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1.
Kardiologiia ; (3): 84-93, 2018 Mar.
Article de Russe | MEDLINE | ID: mdl-29782275

RÉSUMÉ

The review is devoted to pharmacotherapy of chronic heart failure (CHF) with preserved left ventricular ejection fraction. In this review we discuss data of meta-analyzes of randomized clinical trials and observational studies, as well as the indications for use of inhibitors of the renin-angiotensin-aldosterone system, ß-blockers, and antagonists of mineralocorticoid receptors in these patients in current clinical guidelines. New approaches to therapy of CHF from the perspective of influence on myocardial fibrosis are considered in this review.


Sujet(s)
Défaillance cardiaque , Inhibiteurs de l'enzyme de conversion de l'angiotensine , Humains , Antagonistes des récepteurs des minéralocorticoïdes , Système rénine-angiotensine , Débit systolique , Fonction ventriculaire gauche
3.
Zh Nevrol Psikhiatr Im S S Korsakova ; 113(4 Pt 2): 71-5, 2013.
Article de Russe | MEDLINE | ID: mdl-23739459

RÉSUMÉ

We have analyzed pharmacoeconomical indicators in the treatment of idiopathic (generalized and focal) epilepsy in children and adolescence in an ambulatory treatment/diagnostic center of a big industrial city. In the total structure, focal epilepsy made up 41.73% (255 patients, 128 boys (50.2%) and 128 girls (49.8%)). Generalized forms were diagnosed in 61.96% (n=158) and partial forms - in 37.6% (n=97%) patients. Minimal direct and indirect costs for one patient were calculated for patients in remission and did not depend on the form of epilepsy. The costs increased by a magnitude of two or more for treatment efficiency 50% and by 3 times for insufficient efficiency of treatment of different forms of epilepsy. In case of a loss of control of seizures, indirect costs exceeded the economy of direct costs. Adequate treatment of idiopathic epilepsy in children is economically profitable because it allows to improve quality of life of a child and maintain manpower resources in the nearest future.


Sujet(s)
Anticonvulsivants/économie , Coûts indirects de la maladie , Coûts des médicaments/statistiques et données numériques , Pharmacoéconomie , Épilepsies partielles/économie , Adolescent , Anticonvulsivants/usage thérapeutique , Enfant , Enfant d'âge préscolaire , Épilepsies partielles/traitement médicamenteux , Femelle , Études de suivi , Humains , Nourrisson , Nouveau-né , Mâle , Induction de rémission , Études rétrospectives , Russie , Résultat thérapeutique
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 110(3 Suppl 2): 44-7, 2010.
Article de Russe | MEDLINE | ID: mdl-20873473

RÉSUMÉ

An aim of the study was to assess clinical-economic effectiveness of therapy in the stages of examination of an epileptic patient by a local neurologist and then by an epileptologist after therapy optimization. Three hundreds and ten patients with different forms of epilepsy and types of epileptic seizures were treated. Costs-of-illness and medical services were assessed using common parameters on the basis of current prices in the health-care system. Special attention was drawn to expenses related to purchasing of antiepileptic drugs (traditional and new ones). The expenses for treatment were compared to treatment effectiveness. It is concluded that mean costs of treatment of epilepsy, including new brands of antiepileptic drugs with high prices, have substantial medical-social benefits that compensate expenses for their purchasing at the expense of other direct and indirect costs.


Sujet(s)
Anticonvulsivants/économie , Coûts indirects de la maladie , Coûts des médicaments , Épilepsie/économie , Adulte , Anticonvulsivants/usage thérapeutique , Analyse coût-bénéfice , Épilepsie/traitement médicamenteux , Femelle , Humains , Mâle , Résultat thérapeutique
5.
Kardiologiia ; 50(12): 79-83, 2010.
Article de Russe | MEDLINE | ID: mdl-21591398

RÉSUMÉ

Review oral modified release drug forms of beta-adrenoblocker metoprolol which is used in arterial hypertension and ischemic heart disease is presented. Metoprolol has salts such as tartrate which is used for production of immediate release (IR) and sustained release (SR) forms and succinate used for production of controlled release form (CR/XL). Metoprolol SR has monolith matrix type, metoprolol CR/XL-system of multiple pellets. Effect of metoprolol tartrate (IR) on mortality was demonstrated in a number of studies in patients with arterial hypertension (AH) (MAPHY), myocardial infarction (SMT, GMT, MIAMI), dilated cardiomyopathy and heart failure (MDC). Studies of efficacy of metoprolol SR are scarce. Antihypertensive efficacy of metoprolol SR in patients with AH did not exceed that of a metoprolol IR or CR/XL. First retrospective analysis of efficacy of metoprolol tartrate and succinate (CR/XL) in patients after myocardial infarction allowed to obtain comparable results of 34% mortality lowering. In a prospective study in patients with chronic heart failure (COMET) metoprolol tartrate IR was not superior to carvedilol when mortality lowering was concerned. At the same time administration of controlled release metoprolol (CR/XL) in 2 large clinical trials (RESOLVD, MERITAHF) was advantageous in patients with chronic heart failure relative to lowering of mortality and rate of hospitalizations. A novel controlled release form of metoprolol has been created as a tartrate salt on the basis of pellet technology (CD/ERT) and its bioequivalence to metoprolol CR/XL has been proved.


Sujet(s)
Antagonistes des récepteurs bêta-1 adrénergiques/administration et posologie , Conception de médicament , Hypertension artérielle/traitement médicamenteux , Métoprolol/administration et posologie , Administration par voie orale , Préparations à action retardée/administration et posologie , Études d'évaluation comme sujet , Humains , Comprimés
8.
Kardiologiia ; 46(5): 40-3, 2006.
Article de Russe | MEDLINE | ID: mdl-16858353

RÉSUMÉ

Hypotensive, organoprotective, and metabolic effects of angiotensin converting enzyme inhibitor moexipril (7.5-15 mg/day for 16 weeks) with or without combination with hydrochlorothiazide was studied in 34 women (mean age 59.6+/-1.6 years) with postmenopausal metabolic syndrome and hypertension. Thirty four women had dyslipidemia, 22 -- disturbances of carbohydrate metabolism, 18 -- obesity (mean body mass index 31.1+/-0.8 kg/m(2)). Treatment was associated with lowering of office systolic(-20.1%) and diastolic (-17.4%) blood pressure (BP). Target BP (140/90 mm Hg) was achieved in 27 patients. There also occurred significant lowering of mean 24 hour, diurnal, and nocturnal systolic and diastolic BP (p<0.05), significant changes of values of systolic and diastolic BP time indexes, normalization of which was observed both during day and night hours. Significant lowering of total cholesterol (-11.6%, p<0.05), low density lipoprotein cholesterol (-16.3%, p<0.02), and in patients with obesity of triglycerides (-27%, p<0.02) was revealed at the background of treatment with moexipril. In a group as a whole we observed significant lowering of excretion of albumins and b2-microglobulin; most pronounced antiproteinuretic effect was noted in patients with high microproteinuria and obesity. Vasodilating function of vessels improved in all patients with postmenopausal metabolic syndrome, mainly at the account of increment of endothelium dependent vasodilation and normalization of index of vasodilatation.


Sujet(s)
Inhibiteurs de l'enzyme de conversion de l'angiotensine/usage thérapeutique , Pression sanguine/effets des médicaments et des substances chimiques , Débit de filtration glomérulaire/effets des médicaments et des substances chimiques , Hypertension artérielle/traitement médicamenteux , Syndrome métabolique X/traitement médicamenteux , Post-ménopause , Tétrahydroisoquinoléines/usage thérapeutique , Adulte , Sujet âgé , Préparations à action retardée , Diurétiques/usage thérapeutique , Association de médicaments , Femelle , Études de suivi , Humains , Hydrochlorothiazide/usage thérapeutique , Hypertension artérielle/complications , Hypertension artérielle/physiopathologie , Lipides/sang , Syndrome métabolique X/complications , Syndrome métabolique X/physiopathologie , Adulte d'âge moyen , Syndrome , Résultat thérapeutique , Vasodilatation/effets des médicaments et des substances chimiques
9.
Kardiologiia ; 46(1): 43-9, 2006.
Article de Russe | MEDLINE | ID: mdl-16474309

RÉSUMÉ

Moexipril (7.4-15 mg/day) was given to 34, spirapril (3-6 mg/day) -- to 18 postmenopausal women with hypertension and metabolic syndrome for 16 weeks. Hydrochlorthiazide was added when therapy was not sufficiently effective. Both angiotensin converting enzyme inhibitors had similar hypotensive activity: blood pressure normalized in 71 and 61% of moexipril and spirapril treated women, respectively. Both drugs promoted normalization of metabolism of lipid (lowering of levels of cholesterol, atherogenic lipoproteins and triglycerides) and carbohydrates (lowering of hyperinsulinemia). Patients with postmenopausal metabolic syndrome had elevation of leptin level up to 27.5+/-5.5 pg/ml. Moexipril and spirapril caused lowering of elevated levels of leptin. These drugs did not affect levels of sex hormones. They exerted vasoprotective (normalization of endothelium dependent and independent vasodilatation) and nephroprotective (attenuation and normalization of microalbuminuria) effects. Thus spirapril and moexipril are effective in treatment of hypertension in patients with postmenopausal metabolic syndrome.


Sujet(s)
Inhibiteurs de l'enzyme de conversion de l'angiotensine/usage thérapeutique , Énalapril/analogues et dérivés , Syndrome métabolique X/traitement médicamenteux , Post-ménopause , Tétrahydroisoquinoléines/usage thérapeutique , Pression sanguine/effets des médicaments et des substances chimiques , Association de médicaments , Énalapril/usage thérapeutique , Femelle , Études de suivi , Humains , Hypertension artérielle/complications , Hypertension artérielle/traitement médicamenteux , Hypertension artérielle/physiopathologie , Lipides/sang , Syndrome métabolique X/sang , Syndrome métabolique X/complications , Adulte d'âge moyen , Résultat thérapeutique
10.
Kardiologiia ; 44(10): 71-7, 2004.
Article de Russe | MEDLINE | ID: mdl-15477795

RÉSUMÉ

Incidence of chronic renal failure has a worldwide tendency to growth. Hypertension occupies an important place among causes of this upward trend. That is why in patients with hypertension and incipient changes of the kidneys it seems most appropriate to use antihypertensive drugs with renoprotective properties. Early treatment with these drugs enables most effective lowering of risk of renal failure development and thus has a potential to prolong life of a patient. Selective microproteinuria is considered to be a marker of incipient renal impairement. Among groups of antihypertensive agents angiotensin converting enzyme inhibitors, angiotensin receptor blockers, calcium antagonists, beta-blockers, and diuretics have proven renoprotective properties.


Sujet(s)
Antihypertenseurs/pharmacologie , Antihypertenseurs/usage thérapeutique , Hypertension artérielle/complications , Hypertension artérielle/traitement médicamenteux , Défaillance rénale chronique/diagnostic , Défaillance rénale chronique/prévention et contrôle , Rein/effets des médicaments et des substances chimiques , Protéinurie/étiologie , Antagonistes bêta-adrénergiques/pharmacologie , Antagonistes bêta-adrénergiques/usage thérapeutique , Adulte , Sujet âgé , Inhibiteurs de l'enzyme de conversion de l'angiotensine/pharmacologie , Inhibiteurs de l'enzyme de conversion de l'angiotensine/usage thérapeutique , Inhibiteurs des canaux calciques/pharmacologie , Inhibiteurs des canaux calciques/usage thérapeutique , Maladie coronarienne/complications , Diabète de type 2/complications , Diurétiques/pharmacologie , Diurétiques/usage thérapeutique , Méthode en double aveugle , Humains , Adulte d'âge moyen , Études multicentriques comme sujet , Placebo , Essais contrôlés randomisés comme sujet
11.
Kardiologiia ; 43(11): 23-6, 2003.
Article de Russe | MEDLINE | ID: mdl-14671558

RÉSUMÉ

AIM: To assess physicians preferences concerning the use of various groups of antihypertensive drugs in Russia. METHODS: Special questionnaires containing 8 questions related to preferential adherence to representatives of various groups of antihypertensive drugs were distributed among practicing physicians who routinely treated patients with hypertension. RESULTS: Of questionnaires returned between January and July of 2002 from 34 towns 530 were considered valid for analysis. Half of responses (50.4%) were from hospital physicians, 40.5% - from physicians of policlinics (outpatient clinics), 9.1% - from physicians working in other health care facilities. Most of respondents were internists (60.8%) and cardiologists (32.7%). Preferences concerning prescription of antihypertensive drugs were distributed in the following way: angiotensin converting enzyme inhibitors - 32% (50% captopril and enalapril); beta-adrenoblockers - 27% (77% atenolol, metoprolol and propranolol); diuretics (hydrochlorothiazide and indapamide) - 22%; calcium antagonists - 15% (81% verapamil, nifedipine, diltiazem, 64% - long acting preparations); angiotensin receptor blockers - 1.7%; centrally acting drugs - 1.5%; alpha-adrenoblockers - 0.8%. CONCLUSION: Tendencies in real life treatment of patients with hypertension in Russia should be considered positive. Basic antihypertensive therapy included agents (mostly long-acting) from 4 main classes and the use of outdated drugs such as clonidine and reserpine was low.


Sujet(s)
Antihypertenseurs/usage thérapeutique , Hypertension artérielle/traitement médicamenteux , Types de pratiques des médecins/statistiques et données numériques , Utilisation médicament/statistiques et données numériques , Études épidémiologiques , Humains , Hypertension artérielle/épidémiologie , Russie/épidémiologie
14.
Ter Arkh ; 69(1): 35-8, 1997.
Article de Russe | MEDLINE | ID: mdl-9163047

RÉSUMÉ

The authors have found that more accurate prognosis of left ventricular myocardial hypertrophy (LVMH) may be made basing on fluctuations and variability of arterial pressure throughout the day: significant fluctuations of arterial pressure at night and pronounced variability of systolic arterial pressure in the day time and at night are indicative of essential hypertension instability and may contribute to LVMH progression. Of still greater prognostic significance is assessment of 24-h arterial pressure rhythm by the degree of a night fall (DNF) in diastolic arterial pressure (DAP). A disturbed 24-h rhythm of arterial pressure (a fall in DNF of DAP) is a predictor of LVMH development.


Sujet(s)
Surveillance ambulatoire de la pression artérielle/statistiques et données numériques , Rythme circadien , Hypertension artérielle/physiopathologie , Pression sanguine , Diastole , Femelle , Coeur/anatomie et histologie , Humains , Hypertrophie ventriculaire gauche/physiopathologie , Mâle , Taille d'organe/physiologie , Pronostic , Caractères sexuels , Systole
15.
Ter Arkh ; 67(9): 53-6, 1995.
Article de Russe | MEDLINE | ID: mdl-7495044

RÉSUMÉ

34 patients with stable arterial hypertension (AH) were randomized by mean arterial pressure (MAP), end-diastolic LV volume and cardiac output in a study of cilazapril efficacy in a dose 2.5 and 5 mg/day. Antihypertensive effect in the majority of patients with MAP 120-135 and 136-150 mm Hg was insufficient (diastolic pressure > 94 mm Hg). Dose-effect action on hemodynamics was absent. Hemodynamic benefits were noted in patients with end diastolic LV volume > 5.0-5.7 cm.


Sujet(s)
Antihypertenseurs/administration et posologie , Cilazapril/administration et posologie , Hypertension artérielle/traitement médicamenteux , Adulte , Relation dose-effet des médicaments , Femelle , Hémodynamique/effets des médicaments et des substances chimiques , Humains , Hypertension artérielle/physiopathologie , Mâle , Adulte d'âge moyen , Placebo , Fonction ventriculaire gauche/effets des médicaments et des substances chimiques
16.
Kardiologiia ; 31(3): 13-6, 1991 Mar.
Article de Russe | MEDLINE | ID: mdl-1875587

RÉSUMÉ

Some aspects of the antiaggregatory action of calcium antagonists were studied in 50 patients with stable angina pectoris. Dilzem (diltiazem) and cordaphene (nifedipine) were tested for their effects on the erythrocytic component of hemostasis, taking into account their capability of suppressing hemolysis, which made ADP, an important thrombocytic activator, enter the blood flow. The two agents significantly reduce the concentration of plasma ADP, free hemoglobin, diminish mechanical erythrocytic resistance, and block platelet aggregation to a varying degree. A relationship was established between the levels of blood nifedipine and the magnitude of rheological effects. With this, the patients with coronary heart disease showed a good antianginal effect.


Sujet(s)
Maladie coronarienne/sang , Diltiazem/usage thérapeutique , Nifédipine/usage thérapeutique , Agrégation plaquettaire/effets des médicaments et des substances chimiques , ADP/antagonistes et inhibiteurs , ADP/sang , Adulte , Sujet âgé , Maladie coronarienne/traitement médicamenteux , Membrane érythrocytaire/effets des médicaments et des substances chimiques , Membrane érythrocytaire/physiologie , Hémolyse/effets des médicaments et des substances chimiques , Hémolyse/physiologie , Humains , Adulte d'âge moyen , Agrégation plaquettaire/physiologie , Antiagrégants plaquettaires
18.
Article de Russe | MEDLINE | ID: mdl-1646516

RÉSUMÉ

Thirty-five stage I-II essential hypertension subjects aged 25-63 were examined after the 1st and 10th acupuncture to clarify the effect of a single procedure and a course of acupuncture treatment on blood ACTH, STH, TTH, beta-endorphine, neurotensin, thyroxine, aldosterone, hydrocortisone and plasma renin activity. The hormonal spectrum was determined by radioimmunoassay using special kits. The blood was obtained before acupuncture, 5 min after introduction of the needles, immediately and 30 min after their removal. It is shown that acupuncture-related decline of arterial pressure occurs in participation of pituitary and adrenal hormones as well as polypeptides beta-endorphine and neurotensin.


Sujet(s)
Thérapie par acupuncture , Hypertension artérielle/thérapie , Système neuroendocrinien/physiopathologie , Adulte , Hormones/sang , Humains , Hypertension artérielle/sang , Hypertension artérielle/physiopathologie , Adulte d'âge moyen , Peptides/physiologie , Récepteurs de surface cellulaire/physiologie
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