[Optimization of sanatorium treatment of patients with essential hypertension stage II by chronotherapy]. / Optimizatsiia sanatorno-kurortnogo lecheniia bol'nykh gipertonicheskoi bolezn'iu II stadii metodami khronoterapii.

A comprehensive chronodiagnostic examination and treatment were performed in 45 patients with essential hypertension stage II aged 37 to 68 years taking 21-day treatment at sanatorium Osetia. The patients were divided into 2 groups: 20 patients of group 1 received basic antihypertensive treatment (enap, hypothiaside) and sulfurated hydrogen balneotherapy not adjusted to individual biorhythm; 25 patients of group 2 received the same treatment by adjusted to biorhythmic phases of basic cardiovascular indices and chronotype established according to Estberg's questionnaire. Estimation of the rhythms of the integral indices of physiological functions (systolic and diastolic arterial pressure, heart rate, body temperature) and "individual minute" was made within 3 days in 4-h intervals. Hemodynamics was studied before and in the end of the treatment with echocardiography, dopplerechocardiography and rheoencephalography. Positive shifts were registered in both groups: a significant fall in arterial pressure, total peripheral vascular resistance, double product and cardiac performance. Patients of group 2 had greater number of significant rhythms of physiological function parameters, primarily circadian, more frequent recovery of amplitude and phase parametric characteristics, better improvement of cerebral circulation, contractile and diastolic functions of the myocardium, reduction of the required medication doses and 2-fold lowering of side effects rate.

[Assessment of time-dependent effects of long-acting altiazem in patients with hypertension stage II]. / Otsenka vremiazavisimykh éffektov altiazema prolongirovannogo deistviia u bol'nykh gipertonicheskoi bolezn'iu II stadii.

A chronodiagnostic examination covered 27 patients with hypertension stage II of indifferent chronotype. The patients were divided into 3 groups by the time of intake of a single daily dose of altiazem--at 8 a.m., 14 p.m., 20 p.m. Chronological organization of the cardiovascular system was studied with autorhythmometry for 3 days in 4-h intervals including night before and in the end of the treatment. Echo-CG, doppler echocardiography and rheoencephalography investigated hemodynamics once daily also before and in the end of the treatment. The findings show advantage of chronotherapeutic prescription of altiazem PP in a mean dose 220 mg/day at evening hours in non-chronodependent patients with hypertension stage II because such a regimen brought about more adequate restoration of the cardiovascular system time organization both by the spectrum of significant rhythms and their parameters; by better improvement of left ventricular diastolic function and pulse cerebral flow. Faster achievement of the therapeutic effect in the evening intake of altiazem supports its chronotherapeutic administration. This leads to reduction of the drug course dose and, therefore, treatment duration.

[Advantages of capoten chronotherapy of patients with hypertension in an outpatient setting]. / Preimushchestva khronoterapii kapotenom bol'nykh gipertonicheskoi bolezn'iu v ambulatornykh usloviiakh.

AIM: To compare the efficiency of a short course of preventive chronotherapy and traditional therapy with capoten in an outpatient setting. MATERIAL AND METHODS: Forty-two patients with stage II essential hypertension were divided into 2 groups: 20 controls were treated with capoten in a dose of 12.5-50 mg 3 times a day and 22 received capoten once a day in the same single dose 1.5-2 h before arterial pressure (AP) acrophase. Central hemodynamics was studied by echocardiography, regional hemodynamics by reheoencephalography before and at the end of therapy. RESULTS: In the control group AP normalized after capoten therapy in 3 patients, decreased by at least 10% but did not normalize in 9, and did not change in 8 patients. The results in the chronotherapy group were as follows: AP normalized in 5, decreased by at least 15% in 13, and did not change in 4 patients. Normalization of daily profiles of hemodynamic values and more favorable shifts in the cerebral bloodflow were more often seen in patients who received chronotherapy. CONCLUSION: Capoten chronotherapy of patients with essential hypertension, carried out in an outpatient setting, is obviously preferable to traditional treatment: no side effects were observed and a better hypotensive effect was attained with lower total dose.