The Assessment of the Effectiveness of Combined Angiotensin II Receptor Antagonists and Cardiac Glycosides in the Treatment of Hypertension Complicated by Chronic Heart Failure
Keywords:
Hypertension, Chronic Heart Failure, Renal Function, Cardiac Performance, DiuresisAbstract
Hypertension and chronic heart failure (CHF) are closely linked conditions contributing to significant cardiovascular morbidity and mortality. This study evaluates a combined therapeutic approach in managing CHF stage II B (NUNA III FK), focusing on cardiac function, renal performance, and clinical symptoms. The treatment resulted in an 8.5% increase in left ventricular ejection fraction, improved renal function as evidenced by a rise in glomerular filtration rate from 98 to 110 mL/min, and optimized hemodynamic parameters with reductions in systolic and diastolic blood pressure. Diuresis improved significantly, alongside reductions in dyspnea and peripheral edema. Electrocardiographic and echocardiographic evaluations, paired with monitoring plasma potassium levels and urine output, provided a comprehensive assessment of therapy efficacy. Despite short-term findings, this approach highlights the need for long-term research to confirm its broader applicability and impact. These results underscore the potential for tailored interventions in improving outcomes in hypertensive CHF patients.
References
Ameri, P., Bertero, E., Meliota, G., Cheli, M., Canepa, M., Brunelli, C., & Balbi, M. (2016). Neurohormonal activation and pharmacological inhibition in pulmonary arterial hypertension and related right ventricular failure. Heart Failure Reviews, 21(5), 539–547. https://doi.org/10.1007/s10741-016-9566-3
Burkhardt, H., Bojarsky, G., Gretz, N., & Gladisch, R. (2002). Creatinine clearance, Cockcroft-Gault formula and cystatin C: Estimators of true glomerular filtration rate in the elderly? Gerontology, 48(3), 140–146.
Chatterjee, K. (2005). Neurohormonal activation in congestive heart failure and the role of vasopressin. The American Journal of Cardiology, 95(9), 8–13.
Ibragimov, K. I. (2022). The risk of cardiovascular disease in rheumatoid arthritis patients treated with disease-modifying antirheumatic drugs: A clinic based case control study. Journal of Global Health Reports, 4(2). http://joghr.com/index.php/JGHR/article/view/32
Ibragimov, K., Sultonov, I., & Ravshanova, M. (2024). The Effectiveness of the Combination Therapy with biologic DMARDS in Rheumatoid Arthritis. Frontiers of Global Science, 2(1), 17–24.
Levey, A. S., Stevens, L. A., & Schmid, C. H. (2011). Cockcroft-Gault Formula. Nephrology Secrets, 174.
Magri, P., Rao, M. A. E., Cangianiello, S., Bellizzi, V., Russo, R., Mele, A. F., Andreucci, M., Memoli, B., Luca De Nicola, & Volpe, M. (1998). Early Impairment of Renal Hemodynamic Reserve in Patients With Asymptomatic Heart Failure Is Restored by Angiotensin II Antagonism. Circulation, 98(25), 2849–2854. https://doi.org/10.1161/01.CIR.98.25.2849
Rigalleau, V., Lasseur, C., Perlemoine, C., Barthe, N., Raffaitin, C., Liu, C., Chauveau, P., Baillet-Blanco, L., Beauvieux, M.-C., & Combe, C. (2005). Estimation of glomerular filtration rate in diabetic subjects: Cockcroft formula or modification of Diet in Renal Disease study equation? Diabetes Care, 28(4), 838–843.
Rizza, A., & Ricci, Z. (2019). Fluid and Electrolyte Balance. In S. F. Flocco, A. Lillo, F. Dellafiore, & E. Goossens (Eds.), Congenital Heart Disease (pp. 115–133). Springer International Publishing. https://doi.org/10.1007/978-3-319-78423-6_6
Roumelioti, M.-E., Glew, R. H., Khitan, Z. J., Rondon-Berrios, H., Argyropoulos, C. P., Malhotra, D., Raj, D. S., Agaba, E. I., Rohrscheib, M., & Murata, G. H. (2018). Fluid balance concepts in medicine: Principles and practice. World Journal of Nephrology, 7(1), 1.
Schärer, K., Schmidt, K. G., & Soergel, M. (1999). Cardiac function and structure in patients with chronic renal failure. Pediatric Nephrology, 13(9), 951–965. https://doi.org/10.1007/s004670050737
Souza, N., Dos‐Santos, R., Silveira, A. L. B. D., R, S., Gantus, M. A. V., Fortes, F., & Olivares, E. L. (2016). Effects of autonomic balance and fluid and electrolyte changes on cardiac function in infarcted rats: A serial study of sexual dimorphism. Clinical and Experimental Pharmacology and Physiology, 43(4), 476–483. https://doi.org/10.1111/1440-1681.12543
Van Deventer, H. E., George, J. A., Paiker, J. E., Becker, P. J., & Katz, I. J. (2008). Estimating glomerular filtration rate in black South Africans by use of the modification of diet in renal disease and Cockcroft-Gault equations. Clinical Chemistry, 54(7), 1197–1202.
Volpe, M., Pagannone, E., Tocci, G., & Rubattu, S. (2004). Hypertension and Heart Failure: Role of Neurohormonal Mechanisms. Clinical and Experimental Hypertension, 26(7–8), 603–610. https://doi.org/10.1081/CEH-200031916
Yonezawa, Y., Horinaka, S., Shirakawa, C., & Kogure, Y. (2018). Estimated glomerular filtration ratio is a better index than creatinine clearance (Cockcroft–Gault) for predicting the prevalence of atrial fibrillation in the general Japanese population. Hypertension Research, 41(6), 451–459.