AIM:To compare effects of isolated antihypertensive therapy (AHT) and AHT combined with anxiolytic and antidepressant on parameters of 24‑hour blood pressure (BP) profile, severity of affective disorders, and quality of life (QL) in patients with uncontrolled arterial hypertension (AH) and anxiety or depressive disorders.MATERIAL AND METHODS:We randomized 140 patients (age 48.6±5.9 year, 72 women) into 2 groups. During 1 year patients of each group received 2 variants of pharmacotherapy: isolated AHT and AHT combined with psychotropic medication (PM) - anxiolytic for persons with anxiety disorder and antidepressant for persons with depressive disorder (AHT+PM). Patients of group I received AHT for first 6 months and AHT+PM for remaining 6 months. Group II patients started with AHT+PM and after 6 months switched to AHT. In each group we selected subgroups of patients with prevailing anxiety (I‑A, II‑A) and prevailing depression (I-D, II-D). In the end of each 6 months period we compared parameters of 24‑hour BP monitoring, severity of affective disorders, and QL in subgroups IA vs. II‑A and ID vs. IID. Same comparisons were done for each subgroup in the end of the first and second stages of treatment.RESULTS:Starting with combination AHT provided more rapid achievement of low values of average diurnal and nocturnal systolic (S) and diastolic (D) BP, lower parameters of BP variability. In patients with comorbid depression it led to lowering of magnitude and velocity of morning increment of SBP and DBP. Only combination AHT demonstrated adequate reduction of affective disorders. Both combination and isolated AHT in 6 months resulted in significant improvement of QL, however combination AHT provided significantly better estimates of QL.CONCLUSION:In patients with AH and anxiety or depressive disorders effectiveness of AHT combined with anxiolytic or antidepressant was higher compared with isolated AHT.

Aim. To compare the influence of the simple and combined with anxiolytic drug tofisopam (AT) antihypertesion therapy (AHT) on the 24-hour blood pressure (BP) profile, anxiety level and life quality of patients with uncontrolled arterial hypertension and anxiety spectrum disorder.Material and methods. Sixty-nine patients (mean age 48,5±5,3 y. o., 35 women) were randomized to 2 groups. Each group consequently during 1 year study received two types of medicines for 6 months each with cross-replacement: isolated AHT and combination AHT with AT (AHT+A). Group 1 (35 persons) for the 1st half year took AHT, and then following half year AHT+A; group 2 (34 persons) — in back order. At the end of every period the following parameters were controlled: ambulatory blood pressure monitoring, prominence of trait and reactive anxiety, and life quality. Also, the same comparisons were done for every group separately at the end of the first and second stages of treatment.Results. The initiation of combination AHT+A led to faster decrease of BP, achievement of lower mean daily and mean nocturnal systolic and diastolic BP, lower BP variability parameters. Only combination AHT+A showed adequate reducement of reactive anxiety. Combination and simple AHT in 6 months led to significant improvement of life quality, however combination AHT showed more significant values.Conclusion. Efficacy of combination AHT+A in hypertensive persons with anxiety disorder is higher comparing to simple AHT.

Aim. To compare the influence of monoand combined with antidepressant antihypertension therapy (AHT) on the parameters of 24-hour blood pressure (BP) profile, severity of depression and life quality of patients with non-controlled arterial hypertension (AH) and depression.Material and methods. 71 patients, aged 48,7±5,2 y.o., 37 females, were randomized to two groups. Each group during a year consequently received two types of pharmacotherapy for 6 months twice: mono AHT and AHT with antidepressant fluvoxamine (AHT+A). Group 1 (n=35) for the first half-year received AHT, then AHT+A; group 2 (n=36) in reversed order. At the end of each half-year, we compared 24-hour blood pressure, and severity of depression by Beck score, with life quality. Same comparisons were done in the group by endings of two periods.Results. Starting with combination AHT led to faster achievement of relatively low values of mean day and mean night systolic and diastolic BP, lower BP variability. Combination AHT made to reach significantly higher level of the value and velocity of morning BP raise. Only combination therapy showed adequate reduction of depression symptomathics. Combination, as monotherapy in 6 month led to significant improvement of life quality; however, combination therapy was significantly better.Conclusion. Efficacy of antidepressant-combined AHT with fluvoxamine in AH patients with depression better than mono AHT.

Работа является фрагментом продольного проспективного пятилетнего обсервационного исследования спонтанной трансформации высокого нормального артериального давления (ВНАД) в артериальную гипертонию (АГ). Цель работы – выявление некоторых предикторов этой трансформации – признаков, наличие которых у пациентов с ВНАД существенно повышает риск развития АГ. При помощи ROC-анализа установлено, что у лиц с ВНАД предикторами развития АГ в ближайшие 5 лет могут служить желудочковая эктопическая активность с количеством экстрасистол ≥ 1000 в сутки, а также патологические значения начала и наклона турбулентности. Наличие суправентрикулярной эктопической активности, независимо от количества экстрасистол, выступать в качестве предиктора не может.