Abstract
Background: The objective is to study the time-dependent hemodynamic effects of altiazem PP-180 and the blood circulation parameters in patients with arterial hypertension of the II degree in outpatient polyclinic conditions.Methods: The study included 78 patients with essential II grade AH aged 42 to 73 years (mean age of 57.65 ± 0.6). Among them were 28 men and 50 women. The duration of the disease ranged from 4 to 23 years (an average of 9.2 ± 0.12). All the groups involved in the research were divided into two subgroups: the main group and the control group. The control group included 30 patients, who took A-180 once a day at non-fixed hours. The main group included 48 patients, who were divided into random subgroups depending on the time they took A-180 once a day. Within 3 days prior to treatment and during the 10-day treatment course, the medical staff measured all the pateints’ heart rate and blood pressure by NC Korotkoff every 3 hours, 6 times a day. The patients’ heart rate and blood pressure were alternatively self-measured. Prior to treatment and at the end of the 10-day course of therapy with altiazem PP-180, all the patients involved in the research underwent ECG examination and echocardiography on the Aloka machine (Japan).Results: The most favorable hemodynamic support for the hypotensive effect of altiazem PP-180 was observed when patients took it at 7 a.m., 10 a.m. and 10 p.m. in their normal mode of work and rest. When patients took altiazem PP-180 at 1 p.m, 4 p.m. and 7 p.m., its hypotensive effect was due to less favorable hemodynamic support.Conclusions: When taken at different hours of the day - both fixed and non-fixed hours - altiazem PP-180 caused a distinct hypotensive effect in patients with the II degree AH in outpatient polyclinic conditions.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.360-368
Highlights
The problem of optimization of a long-term supportive therapy of uncomplicated arterial hypertension (AH) is one of the most urgent issues in modern cardiology
Altiazem РР-180 causes a clear hypotensive effect in II degree AH patients when administered at different intake times both fixed and random under outpatient conditions
The most evident hemodynamic effect of the hypotensive action of Altiazem PP-180 can be observed when administered at 07.00 a.m.; 10.00 a.m. and 10.00 p.m. with a normal work-rest routine
Summary
The problem of optimization of a long-term supportive therapy of uncomplicated arterial hypertension (AH) is one of the most urgent issues in modern cardiology. While analyzing Chrono responsiveness to Altiazem PP the following criteria had to be considered: 1) set-in time for the stable clinical and hypotensive effect in days; 2) SABP, DABP, average ABP, DP within 24 hours prior to, during and after treatment; 3) SD, CI, CMO, SVI, TPR, PVRI, LVM dynamics prior to and after treatment; 4) mechanism of Altiazem PP-180 hypotensive effect; 5) changes in daily ABP, HR, DP profile prior to, during and at the end of the course of treatment; 6) characteristics of the 24-hour rhythm of all researched parameters, including MESOR, amplitude, and acrophase; 7) Determination of circadian rhythm of SABP, DABP, average BP, HR and DP prior to, during and at the end of the course of treatment by Altiazem PP-180. Considering the obtained results it has been concluded that it is reasonable to administer Altiazem PP-180 to patients at 07.00 a.m., 10.00 a.m., and 10.00 p.m. when the drug shows the most evident hypotensive effect
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