ABSTRACT
A prospective five-year study and medicinal treatment were conducted in 317 coronary patients with stable angina in the absence of any signs of heart failure, and stenosing coronary arterial atherosclerosis as evidenced by selective coronary angiography. Total mortality was 2.8%, and the incidence of documented non-fatal myocardial infarction was 3.8% per year. The mortality was mostly dependent on the severity of angina's functional class and the number of affected major coronary arteries (narrowed by more than 70%). A group of patients with unfavorable prognosis was identified (functional class III to IV, low physical stress tolerance, the involvement of two or three major coronary arteries). The results demonstrate the efficiency of long-term medication in coronary patients with stable angina due to stenosing coronary atherosclerosis.
Subject(s)
Angina Pectoris/mortality , Coronary Artery Disease/complications , Coronary Disease/mortality , Adult , Angina Pectoris/drug therapy , Angina Pectoris/etiology , Cardiovascular Agents/administration & dosage , Chronic Disease , Coronary Artery Disease/mortality , Coronary Disease/drug therapy , Coronary Disease/etiology , Drug Therapy, Combination , Electrocardiography , Humans , Male , Middle Aged , Prognosis , Prospective StudiesABSTRACT
A scheme of prolonged continuous treatment has been developed for patients with essential hypertension (EH). It is based on the principle of differentiated application of the drug in individualized doses, and furosemide testing with subsequent switching to small doses of hypothiazide or some other diuretic agent conducive to the maintenance of the daily natriuresis/mean AP ratio at 1.9-2.0. A series of procedures are also proposed which prevent the development of refractory reaction to the drug or side-effects. The scheme was tested in the course of diuretic treatment of 110 in-patients with EH, stage IIA and IIB, of which 23 were subsequently treated for 6-12 months on an out-patient basis. It was noted that 22% of EH patients were highly sensitive to diuretics, 40-43% showed moderate sensitivity, so that 2-3 weeks' courses of small doses of beta-blockers or corinfar were needed 4-5 times a year to provide a good hypotensive effect, and 38-35% of patients showed poor sensitivity to diuretics and should preferably be treated with other hypotensive agents. The diuretic treatment according to the new regimen was associated with a reduced rate of side-effects.
Subject(s)
Benzothiadiazines , Blood Pressure/drug effects , Hypertension/drug therapy , Sodium Chloride Symporter Inhibitors/administration & dosage , Adult , Circadian Rhythm , Diuresis/drug effects , Diuretics , Furosemide , Humans , Hypertension/physiopathology , Male , Middle Aged , Natriuresis/drug effects , Time FactorsABSTRACT
Data of dynamic control of 278 coronary patients with stable angina pectoris are presented. Coronarography was performed in all cases to determine changes in the heart coronary arteries which were of varying markedness. The anginal syndrome, ECG at rest, exercise tolerance, incidence of myocardial infarction and mortality rate were assessed after one and two years of dynamic observation. The incidence of nonfatal myocardial infarction was estimated at an average of 6.3% per year, whereas the mortality rate was 3.8%. The prognosis for patients with stenosing coronary atherosclerosis depends on the number of affected coronary arteries, the functional class of angina pectoris and exercise tolerance. Data on the efficiency of long-term pharmacological treatment of patients with stable angina and stenosing coronary atherosclerosis are obtained.
Subject(s)
Angina Pectoris/physiopathology , Coronary Disease/physiopathology , Adult , Angina Pectoris/complications , Angina Pectoris/mortality , Coronary Angiography , Coronary Disease/complications , Coronary Disease/mortality , Exercise Test , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Prospective StudiesSubject(s)
Anti-Infective Agents, Urinary/administration & dosage , Antihypertensive Agents/administration & dosage , Hypertension, Renal/drug therapy , Pyelonephritis/drug therapy , Adult , Bacteriuria , Chronic Disease , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Male , Middle Aged , Time FactorsSubject(s)
Glomerulonephritis/drug therapy , Hypertension/drug therapy , Indomethacin/administration & dosage , Adult , Ambulatory Care , Chronic Disease , Diagnosis, Differential , Drug Evaluation , Female , Glomerulonephritis/complications , Glomerulonephritis/diagnosis , Humans , Hypertension/diagnosis , Hypertension/etiology , Male , Middle AgedABSTRACT
The work is concerned with the study of the course and efficacy of long-term out-patient treatment of persons with arterial hypertension. The genesis of arterial hypertension was determined more precisely by means of verified objective methods in 194 patients. Hypertensive disease was diagnosed in 57 patients, chronic pyelonephritis with hypertension in 51 patients, and chronic diffuse glomerulonephritis in 86 patients. The function of the kidneys was studied by radioisotope renography. It was established that the dynamics of arterial hypertension and the function of kidneys are directly dependent on the regularity and adequacy of out-patient treatment which makes it possible to arrest the advancement of the disease.
Subject(s)
Ambulatory Care/methods , Hypertension/drug therapy , Adolescent , Adult , Diagnosis, Differential , Female , Glomerulonephritis/drug therapy , Humans , Hypertension/diagnosis , Hypertension/etiology , Male , Middle Aged , Pyelonephritis/drug therapySubject(s)
Coronary Disease/diagnosis , Adult , Aged , Angiography , Constriction, Pathologic , Coronary Angiography , Coronary Disease/mortality , Female , Humans , Male , Middle Aged , Prognosis , Time FactorsABSTRACT
Comparative analysis of the causes of fatal outcomes in hypertensive disease is presented on the grounds of postmortem findings in 2,091 patients who had died in hospitals in the period between 1953 and 1975. It was established that the mortality of disorders of cerebral circulation reduced significantly in 1973--75 as compared to that in 1963--05 and 1953--55. One fourth of patients with hypertensive disease died of myocardial infarction. It was noted that death of renal failure among patients with hypertensive disease decreased progressively.
Subject(s)
Hypertension/complications , Adult , Aged , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/mortality , Female , Humans , Hypertension/mortality , Kidney Diseases/etiology , Kidney Diseases/mortality , Male , Middle Aged , Myocardial Infarction/etiology , Myocardial Infarction/mortality , Thromboembolism/etiology , Thromboembolism/mortalitySubject(s)
Arteriosclerosis/therapy , Physical Therapy Modalities , Adult , Evaluation Studies as Topic , Female , Follow-Up Studies , Health Resorts , Humans , Male , Middle Aged , RussiaABSTRACT
The methods of determining the maximum permissible and functionally justifiable (upper and lower) limits of arterial pressure fluctuations limiting the zones of individual "comfort" "caution" and "alarm" for every patient are described. The mathematical method of the least squares was used for long-term control of the maintenance of arterial pressure within the limits individually pre-set for those treated on an out-patient basis. The above methods permit to decrease the duration of therapy with a minimal drug expenditure and to ensure a mass control of the efficacy of hypotensive therapy.