Denervation of the distal renal arterial branches vs. conventional main renal artery treatment: a randomized controlled trial for treatment of resistant hypertension.

Background: Effective treatment of uncontrolled hypertension using catheter-based percutaneous renal denervation may depend strongly on the anatomic strategy applied when delivering therapy. We hypothesized that concentering renal denervation treatment in the distal region of the artery would improve clinical response.

Methods And Results: We conducted a single-center, double-blind, randomized, controlled, and parallel group study (ClinicalTrials.

[Criteria for selecting patients with resistant hypertension for a renal sympathetic denervation].

Aim: to define and develop a procedure that can select patients with resistant hypertension (RH) for a renal sympathetic denervation (RSD) procedure, by being orienting to the specific initial values of β-adrenoreactivity (β-AR) and systolic blood pressure (SBP).

Subjects And Methods: The analysis included 23 RH patients receiving the maximally tolerable doses of 4 antihypertensive drugs. The investigations involving BP control and a Russian spectrophotometric procedure for determining β-AR in terms of the change in the osmoresistance of erythrocyte membranes (EM) were performed at baseline and 4 and 24 weeks.

[Correlation between indices of 24-h monitoring of blood pressure and disturbed venous cerebral outflow in hypertensive patients].

Aim: To study relations between disturbances of cerebral venous circulation and parameters of 24-h blood pressure monitoring in hypertensive patients.

Material And Methods: A total of 72 patients aged 28 to 60 years with essential hypertension of stage II have undergone 24-h blood pressure monitoring and MR-venography of the brachiocephalic veins on a low-field MR-tomograph using 2D TOF angiography.

Results: Symptoms of disturbed cerebral venous circulation were found in 60% patients.

[Structural-functional manifestations of cerebrovascular pathology in patients with essential hypertension].

Aim: To study functional activity of the brain in hypertensive patients by computer EEG and topographic mapping versus MR-tomography of the brain.

Material And Methods: Computed EEG and MR-tomography (MRT) of the brain were made in 162 patients (age 28-56, mean age 43 +/- 2.4 years) with essential hypertension (EH) stage II.

[Correlation between the parameters of 24-hour monitoring of arterial pressure and changes in arterial wall structure based on the results of a prospective trial].

Aim: To evaluate prognostic value of 24-h monitoring of blood pressure (BPM-24) for assessment of structural changes in arterial walls in patients with essential hypertension living in West Siberia.

Material And Methods: In the course of 5-year prospective study we made two extended clinical and device examinations with use of BPM-24 and ultrasonic measurements of arterial intima-media complex (IMC) in 160 patients (mean age 48.97+/-8.

[Recognition of actual periods of nocturnal rest from 24-hour heart rate profile].

Unlabelled: Inability to delineate exactly periods of nocturnal sleep and diurnal wakefulness during 24-hour blood pressure (BP) monitoring causes reporting of erroneous BP values for these periods. We suggested a simple mathematical algorithm for detection of periods of nocturnal rest determined as period of low values of cardiac rhythm using data of BP monitoring itself.

Aim: To compare novel method of recognition of periods of sleep with 2 standard techniques: use of fixed time interval between 23 and 7 hours (1), or period of sleep according to patient's diaries (2).

Improved automatic analysis of ambulatory blood pressure data based on precise detection of individual night-time from diurnal profile of heart rate.

Background: Software programs sold with ambulatory blood pressure monitoring (ABPM) devices are designed to use some set 'typical' night-time (e.g. 2300-0700) to estimate daytime/night-time blood pressure (BP) with limited accuracy.

[Effect of the vertebral syndrome in cervical osteochondrosis on the course of I-IIA stage hypertension and cerebral electrical activity and hemodynamics].

Examination included two groups of patients with I-IIA stage essential hypertension combined with cervical osteochondrosis: with and without the vertebral syndrome. It revealed significant polymorphism of clinical symptoms, more severe course of vascular pathology, disorders of cerebral hemodynamics with decreased pulse blood filling, increased tone of arterioles, venules and veins, signs of disturbances of venous outflow and features of bioelectric brain activity indicating dysfunction of the middle structures in patients with the vertebral syndrome of cervical osteochondrosis. Since the pathogenic significance of cervical osteochondrosis is mostly realized in the presence of the vertebral syndrome, therapeutic policy should involve both antihypertensive agents and measures that control vertebrogenic pathology as well as medicamentous correction of hemodynamic cerebral disturbances.