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Biomedical subjects

V I Podzolkov

Publications and source records attributed to V I Podzolkov.

At least 19 recordsLinked to original sources
PubMed2006

[Ambulatory blood pressure monitoring in the diagnostics of arterial hypertension associated with nephroptosis].

Nephroptosis, associated with renal circulatory disorder, is one of the reasons for symptomatic arterial hypertension (AH). An obvious dependence of blood pressure (BP) level on the body position is a feature of this form of AH. However, this correlation is not always easy to reveal when performing a routine physical examination. The authors of the article adduce 2 clinical observations in which ambulatory BP monitoring became the key method that allowed assuming dynamic vasorenal AH.

Adult↗
PubMed2004

[The state of microcirculation during use of long acting metoprolol].

The aim of the study was to assess the effect of prolonged action metoprolol on the microcirculation in patients with essential hypertension (EH). We studied 51 patients with EH aged 53,4+/-4,5 years. After 7-10 days of "wash-out" period and after 8 weeks of prolonged action metoprolol (betaloc ZOK) the state of microcirculation was investigated with the use of laser Doppler flux-metry (LDF). We found significant decrease in basically enlarged basal blood flow and the level of sympathetic activity, increase in the amplitude of cardiodependent waves, normalization of basal blood flow decrement in postural test, increase in capillary blood flow reserve in patients with stage I-II EH. We failed to observe any significant changes in the microcirculatory parameters in patients with stage III EH. Treatment with prolonged action metoprolol led to increase in the number of patients with normocirculatory type of microcirculation primarily due to the decrease in the prevalence of hyperemic type. We conclude that prolonged action metoprolol does not alter microcirculation in patients with EF. Moreover, at the early stages of EH it improves the functional state of peripheral hemodynamics due to suppression of sympathetic activity.

Hemodynamics↗
PubMed2004

[New potentialities in the treatment of idiopathic hyperaldosteronism].

The study was undertaken to examine whether the drugs affecting the renin-angiotensin system may be used in the combined treatment of patients with idiopathic hyperaldosteronism (IHA). The study covered 20 patients (mean age 46.6 +/- 7.3 years). The diagnosis in all the patients was verified by a complex of instrumental studies, including the determination of plasma aldosterone concentrations (PAC) and plasma renin activity (PRA), and topical diagnostic studies (ultrasonography, computed tomography (CT)/magnetic resonance imaging (MRI), and angiography). The patients were given spironolactone, dihydropyridine calcium blockers, and beta-adrenoblockers, then with the cross-over method, this combination was added by the angiotensin-I receptor blocker (ATRB) losartane or the angiotensin-converting enzyme inhibitor (ACEI) lisinopril for 4 weeks. 24-hour blood pressure (BP) monitoring was used to evaluate the efficiency of therapy. In the combined therapy losartane, 50-100 mg/day, reduced systolic BP (SBP) by 8.4%, diastolic BP (DBP) by 11.1% while lisinopril, 10-20 mg/day lowered SBP and DBP by 7.6 and 9.9%, respectively. Both drugs improved the daily BP profile. When losartane or lisinopril added to the combined treatment, a therapeutic response was achieved in 15 (79%) and 14 (73.7%) patients, respectively. ARB and ACEI exert an antihypertensive effect in patients with IHA and they may be used in the combined treatment of this disease. The use of the above drugs may reduce the dose of spironolactone to the mean therapeutic one. The pathophysiological rationale for the use of ATRB for IHA is that the sensitivity of aldosterone secretion to the stimulating effect of angiotensin II is preserved despite the fact that the PAC is higher and PRA is lower.

Adrenal Glands↗
PubMed2004

[Assessment of efficacy of combined therapy with antihypertensive agents and biguanides in patients with metabolic syndrome].

To compare effects of antihypertensive and combined therapy on 24-hour blood pressure, biochemical parameters and chronic hyperinsulinemia in patients with metabolic syndrome. 54 patients with metabolic syndrome were observed during 8 weeks. 28 patients (group A) were treated with antihypertensive agents (calcium antagonists, and when required -- ACE inhibitors and diuretics). 26 patients (group B) received the same therapy plus metformin. There were no significant changes in parameters of lipid and carbohydrate metabolism in group A. In group B we found significant decrease in C-peptide (p<0.05) and triglyceride (p<0.1) levels and increase in high density lipoprotein cholesterol levels (p<0.01). The combined antihypertensive and metformin therapy has a significant effect on carbohydrate and lipid metabolism.

Adult↗
PubMed2003

[Current aspects of diagnosis and treatment of symptomatic arterial hypertension of adrenal genesis].

AIM: To analyse the experience in diagnosis and treatment of arterial hypertension (AH) of adrenal genesis. MATERIAL AND METHODS: A total of 243 patients with adrenal AH (mean age 46.3 +/- 3.2 years) were examined. 134 of them had endogenic adrenohypercorticism (EAH), 62--primary hyperaldosteronism (PHA), 47--chromaffin tissue tumors (CTT). Diurnal urinary excretion of adrenal hormones (epinephrine, norepinephrine, aldosteron, hydrocortisone) and peripheral blood hormones (aldosteron, renin, hydrocortisone, ACTH) were measured. Topic diagnosis was made with ultrasound, computed tomography, MR-imaging, angiography, adrenal venous sampling and 123I-MIBG scintigraphy. RESULTS: Adrenalectomy was made in 224 patients (predominantly with tumor lesions). 19 patients (idiopathic hyperaldosteronism, advanced adrenocortical carcinoma) were treated conservatively (calcium antagonists, ACE inhibitors, AT1-receptor blockers, spironolacton). Good results of the surgical treatment were achieved in 60% patients with aldosterone-producing adenoma and adrenal Cushing's syndrome as well as in 80.5% patients with pheochromocytoma. Long-term outcomes depend on hypertension duration, histologic type of the tumor, age and family hypertension history (risk of essential hypertension). CONCLUSION: Hypertension of adrenal origin occurs more frequently than it was supposed previously. Its late diagnosis may be due to lack of typical signs and symptoms, insufficient application of novel diagnostic techniques and poor alertness of physicians. It is recommended to include tests for adrenal hormones in urine and blood and ultrasound investigation of the adrenals in a complex of primary examination of patients with severe refractory hypertension.

Adrenal Cortex↗
PubMed2003

[Microcirculation in hypertension].

Changes of microcirculatory vascular bed play important role in pathogenesis of essential hypertension. All components of the system of microcirculation including vessels and circulating blood are involved into pathological process. Resistance to blood flow is mostly formed in this system. Resistance depends on length, diameter of microvessels and viscosity of blood. In the process of the disease development the following signs of remodeling at the level of microcirculation emerge: decrease of density of vasculature, modification of the media/lumen ratio, increase of blood viscosity, slowing of angiogenesis, impairment of endothelial function. These phenomena can be both cause and consequence of hypertensive disease. Their heterogeneity depends on a variety of factors (duration, stage of the disease, etc.). It seems feasible to differentiate therapy in accordance with character and severity of changes in the system of microcirculation.

Animals↗
PubMed2003

[Isradipine-SRO: antihypertensive efficacy, central and peripheral hemodynamic effects in patients with hypertensive disease].

AIM: To assess antihypertensive efficacy of isradipine, to study its effects on central and peripheral hemodynamics, and to investigate relationships between state of microcirculation and response to treatment. MATERIAL AND METHODS: Isradipine was given for 12 weeks to 30 patients (16 men, 14 women, mean age 50.2+/-9.8 years) with I-II stage mild and moderate hypertension. Twenty four hour blood pressure monitoring, assessment of parameters of central hemodynamics and state of microcirculation were carried out before and after 12 weeks of isradipine administration. RESULTS: Administration of isradipine was associated with improved sense of well-being and significant lowering of 24-hour, diurnal and nocturnal systolic/diastolic blood pressure (by 6.4/12.7, 7.6/9.4, 10.5/13.4%, respectively). Average 24-hour heart rate increased mainly during daytime (by 10.6%). Mean hemodynamic blood pressure was lowered by 16.3% due to reduction of total peripheral vascular resistance. There occurred redistribution of types of microcirculation with increase of proportion of normocirculatory and decrease - of spastic types. Changes of parameters of microcirculation at rest and during functional tests evidenced for resolution of baseline arteriolar spasm, stasis and venous congestion in microcirculatory vascular bed. Patients who responded to isradipine more often had spastic (50%) and congestive (35%) types of microcirculation. Patients with hyperemic type did not respond to isradipine. Most frequent side effect was flushing (23.3%) because of which 2 patients stopped taking the drug.

Adult↗
PubMed2002

[Metabolic syndrome from the point of view of a cardiologist: diagnosis, non drug and drug treatment].

Timely diagnosis and treatment of metabolic syndrome is important because of high prevalence of this pathology in population. For the elaboration of approaches to complex treatment of this syndrome it is necessary to understand pathogenetic mechanisms of development of hypertension and metabolic changes as well as acquire an array of non drug and drug methods of influence on elevated blood pressure and disordered carbohydrate, lipid and purine metabolism. Phenylalkylamine calcium antagonists should be used as drugs of choice for treatment of hypertension. These agents exert slowing of heart rate, coronarolytic and antiatherogenic effects, the latter being especially important in this group of patients. Resistance of hypertension to treatment developing on the background of insulin resistance of peripheral tissues dictates necessity of the use of combinations of antihypertensive drugs with consideration of their metabolic effects. For correction of metabolic changes metformin is used in addition to non drug methods which include diet and exercise. Treatment with metformin allows to decrease insulin resistance and thus severity of derangements of metabolism.

Antihypertensive Agents↗
PubMed2002

[Pathogenetic role of moxonidine in the treatment of hypertension in postmenopausal women].

AIM: To assess efficacy of monotherapy with moxonidine in female patients with hypertension and climacteric syndrome. METHOD: Twenty-four hour blood pressure monitoring was carried out in 32 women (mean age 52.3-/+5.2 years) before and after 28 days of monotherapy with moxonidine (0.2-0.4 mg). RESULTS: In 4 weeks the following significant changes were registered: lowering of systolic and diastolic blood pressures, decrease of blood pressure variability and rate of its morning rise, increase of 24-hour blood pressure index. This was accompanied by significant decrease of vascular peripheral resistance without changes of myocardial contractility. There were no significant changes of parameters of carbohydrate, lipid and purine metabolism. CONCLUSION: Moxonidine in women with hypertension and climacteric syndrome caused blood pressure lowering at the account of decreased total peripheral resistance and restoration of physiological blood pressure rhythm.

Antihypertensive Agents↗
PubMed2002

[Use of selective long-acting beta-blocker with vasodilating activity celiprolol in patients with essential hypertension].

Effects of 8 weeks therapy with long-acting selective b-blocker celiprolol (200 mg o.d.) on 24-hour blood pressure, central hemodynamics (oscillometry) and microcirculation (laser doppler flowmetry) were studied in 30 patients (17 women and 13 men, mean age 51.9 years), with stage I-II essential hypertension. Celiprolol lowered both systolic and diastolic blood pressure (BP) during all periods of 24-hour BP monitoring and improved BP circadian rhythm. Treatment with celiprolol was not associated with considerable heart rate decrease or changes of stroke volume and cardiac output. 24 hour monitoring of parameters of central hemodynamics during treatment with celiprolol revealed existence of significant direct correlation between mean BP and total peripheral vascular resistance. Thus, hypotensive effect of celiprolol was mostly attributed to its vasodilatory action. This activity of celiprolol was confirmed by its beneficial influence on parameters of microcirculation. After therapy normalization of peripheral blood flow was observed in 50%, and tendency to its improvement--in 83,3 % of patients.

Adrenergic beta-Antagonists↗
PubMed2002

[The state of microcirculation in hypertensive disease (essential hypertension)].

Skin microcirculation was studied by laser doppler flowmetry in 149 patients with essential hypertension (92 men, 67 women; mean age 50.1+/-4.9 years) and in 25 normotensive controls. In patients with hypertension prevailed pathological hemodynamic types of microcirculation. Hyperemic, spastic and congestive types were found in 20.1, 23.5 and 40.3% of patients, respectively, while only 16.1% of patients had normal hemodynamic type. Moreover presence and severity of microcirculatory disorders depended on stage of hypertension and level of blood pressure. Thus, patients with essential hypertension had pronounced impairment of microcirculation caused by structural and functional changes of microcirculatory vascular bed.

Adult↗
PubMed2002

[Complex assessment of efficacy and tolerance of metoprolol CR/ZOK in treating hypertension].

AIM: To study efficacy and tolerance of betaloc ZOK (Astra-Zeneca, UK) in patients with stage I-II (WHO classification) essential hypertension. MATERIAL AND METHODS: 27 patients were enrolled in the study (13 men and 14 women, mean age 40.6 +/- 1.57 years). Complete physical examination, ambulatory blood pressure monitoring, assessment of central hemodynamics, microcirculation were made before the treatment and on the treatment week 8. RESULTS: Monotherapy with betalok ZOK (50-100 mg/day) resulted in a significant lowering of mean daily, day and night systolic and diastolic arterial pressure. Variability index was reduced, circadian rhythm of blood pressure did not change. 28% had to take diuretics (arifon or hypotiazide). CONCLUSION: Betaloc ZOK (50-100 mg) is highly effective in patients with mild to moderate essential hypertension.

Adrenergic beta-Antagonists↗