Specifics of daily blood pressure monitoring in patients with systemic hypertension and obstructive sleep apnoea: a case-control study

Background. The comorbidity of arterial hypertension (AH) and obstructive sleep apnea syndrome (OSA) is becoming increasingly common in clinical practice. However, the priority strategy for selecting antihypertensive therapy in such patients is yet to be defined. 24-hour blood pressure monitoring is important for determining an approach to controlling hypertension.Objectives. To study specific features of 24-hour blood pressure monitoring in comorbid AH– OSA patients.Methods. A total of 130 AH patients were surveyed. The main cohort (1) included AH–OSA patients (n = 90, mean age 54.93 ± 1.04 years), control cohort (2) — non-OSA AH patients (n = 40, mean age 57.92 ± 1.29 years). All patients had a general clinical examination with 24-hour blood pressure monitoring. OSA was verified in overnight respiratory polygraphy using an Alice PDx diagnostic appliance (USA).Results. The following specific features of 24-hour blood pressure monitoring were identified in the comorbid patients: a statistically significant growth of mean 24-hour systolic and average BP, as well as mean nocturnal systolic, diastolic and average BP; a statistically significant growth of mean 24-hour systolic, diastolic and average BP load indices. In addition, the AH-OSA patients had the statistically higher pulse pressure, systolic and average BP variability, as well as morning BP surge rate. The 24-hour BP dynamics in OSA patients had predominant morbid profiles and higher non-dipper and night-peaker rates compared to the control cohort.Conclusion. The identified specific features reflect a high risk of adverse cardiovascular events in AH–OSA comorbid patients, an earlier damage of target organs and negative prognosis of comorbidity, which warrants a further analysis of AH-specific clinical picture and personalisation of blood pressure control measures in such patients

Logistic regression model for predicting failure of dual antihypertensive therapy: a prospective comparative non-randomized clinical trial

Background. Initial dual antihypertensive therapy is currently considered as the first management step for the majority of patients with arterial hypertension. However, it often fails to achieve the target blood pressure levels. An approved algorithm for predicting the failure of dual antihypertensive therapy is still to be developed. Objectives. To establish predictors of dual antihypertensive therapy failure in patients with high and very high cardiovascular risk and to create a model for predicting negative outcome of dual antihypertensive therapy. Methods. The paper presents a prospective comparative non-randomized clinical trial. The recruiting of participants and recording of results were carried out in March–December 2019 with 3 months of the follow-up period. The trial involved examination of 88 patients with poor blood pressure control, stage II and III arterial hypertension, high and very high cardiovascular risk of stages 1–3. Clinical and laboratory examination was carried out in compliance with the current regulatory documents. Additional examination included tests for uric acid, high-sensitivity C-reactive protein, as well as respiratory polygraphy and computerized capillaroscopy. All patients were prescribed dual antihypertensive therapy. The primary search for predictors was performed using the binary logistic regression. The predictive model was developed by stepwise variable selection. The diagnostic significance of the binary classifier was assessed by means of ROC-curve analysis; the calculation was performed using MedCalc 20.218 software (MedCalc Software Ltd., Belgium). Results. Administration of two hypotensive drugs appears to be effective in 33% of patients. The final model for predicting negative outcomes of dual antihypertensive therapy included such independent predictors as interventricular septal thickness, daily mean systolic blood pressure, and area density of the capillary network. The odds ratio accounted for 9.1 (95% confidence interval 3.12; 26.82). The area under the ROC curve based on the multiple binary logistic regression model comprised 0.805±0.05 with 95% confidence interval: 0.707-0.882 (p<0.0001). The sensitivity and specificity of the method amounted to 83.1 and 69.0%, respectively. The prediction accuracy comprised 77.3%. Conclusion. The development of patient-oriented algorithms for selection of hypotensive treatment is considered to be essential due to poor blood pressure control during dual antihypertensive therapy. The developed prognostic model may be applied when managing hypertension

The Genome of the Toluene-Degrading Pseudomonas veronii Strain 1YdBTEX2 and Its Differential Gene Expression in Contaminated Sand.

The natural restoration of soils polluted by aromatic hydrocarbons such as benzene, toluene, ethylbenzene and m- and p-xylene (BTEX) may be accelerated by inoculation of specific biodegraders (bioaugmentation). Bioaugmentation mainly involves introducing bacteria that deploy their metabolic properties and adaptation potential to survive and propagate in the contaminated environment by degrading the pollutant. In order to better understand the adaptive response of cells during a transition to contaminated material, we analyzed here the genome and short-term (1 h) changes in genome-wide gene expression of the BTEX-degrading bacterium Pseudomonas veronii 1YdBTEX2 in non-sterile soil and liquid medium, both in presence or absence of toluene. We obtained a gapless genome sequence of P. veronii 1YdBTEX2 covering three individual replicons with a total size of 8 Mb, two of which are largely unrelated to current known bacterial replicons. One-hour exposure to toluene, both in soil and liquid, triggered massive transcription (up to 208-fold induction) of multiple gene clusters, such as toluene degradation pathway(s), chemotaxis and toluene efflux pumps. This clearly underlines their key role in the adaptive response to toluene. In comparison to liquid medium, cells in soil drastically changed expression of genes involved in membrane functioning (e.g., lipid composition, lipid metabolism, cell fatty acid synthesis), osmotic stress response (e.g., polyamine or trehalose synthesis, uptake of potassium) and putrescine metabolism, highlighting the immediate response mechanisms of P. veronii 1YdBTEX2 for successful establishment in polluted soil

The influence of the combined antihypertensive therapy on the results of daily monitoring of blood pressure and cerebral blood flow in patients with hypertension and ischemic stroke in history.

hemodynamics, combination antihypertensive therapy. The aim of our study was to investigate the effect of different variants of combined antihypertensive therapy on the dynamics of the circadian rhythm of blood pressure and cerebral blood flow in patients with hypertension and ischemic stroke in history. Materials and methods. In the study group - 75 patients (male and female, age 60,85±0,96) with stage 1 and 2 of hypertension and ischemic stroke in history who were randomized into two groups (gr): A - 37 patients, administered combination of olmesartan and hydrochlorothiazide in therapeutic doses, gr. B - 38 patients, administered of olmesartan and amlodipine combination. And comparison group - 30 patient with stage II 1 and 2 degree. All patients underwent blood pressure monitoring, Doppler examination of the cerebral blood vessels. Estimation of the ABP and cerebral hemodynamics in the study group were conducted at baseline and one year on antihypertensive therapy. Statistical analysis was performed using variation statistics with package «Statistica 10". Results: After year therapy we have evaluated the effects of studied antihypertensive drug combinations. It was found that in group A daily average of SBP and DBP were 118,8 ± 1,23 and 74,95 ± 0,94 mm Hg. Art., Group B - 121,2 ± 1,28 and 72,16 ± 1,2 mm Hg. Art. respectively (p> 0.05), indicating a comparable antihypertensive effect combinations of olmesartan + amlodipine and olmesartan + hydrochlorothiazide. The combination OLM + AML reduced variability of systolic blood pressure per day by 5 points (before treatment was 17,38 ± 0,72, after therapy - 12,41 ± 0,53, p 0.05. In comparative evaluation of the effectiveness of combined antihypertensive therapy in groups A and B showed statistically significant decrease pulse pressure per day, daytime and night-time in group A during therapy with OLM + HCTZ (pulse pressure per night in group A before treatment was 57,24 ± 1,87 mm Hg, during the therapy - 42,61 ± 1,13 mm Hg, p <0.01). Before treatment pulse pressure at night in group B was 56,81 ± 1,17 mm Hg., during the therapy - 54,08 ± 0,76 , p = 0.0548. In the analysis of cerebral hemodynamic reserve in group A during therapy with olmesartan and hydrochlorothiazide revealed an increase of peak systolic flow velocity after hypercapnia test right at 3.5% and left 3,2% (98,61 ± 3,46 and 99,75 ± 3 , 04 cm / s, respectively), the increase in end-diastolic flow velocity in the ACM in Group A on therapy was 8.4% on the right and 9,2% (40,34 ± 1,75 and 41,26 ± 1,88 cm / s, respectively), which was not statistically significant with the indicators of growth velocity parameters before treatment. Conclusions: Combined antihypertensive therapy with amlodipine olmesartan leaded to the significantly reduce of the systolic BAP for the day, as well as reduced vasospasm (Lindegard’s index) and an increase of cerebral reserve, which indicates reduction in stiffness of medium-caliber vessels. The therapy with olmesartan and hydrochlorothiazide resulted in a significant decrease in pulse pressure during the day

Ochrobactrum cytisi IPA7.2 promotes growth of potato microplants and is resistant to abiotic stress

© 2019, Springer Nature B.V. Bacteria in natural associations with agricultural crops are promising for use in the improvement of clonal micropropagation of plants. We clarified the taxonomic position of Ochrobactrum cytisi strain IPA7.2 and investigated its tolerance for salinity, high temperature, and glyphosate pollution. We also tested the strain’s potential to promote the growth of potato (Solanum tuberosum L.) microplants. Using the IPA7.2 draft genome (no. NZ_MOEC00000000), we searched for housekeeping genes and also for the target genes encoding glyphosate tolerance and plant-growth-promoting ability. A multilocus sequence analysis of the gap, rpoB, dnaK, trpE, aroC, and recA housekeeping genes led us to identify isolate IPA7.2 as O. cytisi. The strain tolerated temperatures up to 50 °C and NaCl concentrations up to 3–4%, and it produced 8 µg ml −1 of indole-3-acetic acid. It also tolerated 6 mM glyphosate owing to the presence of type II 5-enolpyruvylshikimate-3-phosphate synthase. Finally, it was able to colonize the roots and tissues of potato microplants, an ability preserved by several generations after subculturing. We identified the development phase of potato microplants that was optimal for inoculation with O. cytisi IPA7.2. Inoculation of in vitro-grown 15-day-old microplants increased the mitotic index of root meristem cells (by 50%), the length of shoots (by 34%), the number of leaves (by 7%), and the number of roots (by 16%). Under ex vitro conditions, the inoculated plants had a greater leaf area (by 77%) and greater shoot and root dry weight (by 84 and 61%, respectively) than did the control plants. We recommend O. cytisi IPA 7.2 for use in the growing of potato microplants to improve the production of elite seed material. Graphical abstract: [Figure not available: see fulltext.]

ACHIEVEMENT OF ARTERIAL HYPERTENSION CONTROL VIA APPLICATION OF PERINDOPRIL ARGININE AND AMLODIPINE COMBINATION

Aim. Evaluation of the opportunity to improve efficacy of arterial hypertension (AH) control using fixed combination of perindopril arginine and amlodipine.Material and methods. Totally, 52 patients (27 men and 25 women, age 40-63 y.o.) studied, with AH 2-3 stage. All patients underwent 24-hour blood pressure monitoring (ABPM) with analysis of the data obtained: mean 24-hour pressure, velocity of morning hypertension onset for systolic BP (sBP) and diastolic BP (dBP), and variability of (Var) of PsBP (Var PsBPs, Var PsBPd). The inclusion criteria was non-sufficient control of blood pressure on the intake of voluntary combinations of ACE inhibitor and angiotensine II receptor blocker and diuretic or calcium channel blocker. For BP control, to all patients we prescribed fixed combination perindopril arginine/amlodipine with start dosage 10/5 mg (Prestance, “Les Laboratoires Servier”, France) with further possibility to increase dosage to 10 mg of perindopril arginine and amlodipine.Results. At the background of therapy provided, 84,6% of patients reached “target” BP. Mean 24-hour sBP decreased from 139,29±1,7 to 121,17±1,26 mmHg. (р&lt;0,05), dBP decreased from 84,49±2,06 to 73,14±1,4 (р&lt;0,05), mean BP decreased from 102,09±1,49 to 87,96±1,12 (р&lt;0,05). 24-hour variability of sBP significantly reduced from 15,28±0,72 to 10,21±0,42 (р&lt;0,05), dBP from 13,46±0,72 to 10,72±0,31 (р&lt;0,001). Parameters of morning onset (MO) after the treatment also decreased. Before treatment MO sBP was (26±4,23 mmHg/hour), with the therapy — (16,3±4,03 mmHg/hour, р&lt;0,01); also, MO dBP decreased from 24,7±2,35 mmHg/hour to 12±1,61 mmHg hour, р&lt;0,01).Conclusion. Replacement of therapy for non-controlled AH with voluntary combinations of antihypertensive medications by fixed combination of perindopril arginine/amlodipine (Prestance) facilitated the effectiveness of AH control. Usage of the fixed combination of perindopril arginine/amlodipine in 84,6% helped to reach target values of BP. The effectiveness of BP control achieved, followed with ABPM data of 24-hour BP values decrease during the day and night, variability and velocity of morning BP onset. Usage of the drug studied showed good tolerability and high adherence of patients to treatment

Ochrobactrum cytisi IPA7.2 promotes growth of potato microplants and is resistant to abiotic stress

© 2019, Springer Nature B.V. Bacteria in natural associations with agricultural crops are promising for use in the improvement of clonal micropropagation of plants. We clarified the taxonomic position of Ochrobactrum cytisi strain IPA7.2 and investigated its tolerance for salinity, high temperature, and glyphosate pollution. We also tested the strain’s potential to promote the growth of potato (Solanum tuberosum L.) microplants. Using the IPA7.2 draft genome (no. NZ_MOEC00000000), we searched for housekeeping genes and also for the target genes encoding glyphosate tolerance and plant-growth-promoting ability. A multilocus sequence analysis of the gap, rpoB, dnaK, trpE, aroC, and recA housekeeping genes led us to identify isolate IPA7.2 as O. cytisi. The strain tolerated temperatures up to 50 °C and NaCl concentrations up to 3–4%, and it produced 8 µg ml −1 of indole-3-acetic acid. It also tolerated 6 mM glyphosate owing to the presence of type II 5-enolpyruvylshikimate-3-phosphate synthase. Finally, it was able to colonize the roots and tissues of potato microplants, an ability preserved by several generations after subculturing. We identified the development phase of potato microplants that was optimal for inoculation with O. cytisi IPA7.2. Inoculation of in vitro-grown 15-day-old microplants increased the mitotic index of root meristem cells (by 50%), the length of shoots (by 34%), the number of leaves (by 7%), and the number of roots (by 16%). Under ex vitro conditions, the inoculated plants had a greater leaf area (by 77%) and greater shoot and root dry weight (by 84 and 61%, respectively) than did the control plants. We recommend O. cytisi IPA 7.2 for use in the growing of potato microplants to improve the production of elite seed material. Graphical abstract: [Figure not available: see fulltext.]

Ochrobactrum cytisi IPA7.2 promotes growth of potato microplants and is resistant to abiotic stress

© 2019, Springer Nature B.V. Bacteria in natural associations with agricultural crops are promising for use in the improvement of clonal micropropagation of plants. We clarified the taxonomic position of Ochrobactrum cytisi strain IPA7.2 and investigated its tolerance for salinity, high temperature, and glyphosate pollution. We also tested the strain’s potential to promote the growth of potato (Solanum tuberosum L.) microplants. Using the IPA7.2 draft genome (no. NZ_MOEC00000000), we searched for housekeeping genes and also for the target genes encoding glyphosate tolerance and plant-growth-promoting ability. A multilocus sequence analysis of the gap, rpoB, dnaK, trpE, aroC, and recA housekeeping genes led us to identify isolate IPA7.2 as O. cytisi. The strain tolerated temperatures up to 50 °C and NaCl concentrations up to 3–4%, and it produced 8 µg ml −1 of indole-3-acetic acid. It also tolerated 6 mM glyphosate owing to the presence of type II 5-enolpyruvylshikimate-3-phosphate synthase. Finally, it was able to colonize the roots and tissues of potato microplants, an ability preserved by several generations after subculturing. We identified the development phase of potato microplants that was optimal for inoculation with O. cytisi IPA7.2. Inoculation of in vitro-grown 15-day-old microplants increased the mitotic index of root meristem cells (by 50%), the length of shoots (by 34%), the number of leaves (by 7%), and the number of roots (by 16%). Under ex vitro conditions, the inoculated plants had a greater leaf area (by 77%) and greater shoot and root dry weight (by 84 and 61%, respectively) than did the control plants. We recommend O. cytisi IPA 7.2 for use in the growing of potato microplants to improve the production of elite seed material. Graphical abstract: [Figure not available: see fulltext.]

EFFECTIVENESS OF PERINDOPRIL AND AMLODIPINE COMBINATION IN HYPERTENSIVES WITH COPD

Aim. To study efficacy of the standard combination of perindopril and amlodipine in target blood pressure levels achievement in COPD patients with AH.Material and methods. Totally 28 patients included 17 men and 11 women, mean age 51,42±1,45 y.o. with the COPD II-III stage established, with arterial hypertension II stage, 2 grade. In treatment we used fixed antihypertensive combination of ACE inhibitor and calcium channel blocker amlodipine. The values of “office BP” were measured, with ambulatory blood pressure monitoring and spirometry data. Results. After 30 days there was significant decrease of the mean “office BP” values, in 24 (85,7%) patients there was decrease of target BP. By ABPM data the decrease of mean clock-round, daytime and nocturnal BP values revealed. There was increase of the quantity of patients with physiological sleep pattern of BP from 5 to 12 (17,8% to 42,8%). Various dose regimens of perindopril/arginine combinations in 27 patients (96,4%) made it to achieve the BP level less than 140/90 mmHg. Long-term outcomes, tracked in the most of patients, showed good tolerability andhigh antihypertensive efficacy of the fixed perindopril and arginine combination.Conclusion. The use of fixed ACE inhibitor and calcium channel blocker combination fulfilled effective, dose dependent BP decrease and let most of COPD and AH patients reach the target BP. The treatment was followed by significant decrease of mean, daytime and nocturnal levels of ABPM. With the treatment there was recovery of physiological circle-round BP with reliable decrease at night. The possible side effect — dry cough — was rare and did not lead to the decrease of spirography parameters