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Information × Registration Number 0218U001943, 0116U000057 , R & D reports Title To eleborate of the individual approaches to drug and device treatment of patient with different degree arterial hypertension popup.stage_title Head Sirenko Yuriy Mykolayovich, Registration Date 26-12-2018 Organization NCS The M.D.Strashesko Institute of Academy of Medical Sciences of Ukraine popup.description2 As a result of the survey of patients receiving 3 or more antihypertensive drugs, secondary hypertension was found in 11.52% of patients. Most often, secondary arterial hypertension was detected in adrenal glands and abnormalities of the thyroid gland, which in the structure of secondary hypertension was 56.8%. Resistant arterial hypertension was detected in 31% of patients who received 3 or more antihypertensive drugs. Renal arterial denervation was performed in 8 patients (0.7%), among those who received 3 or more antihypertensive drugs. Renal arterial denervation contributed to reaching 100% of patients with target blood pressure levels, reducing the number of antihypertensive drugs from an average of 5.5 to 3.5 per day, and was more effective in patients 40 to 60 years of age with higher blood pressure figures. The procedure was absolutely safe, as evidenced by the preserved function of the kidneys 4.5 years after its implementation. It has been established that for resistant arterial hypertension, the predominance of obstructive sleep apnea syndrome of severe degree is characteristic. In patients with arterial hypertension, a very high frequency of obstructive sleep apnea syndrome was recorded. Resistant arterial hypertension, along with a higher frequency, was characterized by a greater severity of the syndrome of obstructive sleep apnea. It was first established that the severity of positive dynamics in the treatment of constant positive air pressure in the respiratory tract depended on the severity of hypertension, which was determined by the levels of the office and central BP, the damage of large arteries as target organs, and a decrease in the level of night hypoxemia in the background of treatment. High effectiveness of treatment with constant positive air pressure in the respiratory tract in combination with antihypertensive therapy in patients with arterial hypertension and obstructive sleep apnea syndrome of middle and severe degrees in reducing of office systolic blood pressure (11.09 ± 4.47 mm Hg. ) and diastolic blood pressure (at 7.74 ± 2.81 mmHg) with the achievement of their target levels, in reducing the rate of pulse wave velocity by the arteries of the elastic type (at 2.19 ± 0.74 m / s) from reaching the normal values of this show as well as central systolic blood pressure (10.52 ± 3.84 mm Hg) and central diastolic blood pressure (7.61 ± 2.82 mm Hg). The factors that determined the attachment of patients with arterial hypertension and obstructive sleep apnea syndrome to the treatment of constant positive air pressure in the respiratory tract were the weight of the body and the severity of the obstructive sleep apnea syndrome. This was confirmed by the presence of an independent connection to the constant positive air pressure in the respiratory tract with body weight (В= 0,346; p = 0,005), the desaturation index (В = 0,432; p = 0,010) and the duration of snoring (В = 0,369; p <0.001). It was found that taking antihypertensive drugs telmisartan more significantly reduced daily average blood pressure when taken in the morning compared with evening reception, olmesartan lowered blood pressure better during admission in the evening hours, and the use of azilsartan equally influenced the decrease in blood pressure, regardless of the time of taking the drug. Due to the influence on the reduction of the median AT of evening reception, olmesartan was more effective compared to morning use of the drug, both in the reduction of SBP, and in the reduction of DBP. Azilsartan significantly reliably lowered the night DBP when taken in the evening hours compared with morning reception. Telmisartan more effectively lowered the middle as SBP, and DBP in the morning receptions compared with the evening. Product Description popup.authors Рековець Оксана Леонідівна popup.nrat_date 2020-04-02 Close