The first results of an objective assessment of the safety of emergency antihypertensive therapy at the pre-hospital stage
https://doi.org/10.24884/2072-6716-2021-22-4-47-54
Abstract
We studied the possibilities of urgent monitoring of blood pressure and an objective assessment of its results at the pre-hospital stage. Of the 105 patients included in the study, 6 were excluded for technical reasons and 8 due to additional antihypertensive drugs. For emergency antihypertensive therapy, two-component combinations were used: captopril+furosemide, moxonidine+furosemide, moxonidine+nifedipine (if there was no intolerance to any of the studied drugs, they were prescribed using random numbers), blood pressure monitoring was simultaneously started, which lasted for a day. The stability of the antihypertensive effect, the frequency of excessive lowering of blood pressure in relation to its target value was evaluated. It was shown that the use of blood pressure monitoring techniques from the first minutes of sublingual use of various combinations of antihypertensive agents allows objectively assessing and documenting the safety of the effect of emergency therapy.
About the Author
O. V. Grishin
City polyclinic No. 17
Russian Federation
Russian Federation
Oleg V. Grishin
St. Petersburg
References
1. Golikov A. P. Hypertensive crises yesterday and today. Arterial Hypertension, 2004, Vol. 10, No. 3, рр. 147–151 (In Russ.)
2. Golikov A. P., Lukjanov M. M., Polumiskov V. Yu. et аl. Hypertensive crises in patients with essential arterial hypertension and coronary heart disease: new perspectives in treatment and prevention. Cardiovascular Therapy and Prevention, 2005, Vol. 4, No. 3, сh. I, рр. 10–16 (In Russ.)
3. Slepushenko I. A. Improving the organization of emergency medical care in the Russian Federation. Emergency medical care, 2007, Vol. 8, No. 3, рр. 3–6. (In Russ.)
4. Ruksin V. V., Grishin O. V., Sokolov Yu.V. et el. Features of emergency conditions associated with high blood pressure and a differentiated approach to emergency medical care. Emergency medical care, 2009, Vol. 10, No. 2, рр. 11–21 (In Russ.)
5. Ruksin V. V., Grishin O. V. Increase in blood pressure: the unused resources. Emergency medical care, 2017, Vol. 18, No. 2, рр. 18–23 (In Russ.)
6. Kobalava Zh.D., Konradi A. O., Nedogoda S. V. et el. Arterial hypertension in adults. Clinical guidelines 2020. Russian Journal of Cardiology, 2020, Vol. 25, No. 3, рр. 37–86 (In Russ.)
7. Williams В., Mancia G., Spiering W. et el. ESC Scientific Document Group 2018 ESC/ESH guidelines for the management of arterial hypertension // Eur. Heart J. 2018, Vol. 39, No. 33. Р. 3021–3104.
8. Konradi A. O. Key advances in antihypertensive therapy during last years. Arterial Hypertension, 2012, Vol. 1, No 6, рр. 491–496 (In Russ.)
9. Kobalava Zh.D., Konradi A. O., Nedogoda S. V. et el. Russian Society of Cardiology position paper on 2018 Guidelines of the European Society of Cardiology/European Society of Arterial Hypertension for the management of arterial hypertension. Russian J. Cardiol., 2018, Vol. 12, рр. 131–142 (In Russ.)
10. Chazova I. E., Zhernakova Yu.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension, 2019, Vol. 16, No. 1, рр. 6–31 (In Russ.)
11. Hebert Ch.J., Vidt D. G. Hypertensive Crises // Prim. Care Clin. Office Pract. 2008. Vol. 35, No. 3. Р. 475–487.
12. Wyss F., Coca А., Lopez-Jaramillo P. et el. Position statement of the Interamerican Society of Cardiology (IASC) on the current guidelines for the prevention, diagnosis and treatment of arterial hypertension 2017–2020. The Task Force for the management of Arterial Hypertension of the Interamerican Society of Cardiology (IASC), and Reviewers from European Society of Hypertension (ESH), Latin-American Society of Hypertension (LASH), Spanish Society of Cardiology (SSC) // Int. J. Cardiol. Hypertens. 2020. Vol. 6. Р. 100041.
13. Qi Hua, Li Fan, Jing Li, Joint Committee for Guideline Revision 2019 Chinese guideline for the management of hypertension in the elderly. Joint Committee for Guideline Revision // J. Geriatr. Cardiol. 2019. Vol. 16, No. 2. Р. 67–99.
14. Tereschenko S. N., Gaponova N. I., Abdrakhmanov V. R. Randomized comparative study of the moxonidine effectiveness in patients with uncomplicated hypertensive crisis. (AVES). Arterial Hypertension, 2011, Vol. 17, No. 4, рр. 316–324 (In Russ.)
15. Ruksin V. V., Grishin О. V. The direct and remote results of urgent antihypertensive therapy at the pre-hospital stage. Emergency medical care, 2019, Vol. 20, No 3, рр. 22–29 (In Russ.)
16. Grigoriev S. G., Yunkerov V. I., Rezvantsev M. V. Mathematical and statistical processing of medical research data. 3rd ed., additional. St. Petersburg: VMedA, 2011 (In Russ.)
17. Ruksin V. V., Grishin O. V., Syamtomov A. S. Emergency medical care with increased blood pressure: opportunities and prospects. Cardiology and cardiovascular surgery, 2018, Vol. 11, No. 2, рр. 19–23 (In Russ)
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For citations:
Grishin O.V. The first results of an objective assessment of the safety of emergency antihypertensive therapy at the pre-hospital stage. EMERGENCY MEDICAL CARE. 2021;22(4):47-54. (In Russ.) https://doi.org/10.24884/2072-6716-2021-22-4-47-54
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