on Quantitative Assessment of adherence to treatment», approved by the XII National Congress of Internal Medicine (2017) and Clinical Guidelines «Treatment Management on the Basis of adherence», approved by the XIV National Congress of Internal Medicine (2019), taking into account the Consenting Document - Interdisciplinary Guidelines of RSMSIM, GSSR, NATH, SEN, GSRAS, ROHS, RSP «Treatment Management on the Basis of Adherence» (2020). The algorithms of treatment strategies are recommended by the Working Group to be used as a basis for inclusion into relevant sections of clinical guidelines and clinical handbooks developed by professional medical communities, as well as for use by practitioners in medical practice. © 2020 Stavropol State Medical University. All rights reserved