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Features of treatment and secondary prevention of hypertension

Resume. Methods of treatment and secondary prevention of patients with hypertonic disease are described. The influence of Neurin and Proven on the clinical course and functional state of hypertensive patients was studied.

These drugs are recommended in the treatment and can be used as a secondary prevention of patients with hypertension.

Key words: patients, treatment, Neurin and Proven preparations, hypertonic illness.

Hypertonic disease (HD) is the most common pathology in most regions of the world. From 20% to 40% of the adult population of economically developed countries, the increase in blood pressure is higher than 140/90 mm Hg. The most dangerous is not the increase of blood pressure, but the damage to target organs (heart, brain, kidneys, eyes, etc.) that can lead to death and disability. The need for the most early onset of antihypertensive therapy is confirmed by many, both overseas and domestic research. This is especially important in the early stages of HD, when changes are observed only at the subcellular level, and secondary changes in target organs are not developed - left ventricular hypertrophy, narrowing of the arteries of the retina, proteinuria, atherosclerotic lesions of the aorta, coronary, sinus, iliac and femoral arteries.

The early onset of HD reduces mortality and retards the development of secondary changes in target organs. Therefore, we selected two herbal remedies manufactured by Ecomed - Neurin and Proven to study their effects on systemic hemodynamics and blood pressure levels in patients with stage I of hypertonic disease.

Neurin has neurotropic and neurotrophic effects, it includes black bean, dry grass, valerian rhizomes, grass wormwood, and juniper berries of marsh. According to the results of previous studies of the drug, it normalizes the psycho-emotional state, improves the functions of the hypothalamus, improves trophic and metabolism of the nervous tissue, normalizes neurosecretory and neurohumoral processes, normalizes the activity of the autonomic nervous system.

Proven increases the tone of venous vessels, reduces the permeability of capillaries,
 has anti-inflammatory effects, enhances venous and lymph drainage, reduces swelling of tissues, improves the rheological properties of blood.

Its composition includes the flowers of calendula, the grass of the medicinal grass, tricolor violet, the grass of the strawberry of the forest, the fruits of horse chestnut, the fruits of fennel, inflorescences of linden, the root of chicory, the leaf of sage etc.

These two drugs affect the central mechanisms of central alignment

hemodynamics, as well as vessels of medium and small caliber and microcirculatory channel, and improving blood rheology, in our opinion, were capable of stopping arterial hypertension and making a beneficial impact on patients with HD I st.

Under our supervision, there were 38 patients (9 men and 29 women) with GC 1 stage, 28 patients were 1 Major group, and 10 - 2 control groups.

The average age of patients was 49.1 ± 1.4 years, and the average duration of the disease was 1.8 years. All patients were subjected to routine general clinical and neurological examination both before and after treatment, as well as regular monitoring of blood pressure during treatment.

In addition, patients were examined for target organs (ECG, ophthalmoscopy, blood and urine tests) in order to exclude secondary lesions of these organs. In addition to this survey, a neuropsychological examination (operative assessment of the state of health, activity and mood according to the WAM questionnaire), central cardioghemodynamics by the method of tetrapolar thoracic rheography (TTR) according to V. Kubichecus, determination of the Kerdo index (BI), Hildebrand index (Q) and cerebral Perfusion Tissue (CPT). The results of the WAM questionnaire were derived in the form of scores for Scales (scale: W-well-being; А-activity; M-mood;).

The following parameters were determined with the help of TTR: ATSr - mean dynamic pressure, CI - cardiac index, SI - shock index, CMCP - cardiac muscle contraction power, MV - minute volume of blood flow, GPR - general peripheral resistance. The indices and coefficients BI, Q, CPT, were determined by the corresponding formulas. All paraclinical methods of research were conducted both before and after treatment. All results were processed by the methods of descriptive statistics and the study of the validity of differences in the Student.

Patients in the main group took Neurin 20 drops to 2-3 tablespoons of water 20 minutes before meals 2 times a day and Proven 20 drops for 2-3 tablespoons of water 20 minutes before meals 2 times a day for 1 month.

As a result of the use of these phytoconcentrates, there was a positive clinical and neurological and psychological dynamics.

Studies in the treatment of the change in the Kerdo index (18,5 ± 2,3) indicated a predominance of sympathetic effects on the cardiovascular system, with signs of interrupted inter-system relations (according to the Hildebrand coefficient) (5,08 ± 0,18) and increased mean dynamic (112.1 ± 2> 8) and cerebral perfusion pressure (100.9 ± 3.7).

After treatment, the Kerdo index (9.3 ± 1.3), the inter-system relations (4.3 ± 0.09), and ATSr (98.9 ± 0.7) and CPT (88.8 ± 2.4) According to the results of central cardioghemodynamics, two types of hemodynamic changes were observed prior to treatment. In the first case, the hyperkinetic type of hemodynamics with increased heart rate (3,5 ± 0,13) and the shock index (44,13 ± 1,76), the volume of blood flow (134,3 ± 6,2), decreased peripheral resistance blood vessels (75,7 ± 3,2) and relative compensation of cardiac hemodynamics (2,1 ± 0,05). After treatment, the cardiac index (2.93 ± 0.1) and the minute volume of blood flow (104.7 ± 6.7), the power of reduction of the cardiac muscle (2.93 ± 0.12) decreased and the norm was lowered. total peripheral resistance (98.3 ± 1.9), but changes in the shock index were not reliable. In the second case, a hypokinetic type of hemodynamics with a decreased heart rate (2,03 ± 0,01) and a shock index (38,2 ± 0,16), a minute volume of blood flow (78 ± 0,98), an increased peripheral resistance blood vessels (130.3 ± 1.8) and relative compensation of cardiac hemodynamics (1.7 ± 0.02). Such a picture of hemodynamics is found somewhat less frequently at first in hypertension, and more characteristic of the later stages of the disease. After treatment, the cardiac index (2,43 ± 0,04) and the minute volume of blood flow (92,7 ± 2,5), the normalized increase in the total peripheral resistance (110,3 ± 3,03), increased significantly, but changes the power of reducing the heart muscle was not reliable.

Thus, based on the research carried out, the following conclusions can be drawn:

Drugs Neurin and Proven have a positive effect on the clinical course and functional state of patients with hypertension and stage I, correct their psychological state and positively affect the subjective symptoms and complaints of patients. These drugs improve the state of the vegetative nervous system and inter-systemic interactions reduce the elevated CPT.

Neurin and Proven, which influence both the central mechanisms of regulation of hemodynamics and peripheral circulation, are able not only to stabilize blood pressure, but also to change the type of hemodynamics and general peripheral resistance in the direction of their normalization.

Given the absence of side effects and complications, as well as a positive impact on clinical and paraclinical parameters in the examined patients. Neurin and Proven can be recommended for use as drug of choice in the treatment and secondary prevention of patients with hypertension and stage I , as with the hyperkinetic type of hemodynamics, and with the hypokinetic.

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