The method of determining the chronobiological criterion destination-blockers in patients with arterial hypertension in combination with coronary heart disease

 

The invention relates to medicine, namely cardiology, and for the treatment of hypertension in combination with coronary heart disease. For this conduct daily monitoring of arterial pressure and comparison of the curves of blood pressure and heart rate. When identifying at least one matching acrofs blood pressure and heart rate is prescribed-blockers. The method provides effective blood pressure lowering in patients with CHD. table 1.

The invention relates to medicine, namely to cardiology.

According to who [1] and the International Society for the study of hypertension (ISH) [1] for the treatment of arterial hypertension (AH) in combination with coronary heart disease recommended 6 groups of drugs. When this-blockers are first-line drugs because they have demonstrated their efficacy and safety for 30 years.

However, the information COULD [1]-blockers is effective only in 40-50% of cases. It is known that the efficiency of-adrenoblokatorov is visible after 4-5 days, in case of absence of effect from therapy is Oteri consciousness.

The objective of the invention is the provision of the effectiveness of treatment of hypertension due to the objectification of indications to appointment-blockers.

This is due to the fact that when comparing the curves of blood pressure and heart rate obtained as a result of daily monitoring of arterial pressure, at least one matching acrophase (maximum values) assign-blockers.

Hemodynamically blood pressure consists of 2 components: cardiac index and specific peripheral resistance. The point of application-blockers - heart release. Cardiac output consists of the stroke volume multiplied by the number heartbeat.-blockers reduce blood pressure by reducing the impact of emissions and ischemia of the heart rate. Thus, the coincidence of acrophase blood pressure with acrophase heart rate is a theoretical basis for the use of-blocker antihypertensive purpose.

In the case of nesovpadeniya, in addition, there is a reflex increase in peripheral resistance. Therefore, when the mismatch acrofs blood pressure and heart rate assignment-adrenoblokatorov gives a less pronounced hypotensive effect and is accompanied by complications.

The method is as follows: the patient spend daily monitoring of arterial pressure, if the obtained curves indices of heart rate and magnitude of blood pressure at least once match acrophase, assign-blockers.

Clinical case 1 the Patient K., 48, and/b 4876, 1998. The diagnosis of Arterial hypertension of the III degree. Complaints about headaches, dizziness. History - 5 years AG. The results of daily monitoring AD: Mean BP systolic (SBP) 190 mm RT.art., mean BP diastolic 110 mm RT.article Acrophase HELL intermediate (HELL Wed) 20 hours. The acrophase of the number of heart rate (HR) - 19.30. See matching acrophase. Scheduled Concor (bisoprolol) 10 mg per day. After 14 days of HELL cf. 130/80 mm RT.art., headaches, no dizziness. After 6 months, 1 year HELL 120/80-130/80 mm RT.article Hypertensive crises was not.

Clinics "flicker flies before the eyes", the headaches. History of 7 years AG. The results of daily monitoring AD: Acrophase HELL cf. (170/100 mm RT.CT.) 18 hours, acrophase HR (110 min) 17.30 minutes Watching the match acrophase. Appointed atenolol dose of 100 mg per day. After 14 days disappeared nausea, headache. HELL 120/80 mm RT.article After 3 months, 6 months, 1 year HELL 130/80-120/80-120/80 mm RT.article.

The table shows the chronobiological criterion for appointment-blockers for hypertension.

Information source 1. Clinical pharmacology and therapy. - 1999 - 3. - S. 3-17.

Claims

The method of determining the chronobiological criterion destination-blockers in patients with arterial hypertension in combination with coronary heart disease, which consists in mounting blood pressure and heart rate during the day and in recognition of the basis for appointment-adrenoblokatorov at least one match of acrophase blood pressure and heart rate.

 

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