Comparison of dynamic of autonomic control indices in cardiovascular system under the treatment by ACE inhibitor (Enalapril) and beta-blocker (Metoprolol) in patients with hypertension

The objective of the present research was to compare the influence of Enalapril and Metoprolol on synchronization of 0.1 Hz-regulation of heart and blood microcirculation. 42 patients aged 49±9 years old with hypertension I, II were included in the study. 0.1 Hz-oscillations in heart rate variability (HRV) and blood microcirculation were registered during the passive orthostatic sign while breathing spontaneously. The duration of each test was 10 minutes. Synchronization was estimated as a phase difference between 0.1 Hz-rhythms in heart rate and in filling of blood microcirculation. Quantitative measures of synchronization were also estimated. In addition frequency values of HRV spectrum in LF- and HF-ranges were assessed. Enalapril and Metoprolol had comparable effect on blood pressure reduction. Treatment with both Enalapril and Metoprolol in patients with significant vegetative dysfunction resulted in repair of functional interaction between 0.1 Hz-regulation of heart and blood microcirculation. Enalapril was preferred in hypertensive patients with prevalence of disorders of vegetative regulation of blood microcirculation. Metoprolol influenced positively on 0,1 Hz-rhythm synchronization in patients with predominance of heart vegetative regulation dysfunction and in patients with sympathicotonia. In patients with hypertension and initially normal level of synchronization of 0.1 Hz-mechanisms treatment with Enalapril or Metoprolol caused functional dissociation. Differentiated approach to the choice of hypertensive therapy should consider individual peculiarities of system vegetative dysfunction. The level of synchronization of 0.1 Hz-rhythms in cardiovascular system should especially be evaluated initially and during the treatmen

Clinical Effectiveness Of Dynamic Out-Patient Control Technology Over Hypertensive Patients Based On Computer System And Mobile Phone Connection

A new follow-up technology of dynamic out-patient control based on system of mobile monitoring of patients with arterial hypertension (SMMAH) has been created in Saratov Scientific Research Institute of Cardiology. SMMAH is based on exchange of information between patient and doctor with the help of Internet and standard short mobile messages. The aim of the present work is to study the effectiveness of SMMAH for follow-up control of hypertensive patients for the period of 12 months. 79 patients with hypertension aged 49±11 were included in the investigation. Control period lasted 12 months. Control visits were made in the 1st, 6th and 12th months. The number of patients became out of control, its causes, percentage of patients who achieved and maintained target blood pressure (BP) were analyzed after each visit. Data were presented as M (95% confidence interval). As a result in 1 month period of investigation 88,6% of patients regularly used mobile messages, 11% of patients were out of control. In 6 months period 68,4% of participants were under control, 31,6% of patients dropped out. In 12 months period — 67% and 33% of patients accordingly. Target BP was maintained in 87% (77%-96%) of patients in 1 month period, in 78% (66%-90%) of patients in 6 months period and in 68% of patients (53%-84%) in 12 months period. High clinical effectiveness of SMMAH has been proved during the study: 67% of patients have followed prescribed therapy after the investigation period and 68% of them have maintained target BP level