[Treatment of patients with essential hypertension using bifunctional 24-hour blood pressure and ECG monitoring].
The results of 24-hour blood pressure monitoring (BPM) help to divide patients into therapeutic groups according to the leading hemodynamic mechanism offorming essential arterial hypertension (EAH). In patients with a mean day heart rate of > or =73 bpm antihypertensive therapy should begin with beta1-adrenoblockers when not contraindicated. In patients with a mean day heart rate of < or =73 bpm antihypertensive therapy may be started with preparations of other pharmaceutical groups. In this study, Plendil or Concor was administered as a chronotherapy; later their combination was used, and diuretics or ACE inhibitors were added when necessary. At any stage of the study, starting from the second week of therapy, if blood pressure (BP) was normal and there were ischemic episodes according to matched 24-hour BPM and ECG, Cardiket and, when not contraindicated, Aspirin, were added. The offered algorithm of choice of therapy made it possible to achieve a good antihypertensive effect in 84% of patients and a satisfactory effect in 7% of patients, which was accompanied by a tendency towards the shortening of total ischemia duration and lowering the frequency of myocardial hypokinesia. The effect of the therapy was poor only in 9% of patients, 2% of whom one left the study due to adverse reactions before BP was normalized. BP was normalized on the 8th week of treatment in 75% of patients. It is appropriate to include matched 24-hour BPM and ECG in the follow-up of patients with EAH and coronary artery disease upon discharge under the conditions of routine physical load. According to 24-hour BPM, mean day heart rate and total length of ischemia grow during this period due to an increase in physical and emotional load, which requires correction of the therapy.
Kuznetsov
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EN
Ivashkin
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VT
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
D000959:Antihypertensive Agents