[Experience in the use of valsartan with the aim to inhibit progression of kidney failure in patients with chronic glomerulonephritis]. / Opyt primeneniia valsartana s tsel'iu tormozheniia progressirovaniia pochechnoi nedostatochnosti u bol'nykh khronicheskim glomerulonefritom.

AIM: To assess the effect of valsartan, angiotensin-II receptor blocker type 1, on key factors of progression of chronic renal failure (CRF)--arterial hypertension (AH), proteinuria (PU), sodium excretion (SE)--in patients with chronic glomerulonephritis (CGN) and initial affection of renal function. MATERIAL AND METHODS: 11 patients (mean age 33.7 +/- 13.3 years, mean duration of nephritis 8.6 +/- 6.4 years, male to female ratio 8:3) with AH (AP > 140/90 mm Hg) and marked PU (> 1 g/day) who had not received immunosuppressive drugs for at least 6 months before the trial were given valsartan. It was administered after the period of "washing out" at the initial dose 80 mg/day with further addition of diuretics or raising the dose twice (in hyperuricemia) to decrease AP under 140/90 mm Hg. The duration of the treatment was 3 months. RESULTS: After 3 months of valsartan therapy systolic arterial pressure fell from 162 +/- 18 to 138 +/- 20 mm Hg (p < 0.05), diastolic pressure from 100 +/- 8 to 92 +/- 15 mm Hg (single measurements). 24-h monitoring of AP showed a significant lowering of mean 24-h and night systolic and diastolic AP, day-time diastolic AP, 24-h time index of systolic and diastolic AP. Initial antiproteinuric effect was observed after 1 month of the treatment and after 3 months of therapy PU reduced significantly (from 5.7 +/- 6.0 g/day to 3.3 +/- 3.3 g/day). After 3 months sodium excretion significantly rose, while creatinine level and glomerular filtration rate did not. Potassium rose in one patient. CONCLUSION: In CGN with initial CRF valsartan in a dose 80-160 mg/day produces a pronounced antihypertensive and antiproteinuric actions, stimulates sodium excretion. No serious side effects were noted. It is necessary to continue studies on the ability of valsartan to inhibit progression of CRF.

[Some approaches to raising quality of treatment for arterial hypertension (experience of school for arterial hypertension patients)]. / Nekotorye podkhody k povysheniiu kachestva lecheniia patsientov s arterial'noi gipertoniei (opyt "Shkoly patsienta s arterial'noi gipertoniei").

AIM: To investigate involvement of patients into control of their pressure to improve quality of treatment for arterial hypertension (AH). MATERIALS AND METHODS: 134 hypertensive patients (76 females and 58 males) were interviewed. Criteria of efficacy of AH control were ability and motivation of self-measurement of blood pressure and its maintenance at the optimal level. RESULTS: For the past year, 40% of the patients measured pressure regularly (once a day or more frequently), 34%--1-3 times a week, 9%--1-3 times a month, 17%--rarely, mostly, males. Most of the patients controlled their pressure insufficiently. This is explained by "working pressure" (high in many cases) which was registered in most of the examinees. When part of the patients reached that working pressure they discontinued treatment. CONCLUSION: Involvement of hypertensive patients and members of their families into control of hypertension is a feasible and valuable method of improving quality of hypertension treatment.