RESUMO
The aim of the work was to compare efficiency of traditional therapy with prestarium (tert-butylamine salt) and chronotherapy with prestarium A (arginine salt) in elderly patients with polymorbidity syndrome (diabetes mellitus, nephropathy, grade I-II chronic hepatic insufficiency). All patients underwent standard clinical and laboratory examination including measurement of glycemic profile, plasma urea, creatinine, K+ and Na+, AP monitoring, ECG, and echo-CG. The results suggest persistent hypotensive effect of prestarium and prestarium A within 4 days after the onset of therapy. However, in patients with a more severe disease, twice lower doses of prestarium A were needed to achieve positive effect and transform circadian AP rhythm from non-dipper to dipper pattern.
Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Hipertensão/tratamento farmacológico , Nefropatias/tratamento farmacológico , Perindopril/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Cronofarmacoterapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perindopril/administração & dosagem , Insuficiência Renal Crônica/tratamento farmacológico , SíndromeRESUMO
The study included 20 patients aged 61-86 (mean 73.1 +/- 3.1) years with stage II hypertensive disease, type 2 diabetes and nephropathy with signs of grade I chronic renal insufficiency (CRI). The major parameters measured were AP, HR, laboratory characteristics of carbohydrate metabolism and renal function. Prestarium given at a dose of 4 mg BID had not only antihypertensive but also negative chronotropic effect, decreased energy consumption by myocardium, and normalized daily AP profile (24 hr AP monitoring). Adequate control of diabetes ensured close-to-normal carbohydrate metabolism. Prestarium therapy did not cause further aggravation of renal insufficiency in patients with grade I CRI, nor did it alter creatinine and urea levels.
Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipertensão/tratamento farmacológico , Perindopril/uso terapêutico , Insuficiência Renal/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Glicemia/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Creatinina/urina , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Perindopril/administração & dosagem , Insuficiência Renal/complicações , Insuficiência Renal/metabolismo , Resultado do TratamentoRESUMO
We examined 20 patients (mean age 69.4 yr) with stage II AH and CHD. 13 ones suffered CHD with stable FC II and III angina, two others had myocardial infarction. The patients were given monopril, 10 mg BID (08.00 & 20.00). Those with CHD were additionally treated with cardiket (20 mg BID) or monocinque (20 mg BID). If appropriate, hypothiazide or triampur compositum (25 mg each) was given in the morning. Usual clinical examination was supplemented by dynamic studies and evaluation of clinical symptoms on day 21 after therapy including systolic and diastolic AP, pulse and mean dynamic AD, double product, heart rate, ECG, echoCG, AP and ACG monitoring. The above treatment produced marked antihypertensive and antianginal effects in the absence of adverse events.