Hypertension and nephrology

[The effect of the β-blockers on left ventricular sytolic and diastolic function]

MOSER György

DECEMBER 12, 2019

Hypertension and nephrology - 2019;23(06)

DOI: https://doi.org/10.33668/hn.23.026

[The author surveys the pharmacodynamic effects, by which the β- blockers can exercise an influence on systolic and diastolic function. He points out, that the constituents of the effect can be separated only in didactic aspect, its worthwile to take the situation of their interdependence. Analyses the how the when and the wherefore the hemodynamic state determines the component of the complex mode of action that sets off. Deals with the problem, that what kind of effects are desired in certain clinical settings and which of those are deletorious. On emphasized he discusses the greatest danger of the β-blockade, the negative inotropic effect, and the mode of its offset or rather counteraction of its hemodinamic result.]

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[The association of hypertension with ischemic heart disease, diabetes and chronic kidney disease is the greatest therapeutic challenge because these associations significantly increase mortality and deteriorate life expectancy. It is important for the clinician to clarify the predictive factors of each association for successful prevention or slowing the progression of diseases. According to the database of the Hungarian Hypertension Registry 2011-2013-2015, 11,137 men and 11,112 women with hypertension and comorbidities (CHD, diabetes, CKD) aged between 35 and 64 were analyzed for the purpose of assessing the predictive value of the traditional risk factors in co-morbidity. We analyzed the predictive weight of each variable with single- and multi-variable stepwise logistic regression, and reported Odds ratio (OR, odds ratio). In patients with hypertension aged 35-64 (male / female), the prevalence of CHD was 41.6% / 35.8%, diabetes 27.1% / 23% and KVB 16.2% / 33.8%, respectively. The chance of developing CHD is highest in hypertensive individuals (male/female) who have diabetes (OR 1.30/1.48), who are obese (OR 1.22/1.21), who smoke (OR 1.50/1.51), and whose blood pressure >140/90 mmHg (OR 1.23/1.29). The dominant predictive factors of type 2 diabetes are obesity (visceral obesity) (OR 1.46/1.49), low HDL cholesterol (OR 1.32/1.35), and high triglyceride levels (OR 1.20/1.42); in women the uric acid level also showed high odds ratio (OR 1.39). There is a significant chance of developing chronic kidney disease in hypertension in both sexes, if abnormal uric acid levels (OR 1.73/1.46) and inadequate treatment of high blood pressure (>140Hgmm SBP) (OR 1.43/1.19) are present. In women, the abnormal triglyceride level) also showed a high odd (OR 1.81).]

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