Prevention Of Arterial Hypertension Research Articles

Level of knowledge about prevention of arterial hypertension in patients without this disease

Level of knowledge about prevention of arterial hypertension in patients without this disease

Arterial hypertension prevention among workers of oil refining industry

Arterial hypertension prevention among workers of oil refining industry

Physiological and hygienic validation of the health benefits of garlic salt to prevent arterial hypertension

Introduction. From hygienic point of view, the consumption of table salt (TS) neither below nor above the physiological norm is relevant to ensure normal biochemical processes of sodium metabolism in the body. The aim of the study was a physiological and hygienic validation of the health benefits of Adyghe garlic salt (GS), made by using traditional technology, for optimizing the level of NaCl consumption and prevention arterial hypertension. Materials and methods. Seventy-one adolescent girl aged 12-15 years and 124 women aged 38.5±4.2 years of Adyg nationality took part in the studies. The attitude to GS and the level of its consumption were revealed by the method of focus groups, questionnaires and analysis of 3-day diets. Blood pressure indicators were determined by the oscillometric method, the content of albumin in morning urine - by the ICA method, the taste sensitivity threshold to salt (STST) - by the density measurement method, the efficiency of achieving a salty taste when using GS - by the tasting analysis method. Results. Adolescent girls and women from families regularly using garlic salt (GS) in home cooking have been found to have low levels of NaCl consumption (LLNaClC). In families that do not use GS in practice, a high level of NaCl consumption (HLCNaCl) is detected. The STST values are reliably lower in LLNaClC groups . GS compared to TS is more effective in achieving salty taste by 23.2±1.84%. In the group of women with LLNaClC, blood pressure indices are lower, microalbuminuria is not detected. Limitations. To substantiate the effectiveness of the use of GS to optimize the level of NaCl consumption and to carry out prevention of arterial hypertension, we took only female persons of the Adyghe nationality as participants of research. In the future, it is planned to expand research taking into account gender and national aspects. Conclusion. GS reduces the NaCl consumption without disturbing hedonistic perception of taste. Increasing public awareness of the benefits of GS in achieving salty taste and its widespread introduction into the modern nutritional system of various populations can be an effective hygienic approach to optimizing NaCl consumption, and reducing the risk of arterial hypertension.

Вплив соціальних медіа на профілактику артеріальної гіпертензії

Наведено результати аналізу впливу соціальних медіа на профілактику артеріальної гіпертензії. Проаналізовано наявний стан та можливості використання соціальних медіа для інформування, попередження та моніторингу обізнаності населення щодо факторів ризику артеріальної гіпертензії та формування здорового способу життя та можливі ризики пенетрації соціальних медіа у медицину.

К вопросу развития артериальной гипертензии у городских жителей с ожирением

Актуальность исследования обусловлена необходимостью оптимизации профилактики артериальной гипертензии (АГ) среди городского населения Украины, в первую очередь с ожирением (Ож). Цель: детализировать особенности развития АГ у городских жителей с Ож, разработать метод прогнозирования АГ на основании определения особенностей взаимодействия параметров, которые характеризуют основные звенья патогенеза обеих патологий. Материалы и методы. Обследованы 1094 жителя г. Харькова, которые не лечились в прошлом по поводу Ож и АГ. Определяли индекс массы тела, окружность талии, измеряли артериальное давление. Методом биоимпедансного анализа исследовали состав тела пациентов, иммуноферментным методом — уровни инсулина, лептина, ренина, альдостерона и кластерина в сыворотке крови. Особенности центральной гемодинамики оценивались методом интегральной реографии тела: определяли ударный объем (мл), сердечный выброс (л/мин), ударный индекс (мл/м2), сердечный индекс (л/мин • м2). Результаты. Городские жители среднего возраста с ожирением нуждаются в интенсификации профилактической работы в отношении АГ. У мужчин ее нужно начинать уже в возрасте до 40 лет. Развитие сочетанной патологии (АГ и Ож) у лиц среднего возраста обусловлено наличием инсулинорезистентности, которая сопровождается изменениями циркулирующих уровней инсулина, лептина, альдостерона, изменениями ударного индекса и общего периферического сопротивления сосудов, возникновением системного низкоинтенсивного воспаления в организме. К факторам, которые в первую очередь обусловливают развитие и прогрессирование Ож у данной категории населения, следует отнести проявление инсулинорезистентности. Определение с помощью метода интегральной реографии тела изменений ударного индекса — информативный маркер развития и прогрессирования АГ. Наличие сочетанной патологии (АГ с Ож) характеризируется изменениями уровней лептина и кластерина по сравнению с пациентами с Ож без АГ, что также нужно учитывать при разработке терапевтических подходов. Выводы. Выявленные в процессе работы подходы к прогностической классификации, созданной с помощью дискриминантного анализа, городских жителей среднего возраста — представителей украинской популяции могут стать основой для оптимизации алгоритмов формирования средних групп риска развития Ож и АГ.

MEDICO – SOCIAL SUBSTANTIATION OF THE CONCEPT OF PERSONALIZED MEDICINE IN THE PREVENTION OF ARTERIAL HYPERTENSION AMONG THE ADULT POPULATION AT THE REGIONAL LEVEL

The aim: Is to scientifically substantiate the concept of personalized medicine in the prevention of arterial hypertension (AH) among the adult population at the regional level. Materials and methods: The study, after obtaining informed consent, involved 2000 patients, residents of Zaporizhzhia Region, including 1000 patients (average age 59±0.5 years, the ratio of men to women 1:1.22 people) with and 1000 patients (average age of whom is 62±0.7 years, the ratio of men to women is 1:1.1) without AH. The data of the sociological survey were processed, the methods of mathematical modeling, statistical, system analysis were applied. Odds ratio (OR) is determined by generally accepted methods with the calculation of 95% of confidence interval (CI). Results: The application of the concept of personalized medicine in the prevention of AH among the adult population has been scientifically substantiated by studying the associations between medical and social risk factors and the development of AH and determining on their basis 3 modules - "risk behavior", "adverse health factors" and "social determinants of the development of AH", based on stepwise multiple logistic regression analysis. Conclusions: It has been proved that the use of the final prognostic model of the development of arterial hypertension with the inclusion of the most significant risk factorshas high operational characteristics: sensitivity - 78.6%, specificity - 96.6%, positive predicative value - 95.85%, negative predicative value - 81.86%, the area under the ROC curve is 0.9623. The application of the concept of personalized medicine in the prevention of this disease among the adult population was substantiated by studying the associations between medical and social risk factors and the development of arterial hypertension.

Integrative assessment of candidate gene polymorphisms distribution by forming a gene modification index in arterial hypertension with and without obesity: a new perspective in cardiology management

Abstract The concept of evolutionary accumulation of candidate gene polymorphisms in the realization of the hypertensive phenotype becomes promising in understanding of arterial hypertension (AH). A large amount of data about genetic polymorphisms in population have been accumulated and perspective approaches to their integrative assessment are being formulated for practical management. The purpose of the research was to analyze and compare the proportion of modified candidate genes (CG) in the group of hypertensive patients with and without obesity with the group of non-hypertensive patients by calculating the gene modification index (GMI) for the assessment of possible usage of genetic stratification in the management of AH. Methods 106 patients with AH and obesity (age 46.2 [24–72], m/f 79/27), (group 1), 96 hypertensive patients without obesity (age 48.3 [26–75], m/f 72/24), (group 2) and 98 non-hypertensive patients (age 41.6 [26–69], m/f 39/59), (group 3) (ESC/ISH 2018, WHO 1997) were examined. The analysis of polymorphisms of the following CG by PCR was perfomed: ADD1: 1378, AGT: 704, AGT: 521, AGTR1: 1166, AGTR2: 1675, CYP11B2: −344, GNB3: 825, NOS3: −786, NOS3: 894. The GMI which represents the percentage of “pathological” genotypes was formed and calculated by the formula: GMI = (N/13.5) × 100, where N is the sum of points of present GP (“pathological” homozygous was 1,5 points, heterozygous – 1 point, “normal” genotype – 0 points); 13.5 – maximum number of points. The GMI from 0 to 20% was considered as low genetic risk (GR), from 21 to 40% – moderate GR, from 41 to 70% – high GR, from 71 to 100% – very high GR. Results In patients with AH and obesity, a low GR was in 4 (3.8%), in the group of hypertensive patients without obesity – 13 (13.5%), in normotensive patients – in 81 (82.7%) (p1–3 = 0.0001, p2–3 = 0.0001, p1–2 = 0.02). Moderate GR was observed in 21 (19.8%) patients of the 1st group, in 25 (26%) patients of the 2nd group and in 12 (12.2%) patients of the 3rd group (p1–3 = 0.07, p2–3 = 0.01, p1–2 = 0.02). 54 (50.9%) patients of group 1, 41 (42.7%) patients of group 2 and 5 (5.1%) of patients of group 3 had a high GR (p1–3 = 0.0001, p2–3 = 0.0001, p1–2 = 0.08); a very high GR was in 27 (25.5%) patients of the 1st group, in 17 (17.8%) of the 2nd group and was absent in the patients of the 3rd group (p1–3 = 0.0001, p2–3 = 0.0001, p1–2 = 0.02). The average GMI in group 1 was 66.2% [CI 95%, 20–78], in group 2 – 56.4% [CI 95%, 18–72], in group 3 – 22% [CI 95% 5–41], (p1–3 = 0.0001, p2–3 = 0.0001, p1–2 = 0.04). Conclusions It was revealed a strong significant predominance of the proportion of modified CG in hypertensive patients with and without obesity compared with non-hypertensive patients. There was a moderate significant difference between hypertensive patients, depending on the presence of obesity. Evaluation of GMI is a perspective direction in the diagnosis and prevention of AH and can be used in practical management. Funding Acknowledgement Type of funding source: None

Methods of Physiotherapy in the Medical Rehabilitation of Children with Primary Arterial Hypertension

Introduction. Arterial hypertension (AH) is a widely occurring disease of the cardiovascular system in the children’s population, which often debuts in childhood, persists into adulthood, which dictates the need for early treatment and prevention of arterial hypertension. The formation of AH is associated with maladaptation of physiological mechanisms of self-regulation, with a complex interaction of psychosocial and genetic factors. The use of non-medicinal agents to reduce blood pressure is a starting approach in the treatment of children and adolescents with hypertension and complements medication therapy. Purpose. analysis of literature sources on the effectiveness of hardware physiotherapy methods in the treatment of hypertension in children. Discussion. In the treatment of children with hypertension, the leading role belongs to hardware physiotherapy technologies. Widely used sedative, hypotensive and vegetative-corrective methods are pathogenetically justified and can be used at all stages of arterial hypertension development. Transcranial pulsed electrotherapy (transcranial electrostimulation, electroson, infitotherapy), darsonvalization, aromafitotherapy and medicinal electrophoresis of sedatives belong sedative methods aimed at enhancing inhibitory processes in the Central nervous system. Amplipulster therapy, intermittent normobaric hypoxytherapy, low-intensity magnetic therapy, medicinal electrophoresis of spasmolytic drugs, EHF therapy, laser therapy, which lead to a decrease in arterial hypertension and improve microcirculation, are hypotensive methods. Bio-controlled aerionotherapy, aimed at correcting vegetative dysfunction, is a vegetative corrective method. Conclusion. Currently, there is a wide range of scientifically-based methods of hardware physiotherapy used in the medical rehabilitation of children with arterial hypertension, allowing to improve cerebral hemodynamics, normalize neurophysiological and hemodynamic processes in the Central nervous system, provide sedative and hypotensive effects, stimulate peripheral vasodepressor mechanisms, normalize neuroendocrine processes. The use of hardware physiotherapy methods in the complex treatment of hypertension can improve the quality of life of patients, achieve stable normalization of blood pressure, and reduce the risk of early cardiovascular diseases.

ANALYSIS OF RELATIONSHIP BETWEEN STRESS FACTOR AND FUNCTIONAL STATE OF CARDIOVASCULAR SYSTEM IN ADOLESCENTS

A variety of factors influence the performance of schoolchildren. The main factors are psycho-emotional stress and systematic physical activity that requires a constant tension of body's regulatory systems aimed at mobilizing the functional body reserves. The analysis of blood pressure enables to estimate quantitative and qualitative changes in the regulation of the cardiovascular system. The combination of the Stroop test and the monitoring of the cardiovascular system make it possible to assess not only attention and cognitive function parameters, but the phases of the stress response of regulatory systems as well. The purpose of the study was to analyze the relationship between stress factor and the functional state of adolescent cardiovascular system. In the context of stress factor (Stroop test), the circulatory system of students gets activated, and its indicators vary differently among boys and girls. At rest, girls have the lowest performance of the circulatory system. Before the test, heart rates vary in boys and girls in different ways. In the course of our study, we have found out a direct relationship between heart rate, blood pressure before and after psycho-emotional load that testifies the predominance of the sympathoadrenal system activity. We have revealed the arterial hypertension is determined by physiological and social factors. Prevention of arterial hypertension in existing standards of schools requires reconsidering and improving of educational approaches, especially in terms of physical education.

4-9FEATURES OF HOMOCYSTEINE LEVEL AND A POTENTIAL WAY OF IT'S CORRECTION IN HYPERTENSIVE PATIENTS

Background: Arterial hypertension (AH) is one of the most wide-spread cardiovascular pathology all over the world. Initiation and progression of AH are linked to many potentially modified metabolic factors, for example-hyperhomocysteinemia. Despite the fact that diagnostics, treatment and prevention of AH is evident, key risk factors correction are still concealed at present. Aim: To study the features of serum HH in hypertensive patients and optimize treatment strategy. Methods: According to the aim of our investigation, we examined 74 high cardiovascular risk level hypertensive patients (before and after 12-weeks of atorvastatin 20 mg per day oral administration based on their standard hypotensive treatment) and 68 healthy volunteers (equivalent with group of observation in age and gender representation) with fasting homocysteine plasma level via ELISA. The statistically significance was considered at P < 0,05. Results: It's set that AH is associated with fasting homocysteine plasma concentration 2,22 times more (P < 0,01) opposite to healthy subjects, that was according to mild level of hyperhomocysteinemia. Besides, it was found that additive 12-weeks treatment with atorvastatin (based on specific antihypertensive approaches) leads to clinically significant reduction of homocysteine plasma level by 28,78% (P < 0,05) in the hypertensive patients. Conclusions: HH is stationed as a key metabolic risk factor in way of arterial hypertension's formation and progression over the high cardiovascular risk population. At the same time, specific hypolipidemic and antiatherosclerotic treatment based on regular atorvastatin administration can be counted as an effective way of reducing elevated plasma homocysteine level and shows alternative pleiotropic effect of statins in AH patients.

IDENTIFICATION OF RISK FACTORS IN ARTERIAL HYPERTENSION PATIENTS WITH PARTICIPATION OF A NURSE

Arterial hypertension (AH) is the most frequent among cardiovascular diseases (CVD).About 31% of people suffer from it. The data of epidemiological studies indicate thatoccurrence of the disease is considerably caused by the level of modified and nonmodified risk factors (RF).Under conditions of reforms in the health care system of Ukraine implementation ofqualitatively new measures concerning AH prevention and activity to form a healthy lifestyle have become rather important. Management of a complicated behavior and life styleof AH patients requires experience and mutual efforts of various medical professionals.Professional competence of nurses enables to involve them in realization of up-to-datetechnologies in order to prevent diseases and strengthen health.Timely detection of RFs, elimination of their action, organization of patients’ education isone of the important tasks of nurses.Purpose of the study. To investigate the effect of modified risk factors on the developmentof arterial hypertension and determine the role of a nurse in the management of thedisease on the level of primary health care.Material and methods. 120 AH patients were involved into the study by means of a surveyincluding 43,3% of men and 56,7% of women aged from 23 to 79 (48,33±12,93). Theirarterial pressure was measured and risk factors were found. The results obtained wereprocessed by means of the common statistical methods using the packages of computersoftware STATISTICA V.6.0. The results of the study are presented in the number ofobservations, percentage, and accurate p value.Discussion. The period of arterial hypertension varied widely, though the majorityof patients (82%) suffered from it more than 10 years. The main part of patients – 73(60,83%) were afflicted with I degree of AH, 29 patients (24,17%) had II degree and 18individuals (15%) – III degree. The overweight patients and those with I – II degree ofobesity prevailed (81,67%). For example, 60 patients (50%) had android (abdominal)type of the adipose tissue distribution, which is indicative of metabolic disorders in thebody. All the patients were diagnosed to have moderate and high levels of psychosocialstress, which might be associated with an intensive and stressful life style. The majority ofpatients were characterized by a low (62,5%) and moderate (34,12%) levels of physicalactivity; and only 3,33% of them had sufficient level of physical activity. The surveyfound that 42 (35%) individuals smoked having a mixed type of smoking habits, moderate(40%) and mild (31%) degree of nicotine abuse. The majority of patients mentionedexcessive intake of salt, fats and cholesterol, disturbed dietary habits, insufficient intakeof vegetables and fruit.Conclusions. The amount of modified risk factors promoting development ofcardiovascular diseases increases in AH patients with age. Detection of RFs, educationof patients concerning their elimination is an integral part of nurse’s everyday work. Itwill promote improvement of life quality, prevention, optimization of a comprehensivetreatment and stabilization of arterial hypertension.

Arterial hypertension prevention as an actual medical and social problem

Social changes, technological re-equipment, intensive formation of urban infrastructure have led to a constant increase in stress factors and an excessive growth of the nervous and psychological population burden. As a result of these processes in economically developed countries, acute diseases are becoming less and less significant, unlike the group of chronic disorders, such as arterial hypertension. Data from the review of the literature and the data we have received indicate that there is an increase in the level of cortisol in the blood in the phase of anxiety, which reduces in the resistance phase. A significant role is played by another hormone - insulin, which plays a key role in the development of the general adaptive syndrome. Through it the body implements numerous counter-defects in relation to the regulatory influence of catecholamines and cortisol. In conditions of prolonged stress, the level of insulin in the blood decreases and diabetes develops. The effect of cortisol and catecholamines in the resistance phase persists. The level of oxidative modification of blood plasma proteins indices depends on the behavior of the individual and changes in his psycho-emotional state, while a prolonged increase in the levels of catecholamines and cortisol in peripheral blood causes the development of psychosomatic pathology. It is proved that under the influence of complex action of risk factors there are significant changes in the psycho-emotional state that cause hypertension. This is confirmed by the presence of the highest level of reactive anxiety in patients with hypertension of the 1st stage on the background of the lowest personal anxiety which is the basis for the occurrence of the disease. With the progression of hypertension there are more profound changes in the personality of the patient, which is accompanied by the accumulation of personal anxiety, which can lead to a depressive state of neurotic genesis, which we observed with its complication. On the basis of a comprehensive study, the effect of stress on the occurrence of a syndrome of psychoemotional stress is shown, which leads to a steady increase in blood pressure - hypertension, and with its subsequent action complicates its course.
 Bangladesh Journal of Medical Science Vol.19(4) 2020 p.722-729

Known–Unknowns in Geriatric Cardiology

The present article summarizes the current state of understanding in geriatric cardiology in terms of the main developments in the field. The focus of the present review is on the therapeutics, into the specific characteristics of the elderly pa­tients dealing with the prevention of arterial hypertension, bradycardic arrhythmias, atrial fibrillation, coronary artery syndromes, valve heart diseases, and heart failure. Progress in the field of medicine has rendered it possible to treat lethal cardiac diseases in the extremely old pa­tients. Nonetheless, data regarding the very old cardiac patients are limited, and it is dangerous to directly extrapolate the experi­ence with the young patients to the old ones. ● Preventive therapies are important in the old cardiac patients, although these therapies differ from those for young patients. ● Very old patients with arterial hypertension benefit from antihypertensive treatment, although the therapeutic strategy of one-size-fits-all cannot be applied. ● Elderly patients often require a cardiac pacemaker. In the case of patients with sinus node dysfunction, pacing modes capable of preserving atrioventricular syn­chrony are associated with a reduced incidence of atrial fibrillation. In the case of patients with atrioventricular block, the importance of synchronization is debatable. Implantable cardioverter-defibrillators may be used in very old patients, although a limited number of studies evidencing this in elderly patients are available. ● In very old patients with atrial fibrilla­tion, ablative therapies are seldom used. OAC is useful in such cases, although the HAS-BLED score is inadequate for as­sessing the real bleeding risk in the old people. ● Patients who are ≥80 years old and exhibit acute coronary syndromes would benefit more from a myocardial revascularization compared to a medical therapy, while in the patients who are ≥90 years old, revascularization and medical therapy are equivalent. ● In the very old patients with severe aortic stenosis, transcatheter valve replacement is safe and efficient, while antithrombotic therapy is problematic. The treatment of mitral regurgitation is different in the very old and the young patients; the mortality is high and there is no consensus on the best therapy. Tricuspid regurgitation is recognized as a serious problem in certain old cardiac patients; however, the best therapeutic approach to this problem has not been discovered so far. ● Information regarding the geriatric patients with heart failure is inadequate due to lack of clinical details in the population-based studies and because clinical trials typically enroll younger patients. Elderly patients with heart failure constitute a heterogeneous group and differ substantially from the younger patients enrolled in the clinical trials. The limited data indicate that a proven therapy for heart failure that reduces mortality and morbidity in the younger pa­tients is also beneficial in elderly patients. However, elderly patients exhibit different responses to the pharmacotherapy in comparison to the younger patients, as the former are susceptible to adverse events, such as orthostatic hypoten­sion, renal dysfunction, electrolyte disturbances, and interactions with the medications prescribed for the treatment of comorbidities. Close monitoring of elderly patients undergoing HeFa treatment is essential to ensure optimal outcomes. The number of old people is large, and progress in the field of medicine has made it possible to treat lethal cardiac diseases in very old patients. Certain individuals are biologically younger in comparison to their anagraphic age; however, geriatric patients are often frail and exhibit much comorbidities. The demand for invasive therapies and novel drugs has led to rapidly increasing expendi­tures. Practicing cardiologists are encountering in­creasing number of consultations for very old patients. This creates a requirement for training a greater number of geriatric cardi­ologists to offer the best of care to the old patients. Owing to the comorbidities, several of which are critical in nature, in the elderly patients, the geriatric cardiologists must be, first of all, master internists at all times. Old patients, with their peculiar pharmacokinetics and multiple illnesses, are also oversensitive to drugs. Several aspects of geriatric cardiology are unknown even now. There is a necessity to understand the effects exerted by the aging process on the human heart. Studies in this direction should command priority in the financial as well as the other forms of support.

Personalized medicine for the diagnosis and prevention of arterial hypertension

Personalized medicine for the diagnosis and prevention of arterial hypertension

Новый взгляд на роль поведенческих факторов риска в развитии хронических неинфекционных заболеваний на примере артериальной гипертензии

According to the world health organization, the prevalence of chronic non-communicable diseases has reached epidemic proportions. In today’s world there is a significant increase in the number of patients with arterial hypertension annually. The reasons for the development of this disease, in addition to adverse environmental conditions, are a number of factors related to the lifestyle of a person, as well as behavioral risk factors (bad habits) that provoke violations of the body’s functions and, as a result, the development of the disease. The most significant of them are: overweight, excessive salt consumption, smoking and alcohol abuse, and sedentary lifestyle. These factors are manageable, because as a result of corrective measures, it is possible to reduce their negative impact on the body or to eliminate it completely. In this regard, raising public awareness and actively combating manageable risk factors at the state level is crucial for arterial hypertension prevention. Key words: non-communicable diseases, arterial hypertension, arterial pressure, cardiovascular diseases, risk factors.

Non-drug technologies in the prevention of arterial hypertension in civil aviation dispatchers

Purpose. In recent decades, there has been an increased interest in the study of the prevention of cardiovascular diseases in civil aviation dispatchers, for whom professional stress is one of the leading risk factors in the formation of arterial hypertension in the workplace.
 Material and methods. The article presents the survey data of 120 civil aviation dispatchers, who, in order to reduce the prevention of the development of arterial hypertension, underwent a complex of combined color-light-and psycho-correctional music therapy.
 Conclusion. As a result of the study, it was proved that the combined color-light therapy technology and psycho-correctional music therapy have a pronounced vasocorrecting effect, which is confirmed by a decrease in systolic and diastolic pressure and heart rate to the level of healthy individuals in the studied contingent of air traffic controllers.

P3560Prospects for the use of integrated assessment of gene-candidates polymorphisms in the management of arterial hypertension: let's start

Abstract Nowadays a large amount of data about the frequency of gene-candidates polymorphisms occurrence in patients with arterial hypertension (AH) have been accumulated. The using of single polymorphisms for diagnostic and prognostic purposes appeared to be not perspective. However multiple accumulation of gene-candidates polymorphisms in person is realized mostly in formation of AH. The purpose of the research was to compare the proportion of modified gene-candidates in a group of hypertensive patients with a similar group of non-hypertensive patients using the gene modification index (GMI) calculation for possible using in diagnostic and prevention of AH. Methods 180 patients with AH (age 54,2 [43–75], male/female 86/94) and 82 non-hypertensive patients (age 52,6 [42–71], male/female 38/44) were examined (ESC/ISH 2018). For comparative significance in the conducted research the patients under 40 years old were not included. Patients of both groups were perfomed the analysis of polymorphisms of the following candidate genes by PCR: ADD1:1378, AGT: 704, AGT: 521, AGTR1:1166, AGTR2: 1675, CYP11B2:-344, GNB3:825, NOS3:-786, NOS3:894. Then the GMI was formed where the proportion of “pathological” homozygous polymorphism of one gene was 1.5 points, the heterozygous polymorphism – 1 point, “normal” genotype – 0 points. Then points were summed up and formed the GMI as proportion of the “pathological” genotypes, expressed as a percentage. GMI is calculated by the formula: GMI = (N/13,5) × 100, where N is the sum of points of present genetic polymorphisms; N = n1 + n2 + n3 + n4 + n5 + n6 + n7 + n8 + n9; 13,5 – the maximum number of points of present genetic polymorphisms. The GMI from 0 to 20% was considered as low genetic risk, from 21 to 40% – moderate risk, from 41 to 70% – high risk, from 71 to 100% – very high risk. Results In hypertensive patients the low genetic risk was in 5% of cases, in the group of non-hypertensive patients - in 85.4% (p=0.0001); moderate genetic risk was observed in 22.2% of patients with AH and in 13.4% patients without AH (p=0.14); 52.2% of hypertensive patients and 1.2% of non-hypertensive patients had a high genetic risk (p=0.0001); a very high risk was in 20.6% of patients with AH and was absent in patients without AH (p=0.0001). The average mean of GMI in the group with AH was 64.2% [CI 95%, 30–78], in the group of non-hypertensive patients - 22% [CI 95%, 5–30], (p=0.0001). At the same time in GMI less than 25% there was no case of the presence of AH. Conclusions In the conducted research the representative data was obtained: the proportion of the modified gene-candidates significantly exceeded the proportion of the modified genes in non-hypertensive patients. It demonstratively shows the perspectivity of GMI using in the diagnostic and preventive management of patients with AH. GMI up to 25% mostly is not phenotypically realized and the probability of hypertension developing in these patients is extremely low.

INCREASED BLOOD PRESSURE DURING PUBERTY

Blood pressure is continuously increasing and increases with the child's age, that is, with the growth and development of the child. The change in pressure value in puberty appears due to complex morphological and physiological changes in the organism under the influence of hormones. With this work we have proven that blood pressure has a significant increase in children from 11 to 14 years compared to the previous period. We used the results of the systematic examination of school children of the 5th, 6th and 7th grade in the city of Nis. A total of 2333 children of both sexes were analyzed. The blood pressure was measured in a seated position three times at a time interval of 5 minutes. For statistical processing, the highest value was taken. The greatest differences in blood pressure, diastolic pressure, occurred in boys compared to girls in the fifth grade, while girls had a higher diastolic pressure than boys in the sixth and seventh grades of primary school (p < 0.001). Regarding morphological characteristics, girls had significantly higher body height values than boys in the sixth grade (p < 0.005), while boys had higher values of both body height and body weight in the seventh grade (p < 0.001). In the period of puberty, there are numerous changes in all systems and organs, blood pressure varies significantly, and therefore it has to be measured and controlled more frequently for the detection and prevention of arterial hypertension in children.

Directions of optimization of information providing of pharmaceutical prophylaxis care for arterial hypertension

Improvement of informational providing of pharmaceutical prevention care, especially in arterial hypertension, is the main direction for prevention of rational drug use. It was established that only 33% of patients with arterial hypertension control the level of arterial pressure within the limits of norm, and provision of pharmaceutical care will help to achieve the optimal level of blood pressure, increasing the persistence to the use of drugs and improve quality of life.&#x0D; The aim of the work. The aim was to justify the directions of informational providing of pharmaceutical prevention care of drug prescription for arterial hypertension treatment in implementation of “Affordable Drug Program” for improving data in current provisor (pharmacist) protocol.&#x0D; The study was conducted on the basis of current legislative acts approved in Ukraine and European guidelines for the treatment of arterial hypertension, as well as publications in the evidence-based basis on October 2018. The following research methods were used: systemic, analytical, content-analysis.&#x0D; We analyzed the data of European recommendations 2018 (ESH/ESC) and defined new factors influencing the development of cardiovascular diseases. We also examined the evidence in drugs for prevention of arterial hypertension and the most rational choice of drugs for an individual patient, taking into consideration the concomitant status.&#x0D; We reviewed as well the range of drugs for treatment of arterial hypertension, included in the regulatory lists of Ukraine that are in need of pharmaceutical prevention care. We presented the main interactions of inhibitor angiotensin II receptors. In order to improve the pharmacotherapy of patients the provisors (pharmacists) may use this information for warning about undesired interactions and side effects.&#x0D; We analyzed the pharmacist protocol for prescribing of prescription drugs for treatment of people with hypertension diseases, the cost of which are partially reimbursed.&#x0D; We showed that this protocol needs some basic additional information about both the primary prevention and the drugs such as angiotensin II receptor blockers and diuretics for a rational prescription and use of these medications.&#x0D; The system of information support of pharmaceutists on the rational use of drugs with arterial hypertension is substantiated.

Capacitação do familiar cuidador na adesão à prevenção e ao controle da hipertensão arterial

Objetivo: Analisar o impacto de uma tecnologia educativa em saúde na capacitação do familiar cuidador no controle da hipertensão arterial e na prevenção do risco deste agravo. Métodos: Pesquisa participante com a aplicação de uma Tecnologia Educativa em Saúde (TES) – Capacitação do familiar cuidador na adesão à prevenção e/ou controle da hipertensão arterial, com um grupo de oito familiares cuidadores (FC), de um Serviço de Assistência Domiciliar de um hospital público de Fortaleza-CE, entre julho e outubro de 2016. Resultados: Na primeira entrevista, observou-se que os FC revelaram algum conhecimento sobre hipertensão arterial (HA), modo de descoberta ou diagnóstico, fatores de risco, cronicidade e risco/gravidade. Após a aplicação da TES, ocorreu a apreensão do conhecimento acerca das condutas de controle da HA e de prevenção dos seus fatores de risco, embora de modo irregular sob os aspectos quantitativos e qualitativos em todas as condutas. As experiências vivenciadas pelos FC com a TES emergiram vários significados: incentivo para o autocuidado e para o cuidado do familiar; emponderamento para o cuidado; valorização da saúde; e adoção de hábitos saudáveis. Conclusão: A aplicação da TES com os familiares cuidadores promoveu o envolvimento no autocuidado, no cuidado na família e na comunidade, difundindo o saber construído.