Clinical features of resistant (refractory) arterial hypertension
*Chair of Internal Medicine Propaedeutics; Internal Medicine №2 Avicenna TSMU
The significance of clinico-laboratorial and hemodynamic manifestations of arterial hypertension (AH) in resistance appearing to ongoing antihypertensive therapy (AHT) is studied. During the year, a clinical observation of patients with resistant and nonresistant hypertension to antihypertensive treatment, analyzed the relationship of significant risk factors for cardiovascular complications with the efficiency of ongoing combination therapy. Found that patients with resistant (refractory) hypertension (RAH) is characterized by large fluctuations in blood pressure, particularly SAP, which is reduced with medical therapy only during the day time (214,8±4,3 and 204,0±3,1 mm Hg . cent.), remaining without significant fluctuations in the night (193,3±4,1 and 187,8±3,5 mm Hg. Art., respectively, before and after treatment), and therefore, this factor can be considered as having a causal relationship with the development of resistance to therapy. Shown that RAH currency is labile, increased hospitalization for complications (8,2±0,5 and 5,5±0,4%, respectively, for RAH and AH), early organ damage caused by combined effect of hyperlipidemia, thrombophilic status and hemodynamic changes that accelerate the development of atherosclerosis with increased periods of his instability and increased risk of cardiovascular complications.
Keywords: resistant (refractory) hypertension, hemodynamic changes, lipids, endothelial dysfunction.
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