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https://doi.org/10.14300/mnnc.2020.15055

Multilevel analysis of regulatory mechanism disorders as a principle of choice for individual antihypertensive therapy in patients with hypertension (Part II). Optimization of antihypertensive therapy choice taking into account the multilevel analysis of violations in regulatory mechanisms of arterial blood

[Internal diseases]
Lyudmila Yeliseyeva; Natalya Anatolyevna Samorodskaya;

Aim: optimization of the individual antihypertensive therapy (AHT) choice in patients with hypertension (H) taking into account the violation analysis of arterial blood pressure (AP) regulation system. This study has included 277 patients with hypertension degree II at the age of 58.6±6.4 years. As a form of monotherapy it was administered: nebivolol, lisinopril, losartan, indapamid, amlodipin, and non-fixed combination of lisinopril and indapamid. Changes of indicators were studied at the allocated levels: integrative, vegetative support, organ, initially peripheral levels in 6 months of AGT. Changes at peripheral and organ levels were quite various and postponed, from 3 to 6 months. And this fact demonstrated that it was impossible to apply them as a chosen initial therapy and as an operative express correction; at integrative and vegetative levels: we noticed some signs of regulative and adaptive status (RAS) in sympathicotonic (St) type of vegetative regulation on treatment with nebivolol, lisinopril, losartan, in parasympatheticotonic(Ps) type in treatment with amlodipin, indapamide; in mixed (Mi) type in mixed therapy with indapamide and lisinopril. Integrative and vegetative levels of AP regulative system showed objective quantitative characteristics of functional status of the body, so this allows to improve approach to arterial hypertension therapy.

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Keywords: blood pressure, evaluation of treatment effectiveness for primary arterial hypertension