Method of normalising functional responsiveness of cardiovascular system in arterial hypertension and metabolic syndrom in elderly and senile patients

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to cardiology, and concerns normalising the functional responsiveness of cardiovascular system in elderly and senile patients suffering arterial hypertension and metabolic syndrom. That is ensured by estimating the condition of functional reactivity of the CVS in psychoemotional load by recording systolic, diastolic, average dynamic pressure (BPav.dyn.) and heart rate (HR). These data are used to evaluate a functional responsiveness index (FRI) before and after load by formula: FRI=(BPav.dyn. x HR)100 (standard units). The value PFR increased more than by 20 standard units requires the complex therapy including individually prescribed hypocaloric diet calculated by formula considering sex and age and body weight, graduated static and dynamic physical activity, and introduction of irbesartan in dosage 150 mg once in the morning, and pioglitazone in dosage 30 mg once in the morning at least for 3 months.

EFFECT: complex drug-induced and drug-free therapy combined with empirically prescribed treatment length provides normalisation of functional responsiveness of the CVS in the given group of patients due to potentiation of therapeutic effect of separate components of an individual care.

2 ex

 

The invention relates to medicine, cardiology, and can be used in therapeutic departments of clinics and hospitals. Analogues of the method of normalization of the functional reactivity of the cardiovascular system with arterial hypertension (AH) with metabolic syndrome (MS) in elderly and senile age does not exist.

The aim of the invention is to increase the efficiency of correction of the functional reactivity of the cardiovascular system angiography with MS in elderly and senile age.

The essence of the proposed method of correction of the functional activity of the cardiovascular system is to increase the tolerance of patients with arterial hypertension with MS in elderly and senile age to emotional stress and increase functional reactivity of cardiac-vascular system in the execution of their metered emotional load and reducing the risk of cardiovascular complications during emotional stress, measured after holding dosed emotional load with the ever increasing speed for 18-20 minutes with every minute registration parameters of Central hemodynamics: arterial systolic pressure (SBP), diastolic blood pressure (ADC), arterial pressure medium dynamic (Adsin.) and frequency of serdechnosti (HR), determine the value of the functional reactivity (FIU), which is the work of the AD medium dynamic on heart rate, calculate the relative increment values FIU when performing load compared with the value at rest and largest values FIU assess the type of functional reactivity of the cardiovascular system: when the FIU is more than 20 usled reactivity assessed as hyperfunctional (with AG), the FIU is less than 10 usled response to the load estimate as Hypo-functional and, when values of the FIU from 10 to 20 usled type functional reactivity assessed as normal. Time psychoemotional load no more than 20 minutes. To normalize the indicator functional reactivity in patients with MS in elderly and senile age uses a combination of individualized low-calorie diet, measured static and dynamic loads, daily swimming, irbesartan and pioglitazone for at least 3 months.

The inventive method is carried out as follows. The value of the FIU is determined by Lebedeva OD, Radziejewski S.A., Bugaeva S.A. Method of assessment of the functional reactivity of the cardiovascular system EN 2207044. The patient is seated in front of the screen. The patient on the left shoulder naklada is up cuff for measuring blood pressure systolic arterial pressure diastolic arterial pressure medium dynamic and heart rate prior to loading and during loading. The patient offer two sets of 4 letters: 'ÀNEU and BLOG, of which he must choose to remember one. After registration of the hemodynamic parameters within 3 minutes and the memory (30) of the selected set of letters, begin conducting psycho-emotional loads, namely, that the subject pressing notes scattered letters from the selected set of progress on the monitor screen square frames situated in a random sequence the letters of the alphabet. The speed of advancement of the frames in the series of letters in the process of conducting samples increases with 3 letters 1 at the beginning of the load up to 6 letters 1, starting from 6 min load, and this provides a gradual vrabatavaemomu patient. Errors in elevation of letters from a selected set of auditory signals, for which the subject may be oriented in the proper execution of the load and try to adjust its execution. After the load calculates the average value of the BPA, Add, Map. Dean. and heart rate in the periods: prior to loading and during loading. HELL the average dynamic calculated by the formula: Adsin.=Add+[0,42(SBP-Add)].

HELL the average dynamic is difficult to achiev teruya all variables HELL. The test with emotional stress in healthy individuals the HELL the average dynamic changes slightly, and the heart rate usually increases. According to studies, increased heart rate and HELL leads to increased demand of oxygen and increase its energy costs. In pathology, such as angiography with MS in patients of elderly and senile age in a state of spasm, unable to provide the required increased amount of oxygen, which can increase hypoxia, be coming the cerebral circulation, etc.

On the basis of the data used to calculate the functional reactivity, which allows an integrative measure of the increase in hemodynamic load on the heart and, accordingly, the risk of developing cardiovascular complications, defined as follows:

FIU=(Map. Dinks)·/100(used).

The increment values FIU during the transition from rest to execution of the load determines the index:

FIU-PFR-PFR,

where the FIU is the dierence between the values of the FIU before and during loading

PFR - averaged value of the index before load

PFR - averaged value of the index under load.

The relative increment values FIU assess the type of functional reactivity of the cardiovascular system who we are: if set to * then divide by 100 to obtain conventional units (used - the double digits).

When you study in the dynamics of treatment the patient was given to remember a different set of letters in order to prevent addiction.

When the increment values after conducting dosed emotional load FIU from 10 to 20 usled functional type of reactivity is assessed as normal. When the FIU to load more than 20 used, the type of functional reactivity assessed as hyperfunctional. In this case the patient AG with MS elderly and senile age, you must assign at least 3 months in a combination of individualized low-calorie diet, measured static and dynamic loads, daily swimming in the pool at least 15 minutes a day, irbesartan 150 mg in the morning of 1 times and pioglitazone 30 mg in the morning 1 times.

To create a negative energy balance in the body, patients are advised individually selected low-calorie diet. As one of the possible options the following diagram diets.

Calorie daily diet individually for each patient is calculated in kcal by the formula:

for women older than 60 years (0,0377 × body weight (kg) + 2,7545) × 240,

for men older than 60 years (0,0491 × body weight (kg) + 2,4587) × 240.

The resulting coefficient remains unchanged when minimalistische load, is multiplied by 1.3 in moderate and 1.5 - high physical activity (usually in patients of hypertension with MS geriatric physical activity level low).

It is recommended that 3 main meals and 2 intermediate. With regular skipping one meal significantly increases the incidence of obesity, also revealed a positive correlation between obesity and skipping Breakfast. It is recommended that the following distribution of daily calories: Breakfast - 25%, 2nd Breakfast - 10%, lunch - 35%, tea - 10%, dinner - 20%.

To compile menu the patient uses a special table with the instructions of the chemical composition and caloric content of products, given that the main sources of energy: protein (1 g contains 4 kcal), fat (9 kcal), carbohydrates (4 kcal) and alcohol (7 kcal).

The second component of the proposed method is feasible regular physical exercise.

In real life you can implement the three forms of physical activity: 1) morning hygienic gymnastics (charging); 2) health care gymnastics; 3) fractional exercise during the day.

1. Morning hygienic gymnastics (charging).

Morning gymnastics should do after waking up to Breakfast in a ventilated room. Under the influence of training the body is released the t-state inhibition of physiological processes, taking place during sleep.

The sequence of the exercises involves the alternation of load on different muscle groups (arms, legs, body). Exercises are performed with gradually increasing excursion breathing, stretching, limited use of power conditions. Breathing exercise should be free, rhythmic, without delay, mainly through the nose; the exhalation should be longer than the inhale (breath in 2-3 sec, exhale 3-5).

In good health the load, you can increase the number of repetitions faster, increase range of motion and shorter pauses between exercises.

When fatigue should reduce the load, increase the duration of pauses between exercises, to fill their quiet breathing.

After gymnastics, you must go to the rubbing or take a shower.

Morning exercises should evoke a sense of vitality, increase activity, improve well-being and health.

If you feel unwell, develop shortness of breath or pain in the heart and behind the sternum should be temporarily suspend classes and consult a doctor.

During the day, patients are recommended treatment and preventive exercises. Depending on the initial fitness may apply at the beginning of lightweight option exercise, then the enhanced version.

2. Complexes of preventive and curative gymnastics

2.1. The lightweight version of preventive and curative gymnastics.

Exercise 1. Standing. A quiet walk with a gradual acceleration and deceleration 1-2 minutes on the exercise of the gradual deepening of the breath.

Exercise 2. Circular motion in the shoulder joints. When breeding - breath, when the note - exhale with a slight tilt of the torso and retraction of the abdominal wall 6-8 times. The fingers touch the shoulders, elbows close to the torso.

Exercise 3. Standing, hands on his belt. Alternately shifting the weight of the body from one foot to the other with a small bending the legs at the knee joint without lifting the feet from the floor. Exercise done 10-16 times with the muscles of the legs.

Exercise 4. Standing, feet apart at shoulder width, hands on his belt. Bending the trunk forward, touch right hand to left toe. 4-6 times alternately. When straightened position - breath, when the tilt - exhale. To look ahead.

Exercise 5. Standing with arms along the body. At the same time to take straight arm and one leg to the side with alternating lead leg. 4-6 times in each direction in turn. A wave of the hands and feet, breathe freely, do not delay.

Exercise 6. Standing, feet apart, hands in front of chest with palms down. With a turn of the body to dissolve hand in hand with turning the palms up - breath. To return to the source by agenie with a small tilting forward exhalation. 3-5 times in each direction in turn. Breathing to harmonize with the movement of hands and body. By the end of exhalation to engage the wall of the abdomen.

Exercise 7. Standing, hands free. The walk free - 1 min, then with high flexion of the hips - 10-20 movements with subsequent transition to a peaceful walk 1-2 minutes Breathing rhythmic, medium depth.

Exercise 8. Sitting on the edge of the chair, hands on the waist. The bowing of the back and bending forward of the body. Repeat 6-10 times. Breathing is not to delay.

Exercise 9. Sitting on the edge of the chair, the emphasis tassels on the edge of a chair, and your feet slightly in front of the chair. Squats with a focus hands on the edge of a chair - 4-6 times. When you squat exhale.

Exercise 10. Standing sideways to the back of the chair to hold it with one hand. Swing free straight arm with leg pulling back. To return to the original position. Repeat 4-6 times for each leg and arm. Breathing is not to delay.

Exercise 11. Standing, legs apart widely, hands on waist. Turns the body right and left - 6-10 times alternately. The head does not turn, to look forward.

Exercise 12. Standing, feet together, hands down. Move the hands to the sides, inhale, bend the leg at the knee and pressed his hands to his stomach exhale. 3-5 times each leg alternately. Strive to maintain balance; on the exhale, draw your abdomen.

Exercise 13. Standing, feet together, hands pubescent. The side slopes of corpuses flexion of the opposite hand ("pump"). Breathing is not to delay, to strive for greater excursion of movement.

Exercise 14. Standing. A quiet walk with a uniform average depth of breathing. 1-2 minutes

Exercise 15. Lying on the Mat to put under your head with a pillow. Go to a half-sitting position and bent to hug the hips, exhale, return to the starting position and inhale. Breath hold. Strive in a semi-sitting position to maintain balance. Run 4-6 times.

Exercise 16. Lying down, arms at sides, legs apart. A semi-circular motion right straight leg to the left with the rotation of the pelvis - exhale - return to the starting position and inhale. 3-5 times in each direction. Alternately left and right, with the greatest possible excursion movement of the leg, keeping the emphasis brushes the floor.

Exercise 17. Sitting on the floor; a) to stand on all fours; b) to move into position on his knees; hands up - breath, torso, and hands to take back - exhale. When the tilt pull the stomach. Repeat 4-6 times; d) to go into a standing position, and then in the supine position; (e) self-massage of the abdomen small polukrugom movements clockwise - 1-2 minutes Rest 2 min; W) quiet breathing; C) exercise the protrusion (calm) and retraction (active) abdominal wall. The retraction of the abdomen combined with exhale through the mouth. Repeat 4-6 times.

Exercise 18. Standing with arms bent. Energetic walk on mastery in the room with high flexion of the hips and waves hand - 20-30 steps. Breathing is not to delay.

Exercise 19. Sitting on a chair, legs apart, hands on the waist or rest against the edge of a chair. The circular motion of the pelvis with the retraction of the abdomen when moving the pelvis back. 4-6 times in each direction.

Exercise 20. Standing. A peaceful walk with the breath of the average depth of 2-3 minutes

When the source sufficient trained or arising in the course of the practice of tolerance to physical loads, you can use the following set of exercises.

2.2. Enhanced preventive and curative gymnastics.

Exercise 1. Standing. The quiet walk with rubbing the palms of the thorax, abdomen, lower back. Runs 1-2 minutes

Exercise 2. Standing, hands down. Simultaneous bending with tension and free "throwing" hand forward, sideways and upwards of 12-16 times. When you bend exhale, when the alignment of breath.

Exercise 3. Standing, hands on waist, legs shoulder-width apart. Lateral motion of the pelvis to the right and left, back and forth. Is 6-10 times alternately. Breathe freely.

Exercise 4. Standing, feet shoulder-width apart, hands pubescent. Circular motion direct hand in the shoulder joints, 6-10 times with a maximum excursion, breathing, do not delay.

Exercise 5. Standing, hands in front of chest, bent at the elbows. Walking with high flexion of the hips, with a touch of the hand. 6 to 10 times for each leg of poochera the but. Motion of energetic, hip flexion - exhale through the mouth.

Exercise 6. The quiet walk 1-2 minutes

Exercise 7. Sitting on the edge of the chair, hands on the waist. Bending and bowing of the body. The exercise is performed 8-10 times. The energetic movement. When straightening - breath, bending exhale.

Exercise 8. Standing sideways to the chair, to hold back, the other hand on the waist. Alternate sweeps straight leg forward, with the greatest possible tour. Swing legs to be combined with the exhalation. Runs 4-6 times.

Exercise 9. Standing, feet apart, hands at sides. Bending the body forward, touch right brush left toe of the feet, the other hand is allotted up. To return to the original position. Tilt combined with exhalation, by straightening the breath by 4-6 times.

Exercise 10. Walking the quiet breathing of medium depth. 1-2 minutes

Exercise 11. Standing, hands in a fist and lowered: (a) bending of the arms at the elbows with the power and extension of their diverting ago, with possibly large rectification and voltage and delay in the stress state within 2-3 C. Standing, hands on waist; b) proprietary with subsequent lifting in socks and tension legs. The exercise is performed 4-6 times with possibly large rectification and voltage, and the delay in the stress state within 2-3 C.

Exercise 12. Sitting on the edge of the chair. In the raised position and bent colen is m the leg joint to carry out alternately shaking the hands of the calf muscles and thighs. To reduce muscle tension. 1-2 minutes

Exercise 13. Sitting on the edge of the chair, straight leg divorced. Pinch open and direct the hands and feet. When breeding breath, when the note - exhale. Is 4-8 times.

Exercise 14. Standing. The quiet walk with the transition to the rhythmic quiet running (Jogging) on the spot or moving. For fatigue to go on a peaceful walk with the breath of medium depth. 2-5 minutes

Exercise 15. Lying on the Mat. Simultaneous lifting of the body and legs on the exhale. 4-6 times. Arms and legs should be straight, to keep the balance.

Exercise 16. Lying on the Mat, the emphasis brushes the floor. Cross movement straight leg - scissors. 4-8 times. Breathing is not to delay.

Exercise 17. With a quick straightening of the legs to move into a sitting position, then to lie down. You can help stroke 4-6 times.

Exercise 18. Lying on your back, legs bent. Calm breathing 4-6 times.

Exercise 19. Lying on his back, hands diluted with emphasis brushes the floor. With the rotation of the pelvis to the left to bend the legs, rotate the pelvis with legs crossed to the right and stretch the legs. To repeat such a circular motion feet 3-6 times in each direction alternately. Hands not off the floor. Breathing is not to delay.

Exercise 20. Lying on your back, arms and legs separated. Alternate turns the body right and left laying one hand to the other. Legs not smesiteli divorced hands breath, turning exhale. Performed 3-6 times.

Exercise 21. Lying on your back, arms along the body: a) turn on your left side; b) to turn on the right side; C) switch to lying on his stomach; to kneel; d) to move in a standing position; (e) walking on the spot with high flexion of the hips and the movement of the hand - 20-30 steps; g) to sit on the Mat; C) lie on your back, relaxing breath. The whole complex repeat 3-4 times.

Exercise 22. Standing. Walking the quiet breathing of the average depth of 1-2 minutes

Exercise 23. Standing, feet apart on the width of the foot, hands on waist. Circular motion of the pelvis, right and left 6-8 times. Breathing is not to delay.

Exercise 24. Standing with legs wide apart, hands in front of chest. Alternately bending the legs with the transfer to it of gravity of the body with stretching hand to toe of the bent leg. 4-6 times in each direction. The other leg is straight. When straightening - breath, when the tilt - exhale.

Exercise 25. Standing, feet apart at shoulder width, hands on waist. Circular head movements by 4-10 times in each direction.

Exercise 26. Standing, feet apart at shoulder width, hands on waist. Bend trunk to the right, pulling the left arm up - breath. Return to starting position - exhale. 4-6 times alternately.

Exercise 27. The same hands to the shoulders. Circular motion of the brushes with the maximum excursion in the shoulder joints, when RA is doing - breath during the mixing and retraction of the abdominal wall exhale. Breathing deep.

Exercise 28. Standing. A peaceful walk and breath the average depth. The reduction of the total load. 1-2 minutes

3. Fractional exercise during the day.

Sick AG with MS elderly and senile age is the patient with a number of related disorders, primarily the cardiovascular system. This circumstance limits the simultaneous application of a high physical load during morning exercises, as well as in the main lesson, curative gymnastics. This is why increasing the physical activity of persons suffering from, should be implemented through the distribution of physical activity in small doses throughout the day. This method of increasing the physical activity of patients should be considered as a method of fractional loads.

Depending on the real conditions of life of patients suffering from varying degrees of abdominal obesity, you can recommend various exemplary embodiments of the fractional loads to increase physical (motor) activity during the day.

Option 1.

Exercise 1. Sitting - dilute the elbows to the sides, inhale, extend hands forward voltage exhale, 4-6 times.

Exercise 2. Sit - to stand with the deflection of the housing and land - 8-10 times.

Exercise 3. Sitting - imitation of movements Bo is sulfur with possibly a big turn housing - 10-12 times.

Option 2.

Exercise 1. Standing - walking with high flexion in the hip - 16-30 times.

Exercise 2. Standing - circular head movements to the right and left - 3-8 times in each direction.

Exercise 3. Standing legs apart widely imitated the movements of Costa - 10-12 times.

Exercise 4. Sitting - transition into the standing - 10-12 times.

Option 3.

Exercise 1. The quiet walk - 1 min

Exercise 2. Walking fast - 1 minute

Exercise 3. Walking with high flexion of the hips and alternate wave of the hands 20-30 times.

Exercise 4. Walking the quiet breathing of 1-2 min; quiet running on the spot or move around the room - 2-5 minutes

Option 4.

Walk the pedestrian varying length.

Option 5.

Physical work in different ways and with different duration depending on the conditions (cleaning, home services, cleaning, gardening work, and others).

Timely and effective correction of the FIU in patients with MS, elderly and senile age will allow in the short term to normalize the functional reactivity of the cardiovascular system that will reduce these patients of hospitalization, renders prophylactic action against strokes and heart attacks, reduce pathological burden and reduce mortality among patients with hypertension with MS middle-aged and elderly.

P is the iMER 1. Examined the patient B. 62 years, suffering from hypertension of II degree, stage II with MS for 24 years. In the study of hemodynamics in the initial state before conducting psycho-emotional loads the BPA was equal to 150 mm Hg, Add - 95 mm Hg, Map. Dean. - 118,1 mm Hg, heart rate of 82 beats per 1 minute FIU before psychoemotional load was equal to 96.8 used When conducting psycho-emotional loads BPA increased to 176 mm Hg, Add - 106 mm Hg, Adsin. to 135,4 mm Hg, heart rate of 98 beats per 1 minute, the FIU is increased to 132,7 used, i.e. the increment PPV on the load or what is the same - FIU, accounted for 35.9 used (96,8 used to 132,7 used), which can be considered as a manifestation of hyperthyroidism cardiovascular system. The patient is assigned to a combination of individualized low-calorie diet, measured static and dynamic loads, daily swimming in the pool at least 15 minutes, irbesartan 150 mg in the morning and pioglitazone 30 mg in the morning. After 3 months of treatment, the magnitude of the FIU fell before the load compared to the same before the treatment: the BPA - up to 126 mm Hg, Add - up to 85 mm Hg, Adsin. up to 102.2 mm Hg, heart rate up to 68 beats per 1 minute, FIU - 69,5 to used When performing load marked decrease compared with the condition before treatment the increase in value of the BPA - up to 142 mm Hg, Add - up to 86 mm Hg, Adsin. to 109,5 mm Hg, heart rate is 74 beats per 1 min, PF is - to 81,0 used, that is marked increment values FIU, or FIU, 11.5 used (before treatment - 35.9 used), which may be indicative of increased tolerance of the cardiovascular system to psycho-emotional stress, about the reduction of hyperthyroidism cardiovascular system and, consequently, about the economization of cardiac activity.

Example 2. Examined patient K., 78 years old, suffering from hypertension of II degree, stage II with MS for 30 years. In the study of hemodynamics in the initial state before conducting psycho-emotional loads the BPA was equal to 152 mm Hg, Add - 92 mm Hg, Adsin. - 117,2 mm Hg, heart rate of 78 beats per 1 minute FIU before psychoemotional load was equal to 91.4 used When conducting psycho-emotional loads BPA increased to 166 mm Hg, Add - 100 mm Hg, Map. Dean. to 127,7 mm Hg, heart rate is up to 92 beats per 1 minute, the FIU is increased to 117,5 used, i.e. the increment PPV on the load or what is the same - FIU, was 26.1 used (from 91.4 used to 117,5 used), which can be considered as a manifestation of hyperthyroidism cardiovascular system. The patient is assigned to a combination of individualized low-calorie diet, measured static and dynamic loads, daily swimming in the pool at least 15 minutes, irbesartan 150 mg in the morning and pioglitazone 30 mg in the morning. After 3 months of treatment, the magnitude of the FIU dropped prior to the power compared to the same before the treatment: the BPA - up to 130 mm Hg, ADC - up to 80 mm Hg, Adsin. to 101,0 mm Hg, heart rate up to 68 beats per 1 minute, FIU - to 68.7 used When performing load marked decrease compared with the condition before treatment the increase in values of SBP 140 mm Hg, Add - up to 86 mm Hg, Adsin. up to 108.7 mm Hg, heart rate is 74 beats per 1 minute, FIU - up 80,4 used, that is marked increment values FIU, or FIU, 11.7 usled (before treatment) and 26.1 used), which may be indicative of increased tolerance of the cardiovascular system to psycho-emotional stress, about the reduction of hyperthyroidism cardiovascular system and, consequently, about the economization of cardiac activity.

As a result of application of the proposed method of correction of functional reactivity of the cardiovascular system in patients with hypertension and MS elderly and senile patients achieved normalization of the functional reactivity of the cardiovascular system for dosed psycho-emotional stress, which allows you to use the way for the normalization of the tolerance of these patients to emotional stress, which can reduce the degree of hemodynamic load when exposed to stress, reducing the risk of development of psycho-emotional loads adverse cardiovascular reactions (angina, myocardial infarction, ischemic, and others).

<> Method for optimizing the functional reactivity of the cardiovascular system (CVS) in hypertensive patients with metabolic syndrome in middle-aged and elderly, including assessment of functional reactivity SSS during emotional load, which record systolic, diastolic, srednetehnicheskoe pressure (BP Srdan.), heart rate (HR), on the basis of these indicators define the indicator functional reactivity (FIU) before and after exercise, using the formula: FIU=(Adsin.·HR)/100 (used), and with increasing values FIU after load of more than 20 conventional units implement a comprehensive treatment, including a personalised low-calorie diet, calculated in kcal by the formula:
for women 60 years of age (0,0342·weight, kg + 3,5377)·240
over 60 years of age (0,0377·weight, kg + 2,7545)·240
for men: 60 - (0,0484·weight, kg + 3,6534)·240
over 60 years of age (0,0491·weight, kg + 2,4587)·240,
daily swimming for at least 15 min a day, morning hygienic gymnastics and therapeutic exercises during the day, fractional exercise during the day, as well as the introduction of irbesartan 150 mg 1 every morning and pioglitazone 30 mg 1 every morning for at least 3 months.



 

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SUBSTANCE: invention refers to medicine, particularly to cardiology, and concerns normalising the functional responsiveness of cardiovascular system in arterial hypertension. That is ensured by estimating the condition of functional responsiveness of the CVS in psychoemotional load by recording systolic, diastolic, average dynamic pressure and heart rate (HR). These data are used to evaluate a functional responsiveness index (FRI) before and after load by formula: FRI=(BPav.dyn. x HR)100 (standard units). When observing the FRI gain by 20 standard units and more, losartan is prescribed in dosage 50 mg in the morning once a day and lacidipine in dosage 2 mg in the morning once a day for at least 2 months.

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21 cl, 1 tbl, 146 ex

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26 cl, 7 tbl, 13 ex, 20 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiology, and concerns normalising functional reactivity of cardiovascular system (CVS) at arterial hypertension and abdominal obesity. To that end, the state of CVS functional reactivity at psychoemotional stress is assessed by recording systolic, diastolic and average dynamic blood pressure (BP av.dyn) and heart rate (HR). These data serve as the basis for determining functional reactivity index (FRI) prior to and after the stress, according to the following formula: FRI = (BP av.dyn. × heat rate)/100 (conv. un.). If FRI value after stress rises by more than 20 conventional units, complex therapy is implemented including individual hypocaloric diet calculated by a formula considering sex and age, sensibly graded static and dynamic physical exercise as well as administration of irbesartan in a dose of 50 mg once a day, in the morning, over at least 4 months.

EFFECT: complex of drug and non-drug treatment combined with empirically chosen course duration ensures normalisation of CVS functional reactivity among the specified group of patients due to potentiation of certain components of the therapeutic complex.

1 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiology, and concerns normalising functional reactivity of cardiovascular system (CVS) at arterial hypertension and abdominal obesity. To that end, the state of CVS functional reactivity at psychoemotional stress is assessed by recording systolic, diastolic and average dynamic blood pressure (BP av.dyn) and heart rate (HR). These data serve as the basis for determining functional reactivity index (FRI) prior to and after the stress, according to the following formula: FRI = (BP av.dyn. × heat rate)/100 (conv. un.). If FRI value after stress rises by more than 20 conventional units, complex therapy is implemented including individual hypocaloric diet calculated by a formula considering sex and age, sensibly graded static and dynamic physical exercise as well as administration of losartane in a dose of 50 mg once a day, in the morning, over at least 4 months.

EFFECT: complex of drug and non-drug treatment combined with empirically chosen course duration ensures normalisation of CVS functional reactivity among the specified group of patients due to potentiation of certain components of the therapeutic complex.

1 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiology, and concerns normalisation of cardiovascular system (CVS) functional reactivity among patients suffering from arterial hypertension at the stage of recovery form cerebral circulation disorder without pareses or paralyses. To that end, the state of CVS functional reactivity at psychoemotional stress is assessed by recording systolic, diastolic and average dynamic blood pressure. These data serve as the basis for determining functional reactivity index (FRI) prior to and after the stress, according to the following formula: FRI = (BP av.dyn. × heat rate)100 (conv. un.). If FRI value after stress rises by more than 20 conventional units, telmisartan and labetalole are administered in doses of 40 mg per day and 200 mg twice a day respectively.

EFFECT: method normalises functional reactivity of cardiovascular system and increases tolerance to psychoemotional stresses at the specified group of patients during a 2 month course of therapy.

2 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiology, and relates normalisation of cardio-vascular system functional reactivity in case of arterial hypertension with metabolic syndrome. For this purpose evaluation of CVS functional reactivity state under psychoemotional load is performed by registration of systolic diastolic, mean dynamic pressure and heart beat rate (HBR). On the basis of said data functional reactivity index (FRI) is determined before and after the load by the formula: FRI=(APav.dyn.x HBR)100 (conv.unit). If FRI is higher than 20 conv.units complex treatment including individually composed hypocaloric diet, which is calculated by formula taking into account sex, age and body weight, reasonably dosed static and dynamic physical loads, as well as introduction of valsartan 80 mg 1 time in the morning and pioglitazone 30 mg 1 time in the morning during not less than 3 months.

EFFECT: said complex of medicinal and non-medicinal therapy in combination with empirically selected treatment duration ensure normalisation of CVS functional reactivity in said group of patients due to potentiation of therapeutic effect of certain components of medicinal complex.

2 ex

FIELD: medicine.

SUBSTANCE: invention concerns normalising functional reactivity of cardiovascular system (CVS) in arterial hypertension, dyslipidemia, impaired glucose tolerance and abdominal obesity. That is ensured by estimating the condition of functional reactivity of the CVS in psychoemotional load, with recording systolic, diastolic, average dynamic pressure (PBav.dyn.) and heart rate (HR). These data are used to evaluate a functional responsiveness index (FRI) before and after stress by formula: FRI=(BPav.dyn. x HR)/100 (standard units). The post-load value PFR increased more than by 20 standard units requires the complex therapy including individually prescribed hypocaloric diet calculated by formula considering sex and age, rationally graduated static and dynamic physical activity, and introduction of losartan in a dose of 50 mg once in the morning, and pioglitazone in a dose of 30 mg once in the morning at least within 4 months.

EFFECT: such complex drug-induced and drug-free therapy combined with empirically prescribed treatment length provides normalisation of functional reactance of the CVS in the given group of the patients due to potentiation of therapeutic effect of separate components of an individual care.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely cardiology, and concerns normalising functional reactivity of cardiovascular system (CVS) in arterial hypertension and impaired glucose tolerance. That is ensured by estimating the condition of functional reactivity of the CVS in psychoemotional load by recording systolic, diastolic, average dynamic pressure (BPav.dyn.) and heart rate (HR). These data are used to evaluate a functional responsiveness index (FRI) before and after stress by formula: FRI=(BPav.dyn. x HR)/100(standard units). The post-load value PFR increased more than by 20 standard units requires the complex therapy including graduated static and dynamic physical activity, and introduction of irbesartan in a dose 150 mg in the morning once a day and pioglitazone in a dose 30 mg in the morning once a day at least within 4 months.

EFFECT: complex of drug-induced therapy combined with physical activity and empirically prescribed treatment length provides normalisation of functional reactivityof the CVS in the given group of the patients due to potentiation of therapeutic effect of the used drugs.

1 ex

FIELD: medicine.

SUBSTANCE: invention concerns treatments of the conditions caused by pathological metabolism of glucose and lipids. That is ensured by administration of cystamine or its salt in effective doses.

EFFECT: invention provides normalisation of such factors as C-peptide, uric acid, microalbumin, adiponectin.

17 cl, 11 tbl, 6 ex, 10 dwg

FIELD: medicine.

SUBSTANCE: present invention presents a preparation to reduce insulin resistance. The preparation contains 3-O-v-D-glucopyranosyl-4-methylergost-7-ene-3-ole, or an extract made with using an organic solvent, or an extract made with using hot water, or a drained liquid of a plant of Liliaceae family, or fraction thereof which contains this compound as an active component.

EFFECT: production of the preparation which is suitable for inhibition of adipocytokine production, particularly adipocytokine which cause insulin resistance, and for prevention of pathological conditions caused by insulin resistance, or simplification of clinical course of said pathological conditions.

9 cl, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to cardiology and endocrinology, and concerns normalisation of thromboplastin formation in patients suffering from arterial hypertension with impaired glucose tolerance. That is ensured by integrated treatment including graduated static and dynamic physical exercises, and also introduction of pioglitazone in a dose 30 mg once in the morning and a lisinopril in a dose 10 mg once a day in the morning during 1.5 months.

EFFECT: complex of specific medical agents and physical activity combined with empirically specified duration of treatment provides normalisation of thromboplastin formation that in turn reduces risk of thrombotic complications in given group of patients.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to haematology, cardiology and endocrinology, and concerns correction of blood microvesicle level in arterial hypertension with impaired glucose tolerance. That is ensured by integrated treatment including graduated physical exercises, and introduction of Fosinopril in a dose 10 mg once in the morning and pioglitazone in a dose 30 mg once in the morning. Therapeutic course is at least 7 weeks.

EFFECT: complex of drug-free modalities and specific pharmacological preparations combined with empirically specified time of treatment provides maintained optimum microvesicle level that in turn allows considerably reducing risk of thrombotic complications in given group of patients.

1 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely haematology, cardiology and endocrinology and concerns correction of blood microvesicle level in arterial hypertension (AH) and pancreatic diabetes type II (PD II). That is ensured by integrated therapy involving graduated physical exercises, as well as introduction of lisinopril in a dose 10 mg once in the morning, amlodipine in a dose 5 mg once in the morning and pioglitazone in a dose 30 mg once in the morning for therapeutic course at least 7 weeks.

EFFECT: complex of specific medical preparations and physical exercises combined with empirically specified duration of treatment provides effective correction of blood microvesicle level and, thereby, reduced risk of thrombotic complications in given group of patients.

1 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely haematology and endocrinology, and concerns normalisation of thrombocyte sensitivity to aggregation inducers in patients suffering from arterial hypertension with impaired glucose tolerance. That is ensured by integrated therapy including graduated physical exercises, and introduction of lisinopril in a dose 10 mg once a day in the morning and pioglitazone in a dose 30 mg once a day in the morning. Therapeutic course lasts for at least 6 weeks. The method enables complete normalisation of thrombocyte sensitivity to aggregation inducers owing to potentiation of therapeutic effect of certain components of integrated therapy.

EFFECT: that in turn allows reducing risk of thrombotic complications in given group of patients.

1 ex, 3 dwg, 2 tbl

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely haematology, cardiology and endocrinology, and covers correction of thrombocyte intravascular activity in patients suffering from arterial hypertension with impaired glucose tolerance. It is ensured by integrated treatment including graduated static and dynamic loading, and introduction of pioglitazone in a dose 30 mg once a day in the morning and lisinopril in a dose 10 mg once a day in the morning.

EFFECT: such complex of specific medical agents and physical activity provides short-term - within 1,5 months - normalisation of thrombocyte intravascular activity that in turn reduces risk of thrombotic complications in given group of patients.

1 ex

FIELD: chemistry.

SUBSTANCE: in the formula (I) , R1 is metoxymethyl; R2 is selected out of -C(O)NR4R5, -SO2NR4R5, -S(O)PR4 and HET-2; R3 is selected out of halogeno, fluoromethyl, metoxy and cyano; HET-1 is 5- or 6-member heteroaryl ring linked by C atom and containing nitrogen atom in 2 position and possibly 1 or 2 additional ring heteroatoms selected independently out of O, N and S, which is possible substituted at available carbon atom or at ring nitrogen atom by 1 substitute selected independently out of R6, provided that it would not cause ring quaternisation. The other radicals are indicated in the invention claim. Also invention refers to pharmaceutical composition containing claimed compound as active component, and methods of obtaining compound of the formula (I).

EFFECT: compounds with glucokinase inhibition effect.

19 cl, 2 tbl, 61 ex

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