PubMed Health⌕ Search

Biomedical subjects

A Ia Ivleva

Publications and source records attributed to A Ia Ivleva.

At least 19 recordsLinked to original sources

[The hypotensive effect and tolerance of valsartan (Diovan) in hypertension in a general clinical practice].

AIM: An assessment of a hypotensive effect and tolerance of valsartan. MATERIALS AND METHODS: In 20 patients with mild and moderate blood hypertension (BH) the latter was registered sphygmomanometrically by N. S. Korotkov and by 24-h monitoring. The initial valsartan dose 80 mg/day was raised to a single daily dose 160 mg in 4 weeks in the absence of adequate correction in tolerance. RESULTS: The hypotensive effect of Diovan in a dose 80 mg/day was satisfactory or good in 80% of patients. 15% of patients needed elevation of the dose to 160 mg/day. A complete resistance occurred in 1 patient. There were neither unwanted effects nor biochemical evidence of clinically significant renal or hepatic dysfunction due to valsartan. In stable BH correction, the rate of residual hypotensive effect reached 77.4% and 74.5% for systolic and diastolic BP, respectively. CONCLUSION: High effectiveness, good tolerance and safety of valsartan in single doses 80-160 mg/day allow to recommend it in monotherapy of mild and moderate hypertension.

Adult↗

[Fosinorm in the treatment of essential hypertension with a metabolic syndrome].

The authors made an open-comparative trial of fosinopril (Fosinorm) efficacy and tolerability in 20 patients (9 males and 11 females) with stage II mild and moderate essential hypertension accompanied with disturbed glucose tolerance and dyslipidemia. Fosinorm was given in a dose 10 - 20 mg/day under 24-h monitoring of blood pressure. Diastolic pressure returned to normal in 19 (95%) patients, one patient showed a good hypotensive response. The mean 24-h fall in the systolic and diastolic pressure was significant and made up for systolic pressure 7.5% (9.2% and 9.2%), respectively. Fosinorm had a minimal effect on carbohydrate metabolism, total cholesterol, serum triglycerides. The conclusion is made that Fosinorm is a highly effective antihypertensive drug positively influencing 24-h profile of blood pressure in the absence of negative action on carbohydrate and lipid metabolism.

Angiotensin-Converting Enzyme Inhibitors↗

[Hypertension, diabetes mellitus, atherosclerosis: clinical manifestations of metabolic syndrome X. Prospects of pharmacological treatment].

Currently available data and clinical observations which suggest that there is a pathogenetic relationship between hypertension, diabetes mellitus, and atherosclerosis have provided a concept of the X syndrome, by which hypertensive patients, mainly males, have impaired insulin tolerance along with hyperinsulinemia and concurrent atherogenic disorders of lipid metabolism. The paper discussed the specific pathogenetic mechanisms, clinical manifestations, and prospects for drug correction of the metabolic syndrome. The treatment of arterial hypertension with the calcium antagonist Lomir has indicated there are no negative changes as a control of non-insulin-dependent diabetes mellitus in the presence of effective correction of arterial hypertension and atherogenic dyslipidemias. With the monotherapy of essential hypertension concurrent with hypercholesterolemia with the alpha 1-adrenoblocker Doxazosin, in addition to the agent's high antihypertensive effects, the authors noted its favourable action on lipid spectral parameters and platelet functional activity. There is abundant evidence for the use of specific hypolipidemic agents in patients with essential hypertensive refractory to current antihypertensive drugs. The data obtained with the use of Lescol (fluvastatin) in patients with hypertensive disease and hypercholesterolemia suggest that by substantially reducing the levels of total cholesterol, triglycerides, low density lipoprotein cholesterol and its transport protein apo B does not deteriorate the quality of correction of arterial hypertension in this group of patients.

Anticholesteremic Agents↗

[The hypolipidemic effect of and tolerance for Lescol in treating hypercholesterolemia in hypertension patients (an analysis of the data from a multicenter study)].

Hypertensive patients with hyperlipidemia are at high risk to develop coronary heart disease (CHD). Chemotherapeutic correction of hyperlipidemia seems most reliable modality to prevent CHD. Hypolipidemic effect and tolerance of leskol (fluvastatin) in dietotherapy-resistant hypercholesterolemia were studied in 74 patients with essential hypertension treated with hypotensive drugs. The patients were included in a multicenter trial. A 12-week course reduced total cholesterol level under 6.2 mmol/l in 59% of the patients, under 5.2 mmol/l in 29% of them. LDLP cholesterol lowered to 3.5% in 34% of the patients. Mean apo B diminished by 23%. There was a 27% decrease in the proportion of atherogenic fraction apo B to antiatherogenic fraction of transport proteins apo A-I. Leskol is well tolerated and effective against hypercholesterolemia, it is safe in relation to side effects and blood biochemistry.

Anticholesteremic Agents↗

[The regression of the structural-functional changes in the hypertrophic left ventricle during the long-term correction of the arterial pressure with Inhibace (cilazapril)].

The regression of structural and functional alterations in the hypertrophic left ventricle was measured in the course of long-term correction of arterial pressure with a new inhibitor of angiotensin-converting enzyme ingibeis (chilasapril) in 23 patients with essential hypertension stage II-III. The results were for the most part obtained at echocardiography providing basic hemodynamic parameters and those of left ventricular diastolic function. Adaptability of the hypertrophic myocardium in response to physical loading was studied dynamically under isometric exercise test. The findings proved high efficacy of chilasapril in monotherapy of arterial hypertension. Long-term (6 months) therapy of left ventricular hypertrophy provides regression of the latter and improves left ventricular diastolic function, pumping capacity. In the course of arterial hypertension correction relevant patients with associated coronary heart disease improved their condition, demonstrated less frequent ECG changes indicative of ischemia.

Adult↗

[Ramipril in the treatment of hypertension. The pharmacodynamic validation of its efficacy in the therapy of initial cardiac and renal involvement].

A clinical trial of 75 hypertensive subjects in stage II of the disease receiving ramipril monotherapy has established a marked efficacy of the above treatment. Individually adjusted single doses varied from 2.5 mg to 7.5 mg/day. The drug was well tolerated and had mild adverse effects (dry cough) in 2% of the patients. Long-term 12-week ramipril treatment in effective for hypertension doses is able to reduce myocardial mass without inhibition of the pumping capacity in the patients with left ventricular hypertrophy of the myocardium. In primary signs of nephroangiosclerosis hypertension correction was associated with improvement of filtration function and an increase in effective renal flow of plasma. The above pharmacodynamic effects make it possible to consider ramipril an effective hypotensive agent with organ-protective properties.

Adult↗

[The specificity of the hypotensive effect of calcium antagonists in hypertension].

The purpose of the study was to define prognostic criteria that determine individual sensitivity to the hypotensive effect of slow calcium channel blockers. After two weeks of placebo therapy 45 patients suffering from essential hypertension underwent an acute pharmacological test (APT) with nifedipine in a dose of 30 mg. Then the patients received monotherapy with nitrendipine in the increasing doses for 12 weeks. The drug effect on the renin-angiotensin-aldosterone system and the level of ionized calcium in the blood serum was estimated. In 17 patients who responded to the APT by a decrease of the mean arterial pressure (MAP) by not less than 20%, arterial pressure was corrected with nitrendipine administered in a dose not exceeding 20 mg. 28 patients whose MAP dropped by 10 to 20% in response to the APT required higher drug doses (40 mg). 7 patients in whom the MAP dropped less than 10% were practically refractory to the monotherapy with nitrendipine. A close negative correlation was found between the degree of the MAP lowering in response to the APT during nitrendipine monotherapy and plasma renin activity as well as the concentration of ionized calcium in the blood serum. The low content (less than 1.0 mmol/l) of ionized calcium in the blood serum of patients suffering from essential hypertension appeared the most valuable predictor for the hypotensive effect of the slow calcium channel blockers.

Adult↗

[Transient subendocardial ischemia in abolition of hypertensive crises with nifedipine].

Sublingual nifedipine, 30 mg, was used to abolish hypertensive crises in 32 patients. A follow-up of changes in blood pressure, ECG, and echocardiographic parameters evaluating the cardiac performance and central hemodynamics was performed during 4 hours after the drug. The patients with profound myocardial hypertrophy and dilatation at a left ventricular myocardial weight of over 200 g at the peak of the antihypertensive effect occurred for 15-60 min exhibited transient ECG changes by the type of subendocardial ischemia despite an above 25% reduction in mean blood pressure and the lack of severe reflex tachycardia, the pump function of the heart showing no decreases. The ejection fraction increased from 51.0 +/- 2.8 to 62.0 +/- 2.5% (p less than 0.05) due to lower afterload. There were no clinical manifestations typical of myocardial ischemia.

Adult↗