title: [Arterial hypertension in menopausal women: Clinical, functional, and pharmaco-economical aspects].
abstract: The study was undertaken to define the specific features of daily variations of blood pressure (BP) and autonomic cardiac regulation (ACR), as well as the functional status of the myocardium and vascular endothelium in females with menopausal arterial hypertension (MPAH) and to assess the pharmacotherapeutic and economical aspects of the combined use of arifon retard and clinonorm. The study enrolled 30 reproductive females with mild and moderate arterial hypertension (AH) and 65 females with MPAH who were randomly divided into 2 groups according to the therapeutic model. MPAH was characterized by more unfavorable hemodynamic changes that AH in the presence of preserved fertile function: greater load on target organs, elevated BP, its inadequate nocturnal lowering, greater BP variations, the magnitude and rate of its morning elevation. In AH, the vasomotor function of the endothelium varies with the clinical form of the disease and with the functional status of the female reproductive system. By and large, in the group of patients with MPAH, the latter was characterized by a more significant decrease in endothelium-dependent vasodilation (EDVD). Arifon retard monotherapy has an adequate antihypertensive effect in female patients with MPAH, by ensuring 24-hour control of BP and affecting its chronostructure. A combination of arifon retard and climonorm has no cumulative effect on the level of BP and on the parameters of pressure-induced load; however, this is a pathogenetically grounded combination that potentiates the positive effects of a diuretic in significantly improving EDVD and ACR. The use of arifon retard in combination with climonorm in MPAH is the most cost-effective for public health care facilities and effective for patients. The course of MPAH is of certain peculiarity, which should be taken into account in choosing a therapeutic model for this category of patients.
authors.forename: B I
authors.initials: BI
authors.lastname: Gel'tser
authors.forename: V N
authors.initials: VN
authors.lastname: Kotel'nikov
authors.forename: T A
authors.initials: TA
authors.lastname: Khludeeva
mesh_terms: D002940:Circadian Rhythm; D004232:Diuretics / Q000191:economics / Q000627:therapeutic use*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology*; D007190:Indapamide / Q000191:economics / Q000627:therapeutic use*; D016912:Levonorgestrel / Q000191:economics / Q000627:therapeutic use*; D008593:Menopause; D016896:Treatment Outcome
chemical_list: D004232:Diuretics; D004338:Drug Combinations; C097275:klimonorm; D004958:Estradiol; D016912:Levonorgestrel; D007190:Indapamide