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Both patients and doctors should be well aware of the need for long-term therapy with periodic monitoring of key indicators and the obligatory achievement of the so-called target levels of blood pressure, that is, stable normalization of blood pressure. Only such an approach to the treatment of patients with hypertension can give a successful result. But at present, as mentioned above, only a very small number of patients with hypertension are treated effectively. In this regard, there is no decrease in the frequency of complications of this disease in Ukraine.
В этой связи в рекомендациях Европейского общества гипертензии и Европейского общества кардиологов 2018 подчеркивалось необходимость тщательной стратификации сердечно-сосудистого и общего риска осложнений для выбора наиболее оптимальной антигипертензивной терапии. Первым и обязательным этапом лечения АГ остается модификация стиля жизни (МСЖ), которая направлена на коррекцию вышеуказанных факторов риска, прежде всего модифицируемых.
Treatment with corticosteroids (especially prednisolone ≥20 mg/day or equivalent) is associated with an increased risk of infection. However, it is unclear whether corticosteroid therapy is associated with an increased risk of developing COVID-19 or its complications. Data on budesonide, a topical corticosteroid with low systemic bioavailability, show that these drugs are associated with significantly fewer side effects compared to systemic corticosteroids and their side effects are close to placebo. If possible, corticosteroids should be avoided and a rapid dose reduction considered, and a switch to budesonide is recommended. This must be taken into account, taking into account the risk of exacerbation of CKD. If a patient with COPD is in contact with a person with COVID-19 or develops COVID-19, it is recommended to gradually reduce the dose of corticosteroids, the use of budesonide is preferred, but taking into account the severity of COPD and the risk of exacerbation.
According to him, now there are 5.5 thousand patients in hospitals who have been diagnosed with coronavirus disease. Of these, 2,300 are on beds with oxygen therapy, and most of them receive it. To prevent logistical problems, at the end of last year, state funding was allocated through several mechanisms: one in the form of centralized purchases, one in the form of subventions provided to the regions in order to purchase autonomous sources of oxygen supply. On September 15, the Ministry of Health sent 124,608 packages of the Paxclovid drug for coronavirus disease to the regions. The medicine is prescribed primarily to patients at risk to prevent the complex course of coronavirus disease.
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