Hypertensive crises in patients with essential arterial hypertension and coronary heart disease: new perspectives in treatment and prevention

Aim. To study clinical efficacy of hypertensive crise (HC) complex therapy and prevention in patients with combination of essential arterial hypertension (EAH) and coronary heart disease (CHD), at hospital and posthospital levels. Complex management program included treatment with antioxidant-cytoprotector, Mexicor®, as well as 24-hour blood pressure monitoring (BPM), ECG monitoring, and various BP self-monitoring variants. Material and methods. In total, 157 patients with HC, EAH, and CHD, were examined. The participants were randomized into three groups: standard post-hospital follow-up (Group A, n=45); BP self-monitoring, without (Group B, n=54) or with (Group C, n=58) weekly telephone control by a doctor, and correction of therapy regimen, if necessary. At hospital and post-hospital levels, 20 patients from group B (sub-group B1), and 20 patients from group C (sub-group C1), were additionally administered antioxidant-cytoprotector. Post-hospital follow-up time varied from 1 month (uncomplicated HC) to 2-3 months (HC with cardiac complications). Treatment efficacy assessment included bi-functional 24-hour BPM and ECG monitoring at Day 1, Day 7-10, and Day 40-50 of the follow-up. Results. Among patients with HC and CHD, BP self-monitoring and dynamic medical control facilitated BP normalization (83.1%), and decrease in post-hospital incidence of pre-crise states or recurrent HC (5.2% and 1.7%), compared to standard post-hospital follow-up – 68.9%, 20.0%, and 11.1%, respectively. Adding to complex hospital and post-hospital management was associated with BP normalization, decrease in total cardiovascular event risk, and reduction in pre-crise state or recurrent HC incidence. Conclusion. Efficacy of HC treatment and prevention in patients with EAH and CHD was improved by posthospital BP self-monitoring and additional administration of antioxidant-cytoprotector

RED BLOOD CELL STRUCTURE AND FUNCTION IN PATIENTS WITH PROGRESSING ANGINA RECEIVING DIFFERENT PHARMACEUTICAL THERAPY VARIANTS

The study assessed the dynamic of red blood cell (RBC) structure, aggregation, and deformation in patients with progressing angina receiving standard therapy or therapy including an antioxidant medication mexicor. In total, fifty 53–65-year-old patients with progressing angina and Stage III essential arterial hypertension (EAH) were examined. The comparison group included 20 patients with Stage III EAH. Angina patients were divided into subgroups, according to antioxidant-cytoprotector mexicor presence or absence in combined therapy scheme. RBC structure was assessed by phase-contrast cell microscopy; transformation index (TI), reversible transformation index (RTI), irreversible transformation index (ITI), and reversibility index (RI) were calculated. RBC aggregation was assessed by direct optic method, with mean aggregate size (MAS), aggregation index (AI), and non-aggregated RBC percentage (NAP) calculation. RBC deformation was studied by filtration method, with rigidity index (RiI) calculation. Angina patients demonstrated significant changes in RBC structure and function, comparing to the control group: reduced discocyte number, increased degenerative RBC number, AI, MAS, RiI and decreased NAP. Mexicor therapy was associated with increased discocyte and reduced degenerative RBC numbers, decreased AI and MAS, comparing to standard therapy scheme. Combined mexicor-including therapy demonstrated beneficial effects on RBC structure, aggregation and deformation in patients with progressing angina. Studying the dynamics of RBC rheology provides the evidence for choosing additional pharmaceutical therapy and assessing its effectiveness