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RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

https://doi.org/10.20996/1819-6446-2007-3-2-38-42

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Abstract

Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT).

Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP). This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE) inhibitor, thiazid diuretic (indapamide) and dihydropyridine calcium antagonist (nifedipine XL).

Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.

Conclusion. High incidence of pseudorefractory HT (40,1%) is revealed. Significant prevalence of renal disturbances especially chronic intersti￾tial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL) provides effective control of BP in refractory and pseudorefractory HT.

About the Authors

M. M. Batyushin
Rostov State Medical University
Russian Federation


I. V. Derevyankina
Rostov State Medical University
Russian Federation


M. Z. Gasanov
Rostov State Medical University
Russian Federation


O. V. Akopova
Rostov State Medical University
Russian Federation


K. I. Babiyan
Rostov State Medical University
Russian Federation


Y. N. Boychenko
Rostov State Medical University
Russian Federation


N. V. Vasilchenko
Rostov State Medical University
Russian Federation


T. A. Gabysyan
Rostov State Medical University
Russian Federation


S. Ch. Gayboryan
Rostov State Medical University
Russian Federation


I. S. Golovatenko
Rostov State Medical University
Russian Federation


N. M. Demkova
Rostov State Medical University
Russian Federation


D. O. Dmitriev
Rostov State Medical University
Russian Federation


E. V. Kirtava
Rostov State Medical University
Russian Federation


O. L. Kotyankova
Rostov State Medical University
Russian Federation


G. V. Ludanova
Rostov State Medical University
Russian Federation


S. A. Lyashenko
Rostov State Medical University
Russian Federation


A. E. Malichina
Rostov State Medical University
Russian Federation


O. I. Poroshenko
Rostov State Medical University
Russian Federation


A. V. Svechnikova
Rostov State Medical University
Russian Federation


I. Y. Sidorov
Rostov State Medical University
Russian Federation


E. V. Solyannikova
Rostov State Medical University
Russian Federation


I. D. Tascheyan
Rostov State Medical University
Russian Federation


E. A. Heygetyan
Rostov State Medical University
Russian Federation


S. E. Evruyan
Rostov State Medical University
Russian Federation


References

1. 2003 European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003;21:1011-53.

2. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. Hypertension 2003;42:1206-52

3. Профилактика, диагностика и лечение артериальной гипертензии. Российские рекомендации (второй пересмотр). Кардиоваск тер профилакт 2004; (прил.):1-20.

4. Кобалава Ж.Д., Гудков К.М. Секреты артериальной гипертонии: ответы на Ваши вопросы. М.: Солвей Фарма. 2004.


For citation:


Batyushin M.M., Derevyankina I.V., Gasanov M.Z., Akopova O.V., Babiyan K.I., Boychenko Y.N., Vasilchenko N.V., Gabysyan T.A., Gayboryan S.C., Golovatenko I.S., Demkova N.M., Dmitriev D.O., Kirtava E.V., Kotyankova O.L., Ludanova G.V., Lyashenko S.A., Malichina A.E., Poroshenko O.I., Svechnikova A.V., Sidorov I.Y., Solyannikova E.V., Tascheyan I.D., Heygetyan E.A., Evruyan S.E. RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION. Rational Pharmacotherapy in Cardiology. 2007;3(2):38-42. (In Russ.) https://doi.org/10.20996/1819-6446-2007-3-2-38-42

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)