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Information × Registration Number 0213U003308, 0110U000233 , R & D reports Title Study ability of the long-term treatment by first line antihypertensive drugs in clean-up workers after Chernobyl disaster with essential hypertension and developing of the new approaches for the optimization to prevention/regress myocardial hypertrophy popup.stage_title Head Khomazjuk Inna Belyi David, Registration Date 24-01-2013 Organization State institution "National research centеr for radiation medicine of the National academy of medical sciences of Ukraine " popup.description2 Object of investigation: 440 persons, who took part in clean-up work at the Chernobyl nuclear power plant (CNPP) and have got essential hypertension (EH), and 90 non-irradiated patients. Aim of the study: to determine the peculiarities of EH in CNPP clean-up staff (CUS), which are natural for the third decade after the accident, radiation and non-radiation risk factors that have influence on development of prognostic unsafe left ventricular hypertrophy (LVH), to estimate results of protracted treatment with hypotensive first line drugs and to work out the new pathogenetically grounded approaches that need to prevent myocardial hypertrophy or cause it involution. Methods of investigation: clinical examination, analysis of radiation influence, other risk factors, 24 hours blood pressure (BP) and electrocardiogram (ECG) monitoring, variability of heart rhythm, echocardiography with Doppler investigation, cycle ergometer stress-test. Results. LVH in CUS of CNPP develops according a model of polyetiological process when interaction between prolonged BP burden and radiation together with non-radiation risk factors takes place. Both factors reciprocally increase their impact. LVH frequency in patients with radiation dose ? 25 cSv has reached 94,8 % that was sufficiently higher the doses lesser 10 cSv. Unlike the non-irradiated patients LVH in CUS developed in more young age, has sufficiently higher prevalence and greater risk of diastolic dysfunction and heart failure as well. Essential increase of daily BP, time index, variability of BP, daily profile with BP insufficient night decrease directly correlate with myocardial mass. Diastolic dysfunction preceded systolic one. Its frequency rate amounted to 62,9%. Episodes of myocardial ischemia, predominantly painless, during Holter monitoring, was revealed in every fifth patient. They have association with decrease of heart rhythm variability, disorders of sympathoadrenal balance. The frequency of ventricular extrasystoles in patients with LVH increased twice. It correlated with number and duration of ischemia episodes. A tolerance to physical work, duration of load and value of fulfilled work was sufficiently lower in CUS. The difference of these indices amounted to 30% in patients with radiation dose ? 25 cSv in comparison with non-irradiated ones. According to leading pathophysiological signs, which accompany LVH in CUS, pathogenetic approaches was determined and tactic for LVH involution was worked out. It was shown that treatment during several weeks promotes BP decrease, heart function improvement, but is not enough for LVH involution. The combination of drugs with reciprocally strengthening mechanism promotes the optimization of hypotensive therapy and adherence to treatment. The combination of angiotensin converting factor inhibitors and angiotensin receptor blockers with diuretics or calcium channel blockers twice improves the hypotensive effects and during prolonged treatment demonstrates expressed cardioprotective response with LVH involution on 10% and higher. The combination of angiotensin converting factor inhibitors and beta-adrenoreceptor blockers decreases hypersympathicotonia, but with calcium channel blockers weaken myocardial ischemia. The recommended approaches for EH treatment and LVH involution based on high general risk conception, need to be started on the level of subclinical changes and used differentiated drug choice with dominantly prolonged action and proved hypotensive and cardioprotective effects. These approaches integrate drug therapy with non-medicine measures, which have to decrease the general risk, to improve patient's adherence to treatment and supporting of the healthy life style. They open the new possibilities to optimize treatment and LVH involution in CUS suffering from EH. There were published 41 papers, 2 guidelines and a patent on useful model was taken out. Product Description popup.authors Габулавічене Жанна Михайлівна Курсіна Наталія Вікторівна Настіна Олена Михайлівна Сидоренко Геннадій Васильович popup.nrat_date 2020-04-02 Close