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Nephroprotective effect and impact on the arterial elasticity of the angiotensin receptor blockers II versus angiotensin converting enzyme II in therapy of essential hypertension


Author: Aliona Durnea
Degree:doctor of medicine
Speciality: 14.00.06 - Cardiology and Rheumatology
Year:2011
Scientific adviser: Alexandru Carauş
doctor habilitat, professor, Public Medico-Sanitary Institution Moldavian Institute of Cardiology
Institution: Public Medico-Sanitary Institution Moldavian Institute of Cardiology
Scientific council: D 51-14.00.06
Public Medico-Sanitary Institution Moldavian Institute of Cardiology

Status

The thesis was presented on the 6 September, 2011
Approved by NCAA on the 11 November, 2011

Abstract

Adobe PDF document7.80 Mb / in romanian

Keywords

arterial hypertension, microalbuminuria, arterial elasticity, angiotensin receptor blockers II, angiotensin converting enzyme II

Summary

The thesis consists of 104 pages, beginning with introduction, followed by 4 chapters, general conclusions, practical recommendations and bibliography from 203 reference sources.

Goal of research: To asses the antihypertensive and nephroprotective effects and evolution of the arterial elasticity indices during long-term treatment with angiotensin converting enzyme II – Ramipril versus angiotenzin receptor blocker II - Eprosartan.

Objectives of research: To study the diurnal profile of arterial blood pressure in patients with essential arterial hypertension with microalbuminuria. To establish the impact of long-term antihypertensive medication (Ramipril versus Eprosartan) on arterial blood pressure. To evaluate the impact of long-term antihypertensive medication (Ramipril versus Eprosartan) on the renal function and microalbuminuria. To evaluate effects of long-term antihypertensive medication (Ramipril versus Eprosartan) on the arterial elasticity indices and lipidic profile. To determine the correlation between the blood pressure variability indices, renal disfunction indices and arterial elasticity indices.

Innovation and originality of research: We estimated the impact of the medication with new ARB II-Eprosartan on blood pressure variability (certified by most advanced equipment, like MAATA), renal disfunction and arterial elasticity. For the first time, it has been determined, the correlation between arterial blood pressure variability indices, microalbuminuria and parameters of arterial elasticity.

Academic value: The results of the research underlined the importance of systemic arterial stiffness (large and resistive arteries) and of microalbuminuria which have been identified as being the most important pathophysiological determinants of essential hypertension and prognosis for patients with AHT subject to long term treatment with Eprosartan.

Practical value: The results of the research can be used to improve the therapeutic approach for essential arterial hypertension in patients with another important risk factor for cardiovascular mortality – microalbuminuria, using collected data on vasoprotective effect of medication under research - Ramipril and Eprosartan.

Practical implementation: The results of the research received academic value appreciation and have been implemented in the clinic of the Institute of Cardiology.