MONO- OR COMBINED ANTIHYPERTENSIVE THERAPY IN WOMEN WITH ARTERIAL HYPERTENSION AND MODERATE RISK OF CARDIOVASCULAR DISEASES: WHAT’S BETTER?

The study included 75 women with arterial hypertension, aged 48-51 years (Me 50,0 years [25%; 75%: 48,0; 52,0 years]), who according to the clinical laboratory and instrumental examination was diagnosed essential hypertension (EH) I–II stage of 1–2 degrees. The duration of arterial hypertension did not exceed 5 years (Me 1 year [25%; 75%: 1; 3 years]) and all women had moderate risk of cardiovascular complications on the SCORE scale. All patients were in the perimenopausal period, confirmed by laboratory of hormonal status. After 14 weeks of monotherapy losartan or ramipril or combination with one of RAAS blockers and bisoprolol with low-dose hydrochlorothiazide was achieved target blood pressure and improvement of endothelial and kidney function, which was manifested by decrease in the level of albuminuria and ADMA concentration, significantly exceeding the reference values in the initial state. More pronounced organoprotective effect was in the group of women, receiving combined antihypertensive therapy

Effect of combination antihypertensive therapy on the endothelial function in women with hypertension in perimenopause

The study covered 109 female patients with 1-2 degree hypertension in perimenopause and daily evaluated the results of 24-hour blood pressure monitoring, endothelial function using endothelium-dependent and endothelium-dependent vasodilation of the brachial artery, and endothelin-1 concentration in blood serum before treatment and after 12 weeks of monotherapy with ramipril ACE inhibitor (7 people), losartan angiotensin II receptor blocker (8 people) or combination of ramipril with Lodoz (45 people) and losartan with Lodoz (49 people). In all the observed groups, blood pressure decrease to recommended levels and an improvement of endothelial function were achieved; the latter was manifested in the positive decrease of endothelin-1 concentration in the serum which was high in comparison with reference values already in 1 degree AH, and in the improvement of vasodilator properties in the shoulder artery

Functional status of sympathetic-adrenal system and kidneys in perimenopausal women with arterial hypertension treated with antihypertensive therapy

84 women in perimenopause confirmed by medical history and hormonal status tests participated in the study; control group consisted of 64 patients with first or second degree hypertension and 20 apparently healthy women. Daily monitoring included blood pressure control, assessment of the functional status of sympathetic-adrenal system by the size of β-adrenoreceptors in erythrocyte membranes, test for microalbiminuria and glomerular filtration rate using Cockcroft-Gault formula. Group 1 included patients with first degree hypertension (23 women) which received losartan 50-100 mg/d monotherapy (Losarel, Sаndоz); group 2 patients (43 women) with second degree hypertension received combination therapy: losartan 100 mg/d and Lodoz (bisoporol 5 mg + hydrochlorothiazide 6.25 mg). Treatment lasted 12 weeks; patients were examined before inclusion in the study and after the study. Reduction in blood pressure to the target level was registered in all patients. There were no side or adverse effects. Initially elevated levels of β-adrenoreceptors in erythrocyte membranes significantly decreased in both groups, as a result of improved functional status of sympathetic-adrenal system. Renal excretion of nitrogen evaluated by glomerular filtration rate was not impaired; microalbiminuria increased manifold compared to reference values. After 12 weeks of treatment, microalbiminuria decreased in patients of all groups as a result of nephroprotective effect of antyheprtensive drug therapy

Gender-specific risk factors for heart disease in middle-aged people

A complex clinical, laboratory and instrumental examination of 234 patients found that hypertension occurs with equal frequency in men and women. Gender differences were determined by such most common risk factors as impaired fat metabolism and hypertriglyceridemia. Thickening of the intima-media complex greater than 1.3 mm and atherosclerotic plaques were found consistently more often in patients with hypertension, while their frequency was not linked to gender

ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ КЛЕТОЧНЫХ МЕМБРАН У БЕРЕМЕННЫХ С АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ

Purpose. Examine the functional state of cell membranes in pregnant patients with arterial hypertension.Materials and methods. 110 pregnant patients, aged 19–40 years (mean age 29,1 ± 0,49) were monitored in the second trimester of gestation, of those 41 patients (Group 1) were diagnosed with grade II arterial hypertension, 25 patients (Group 2) had symptomatic and 24 women (Group 3) had gestational hypertension. 20 apparently healthy pregnant women were the control group.Results. Pregnant women with different clinical forms of arterial hypertension have lower osmotic and mechanical resistance of red blood cells compared to the controls. Impaired functional state of cell membranes, with red blood cells as a model, was the most pronounced in patients with gestational arterial hypertension and high beta adrenoreactivity, reflecting the process of adrenoreceptors desensitization induced by endogenous catecholamines in the conditions of hypersympathicotonia.Conclusions. Pregnant patients with different clinical forms of arterial hypertension have impaired functional state of red blood cell membranes, i.e., the decrease in their osmotic and mechanical resistance. These changes are the most pronounced when there is a specific syndrome of gestational arterial hypertension during pregnancy. Apparently healthy pregnant women and those with arterial hypertension have hypersympathicotonia, i.e., high beta adrenoreactivity parameters, especially if there is gestational arterial hypertension.Цель. Исследование функционального состояния клеточных мембран у беременных с артериальной гипертонией.Материалы и методы. Под наблюдением находились 110 беременных женщин в возрасте от 19 до 40 лет (средний возраст 29,1 ± 0,49 года) во 2-м триместре гестации, среди которых у 41 чел. (1-я группа) диагностирована ГБ II ст., у 25 чел. – САГ (2-я группа), у 24 женщин – ГАГ (3-я группа) и группу контроля (4-я группа) составили 20 практически здоровых беременных.Результаты. У беременных с различными клиническими вариантами АГ по сравнению с контролем отмечается снижение осмотической и механической резистентности эритроцитов. Нарушение функционального состояния клеточных мембран, моделью которых является эритроцит, было наиболее выраженным у пациенток с ГАГ и высокими величинами β-АРМ, отражающими десенситизацию адренорецепторов под действием эндогенных катехоламинов в условиях гиперсимпатикотонии.Выводы. У беременных с различными клиническими вариантами артериальной гипертонии выявляется нарушение функционального состояния мембран эритроцитов, определяемое снижением осмотической и механической их резистентности. Эти изменения наиболее выражены при специфическом для беременности синдроме – гестационной артериальной гипертонии. У практически здоровых беременных и у беременных с артериальной гипертонией имеет место гиперсимпатикотония, определяемая повышенными величинами показателя адренореактивности организма – β-АРМ, особенно выраженная у женщин с гестацион-ной артериальной гипертонией