ABSTRACT
Recently thromboembolic and hemorrhagic complications are main causes of maternal morbidity and mortality. Normal pregnancy is associated with ahypercoagulation. This condition is complicated if the patient has a mechanical prosthetic heart valve. Therefore an anticoagulant therapy in these patients is a challenging task. Effects of anticoagulant drugs on the fetus, pregnancy and delivery must also be taken into consideration. The review deals with international clinical guidelines. Diagrams of anticoagulant therapy in pregnant women with mechanical prosthetic heart valves using direct (unfractionated and low-molecular-weight heparins) and indirect (warfarin) anticoagulants are presented in the review.
Subject(s)
Anticoagulants , Heart Valve Prosthesis , Practice Guidelines as Topic , Pregnancy Complications, Hematologic/drug therapy , Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Anticoagulants/therapeutic use , Drug Administration Schedule , Female , Heart Valve Prosthesis/adverse effects , Humans , Pregnancy , Pregnancy Complications, Hematologic/blood , Pregnancy OutcomeABSTRACT
The review summarizes the current views on the pathogenesis of dementia and the significance of blood pressure levels for its development. The present status of the prevention of cognitive disorders and dementia is detailed in the use of antihypertensive therapy: there are the data of prospective cohort studies of the impact of antihypertensive therapy on the risk of dementia, the results of placebo-controlled studies in the groups of elderly and senile patients with a history of cerebrovascular complications, and the data of meta-analyses of studies. As for cognitive function, the effects of different classes of the currently available antihypertensive agents, such as diuretics, calcium antagonists, angiotensin-converting enzyme inhibitors, and angiotensin II type 1 receptor antagonists, are analyzed.
Subject(s)
Alzheimer Disease/etiology , Antihypertensive Agents/therapeutic use , Cognition Disorders/etiology , Dementia/etiology , Hypertension/complications , Aged , Aged, 80 and over , Alzheimer Disease/prevention & control , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/etiology , Cognition Disorders/prevention & control , Cohort Studies , Dementia/prevention & control , Humans , Hypertension/drug therapy , Meta-Analysis as Topic , Placebos , Prospective Studies , Randomized Controlled Trials as Topic , Risk FactorsABSTRACT
The authors review their studies conducted for many years on cardiological prognostication in the context of the republican program "Cardiology" performed in the Udmurt Republic. The lines of the research and results obtained are described.