“To define a set of rehabilitation measures for adolescents with primary arterial hypertension”
(research supervisor – Doctor of Medical Sciences, professor M.M. Korenev, 2008−2010 yrs)
The results of the research work which was carried out within the framework of the program “Prevention and treatment of AH in Ukraine” made in possible to establish a low tendency to the long-term treatment of adolescents with primary AH with antihypertensive medications. Such a tendency was caused by a negative attitude of both adolescents and their family members to application of the prescribed medicine, especially in the absence of subjective complaints. Attention was also drawn to poor medical control at the place of residence.
Object of study: the state of target organs, blood lipid spectrum (BLS) findings, indices of regulative systems and blood pressure (BP) 24h profile in adolescents aged 14–18, with PAH before and after their treatment for 6 and 12 m. with rank I antihypertensive agents (AA) (ATF inhibitors, β-adrenoblocers, and Ca antagonists).
Objective: improving treatment-and-sanitary programs for adolescents with PAH on the basis of determining the effectiveness of AA, different in duration and prescribed regimens, taking into consideration changes in regulative systems, BLS and some signs of target organs damage.
Methods: clinical, instrumental, biochemical, radioisotopes, immunophermental.
Theoretical and practical results: there was established a low inclination of adolescents with PAH to a long-term treatment with AA dependent on their negative athitude to medicines administration, especially in the absence of subjective complaints, as well as on negative athitude of their family members and on insufficient control by medical staff at their place of residence. Treatments with AA of adolescents with PAH during 6 or 12 m. even in the absence of full BP normalization, as well as to MAU decrease. There was singled out a group of adolescents (30 %) with AH development during observation period, with SAS and RAAS activation, formation of exocentric myocardium hypertrophy, increased MAU level and development of atherogenic changes in BLS. The necessity of long-term prescription of rank I AA to adolescents with PAH was proved in the study to prevent AH stabilization, especially in the patients with formation of target organs damage and aggressive risk factors concerning the disease unfavorable course.
Novelty: proof of the necessity of prescribing AA to adolescents with PAH which should continue no less than 12 m., especially for patients with an increased BP rhythm (“non-dipper”, “night-peaker”) with target organs damage (heart, kidneys), metabolism disorders such as atherogenic dyslipoproteidemy and risk factors. There was determined a tendency of treatment-and-prophylactic measures, which made it possible to supplement the methodological recommendations for AH treatment in adolescents.
Effectiveness: long term (from 6 to 12 m.) administration of rank I AA to adolescents with PAH prevents AH development and formation pf target organs (the heart and kidneys) damages.
Fields of application: pediatric cardiorheumatology, pediatrics.
