Combination antihypertension therapy: The “underresearched” combinations

Decrease of blood pressure (BP) and its maintenance on target level is the main factor for cardiovascular mortality and morbidity reduction in hypertensive patients. For effective BP decrease most patients need combination therapy. The article is focused on benefits and adverse events of some combinations. In details an issue considered, on the combination of beta-blocker and renin-angiotensine-aldosteron system blocker, which, by the data from Russian observational programs, is the leader among two-component combinations. © 2017, Silicea-Poligraf, All right reserved

Combination antihypertension therapy: The “underresearched” combinations

Decrease of blood pressure (BP) and its maintenance on target level is the main factor for cardiovascular mortality and morbidity reduction in hypertensive patients. For effective BP decrease most patients need combination therapy. The article is focused on benefits and adverse events of some combinations. In details an issue considered, on the combination of beta-blocker and renin-angiotensine-aldosteron system blocker, which, by the data from Russian observational programs, is the leader among two-component combinations. © 2017, Silicea-Poligraf, All right reserved

Antihypertensive Therapy and its efficacy in outpatient elderly and very elderly subjects

Purpose of the study. The study of the characteristics and effectiveness of antihypertensive therapy (AHT) in patients aged 65 years and older. Material and methods. The study included 356 patients, mean age 74,916,1 years, 80.4% women. The prevalence of arterial hypertension (AH) and the current intake of antihypertensive drugs were evaluated by self-reported patient. Results. The prevalence of hypertension was 88.5%. The predominant variant was isolated systolic hypertension. 51.1% of patients have systolic blood pressure as measured at the reception turned > 140 mm Hg in 34.7% of patients >150 mm Hg AHT received 91.6% of patients with hypertension in 65.6% of cases it was combined. Of the various combinations of bicomponent most patients took angiotensin converting enzyme inhibitor in combination with a Adrenoblocker or a diuretic. Conclusions. The study showed the high prevalence of hypertension and the lack of efficacy in patients AHT elderly seeking outpatient care

ФИЗИЧЕСКИЕ НАГРУЗКИ - "ПОЛИПИЛЮЛЯ" ДЛЯ ПРОФИЛАКТИКИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ И ЗАМЕДЛЕНИЯ СТАРЕНИЯ

The concept of polypill in the prevention of cardiovascular diseases has received growing attention. However, the same, if not greater, therapeutic effect can be achieved through constant physical activity. Compared with pharmacotherapy, physical activity is more accessible, more economical and has no side effects. The epidemiological data on the preventive and curative properties of regular physical exercises and their influence on the main biological mediators are considered.Концепция «полипилюли» в профилактике сердечно-сосудистых заболеваний привлекает все больше внимания. Однако такой же, если не больший, терапевтический эффект может быть достигнут благодаря постоянной физической активности. По сравнению с фармакотерапией, физическая нагрузка более доступна, более экономична и не дает побочных эффектов. Рассмотрены эпидемиологические данные о профилактических и лечебных свойствах регулярных физических упражнений и влияние их на основные биологические медиаторы

Prevention of cardiovascular events: Are all recommendations applicable to elderly patients with senile Asthenia?

Primary prevention of cardiovascular events is based on achievement of optimal control of risk factors - arterial hypertension, dyslipidemia, glycemia - in accordance with current recommendations of scientific societies. But most rapidly growing segment of population - elderly and old individuals - have been underrepresented in randomized clinical trials underlying recommendations on primary and secondary prevention. That is why it is problematic to directly apply recommendations to patients from this group of population. In addition, old patients are characterized by accumulation of functional deficits, development of syndrome of senile asthenia («frailty»), and multimorbidity. Effect of these characteristics on prognosis often exceeds that of risk factors. Other important factor is high susceptibility of old patients to risk of development of unfavorable effects because of both changes of pharmacokinetics and pharmacodynamics of drugs and the need for multiple medicines (polypragmasy). While applying existing recommendations to old people one should recognize limitations of current knowledge on best ways of realization of approaches to prevention of cardiovascular prevention which effectiveness has been proved in younger individuals. Improvement of awareness and development of special skills of physicians involved in management of old patients is required for timely detection of the syndrome of senile asthenia. Special geriatric approaches should be implemented in cooperation with specialists in geriatric medicine

ОСОБЕННОСТИ ВЕДЕНИЯ "ХРУПКИХ" ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ

The aspects of arterial hypertension in patients of elderly and senile age are listed. These are comorbidity and polypharmacyintrinsic to them, as well as such syndromes as orthostatic hypotension, falls, cognitive impairments, senile asthenia syndrome. Recommendations for the treatment of hypertension in this category of patients are proposed.Перечислены особенности течения артериальной гипертонии у пациентов в пожилом и старческом возрасте. Это в первую очередь характерные для них коморбидность и полипрагмазия, а также наличие таких синдромов, как ортостатическая гипотония, падения, когнитивные нарушения, синдром старческой астении. Предложены рекомендации лечения АГ у данной категории пациентов

ОСОБЕННОСТИ ВЕДЕНИЯ "ХРУПКИХ" ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ

The aspects of arterial hypertension in patients of elderly and senile age are listed. These are comorbidity and polypharmacyintrinsic to them, as well as such syndromes as orthostatic hypotension, falls, cognitive impairments, senile asthenia syndrome. Recommendations for the treatment of hypertension in this category of patients are proposed.Перечислены особенности течения артериальной гипертонии у пациентов в пожилом и старческом возрасте. Это в первую очередь характерные для них коморбидность и полипрагмазия, а также наличие таких синдромов, как ортостатическая гипотония, падения, когнитивные нарушения, синдром старческой астении. Предложены рекомендации лечения АГ у данной категории пациентов

ФИЗИЧЕСКИЕ НАГРУЗКИ - "ПОЛИПИЛЮЛЯ" ДЛЯ ПРОФИЛАКТИКИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ И ЗАМЕДЛЕНИЯ СТАРЕНИЯ

The concept of polypill in the prevention of cardiovascular diseases has received growing attention. However, the same, if not greater, therapeutic effect can be achieved through constant physical activity. Compared with pharmacotherapy, physical activity is more accessible, more economical and has no side effects. The epidemiological data on the preventive and curative properties of regular physical exercises and their influence on the main biological mediators are considered.Концепция «полипилюли» в профилактике сердечно-сосудистых заболеваний привлекает все больше внимания. Однако такой же, если не больший, терапевтический эффект может быть достигнут благодаря постоянной физической активности. По сравнению с фармакотерапией, физическая нагрузка более доступна, более экономична и не дает побочных эффектов. Рассмотрены эпидемиологические данные о профилактических и лечебных свойствах регулярных физических упражнений и влияние их на основные биологические медиаторы

Antihypertensive Therapy and its efficacy in outpatient elderly and very elderly subjects

Purpose of the study. The study of the characteristics and effectiveness of antihypertensive therapy (AHT) in patients aged 65 years and older. Material and methods. The study included 356 patients, mean age 74,916,1 years, 80.4% women. The prevalence of arterial hypertension (AH) and the current intake of antihypertensive drugs were evaluated by self-reported patient. Results. The prevalence of hypertension was 88.5%. The predominant variant was isolated systolic hypertension. 51.1% of patients have systolic blood pressure as measured at the reception turned > 140 mm Hg in 34.7% of patients >150 mm Hg AHT received 91.6% of patients with hypertension in 65.6% of cases it was combined. Of the various combinations of bicomponent most patients took angiotensin converting enzyme inhibitor in combination with a Adrenoblocker or a diuretic. Conclusions. The study showed the high prevalence of hypertension and the lack of efficacy in patients AHT elderly seeking outpatient care