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The last (seventh) category includes artificial (trophic) changes in facial tissues that occurred in patients with artificial lung ventilation and due to prolonged lying on the stomach. The classifications given were the first descriptions of skin lesions in COVID-19 and therefore different signs were given: those that were caused specifically by COVID-19, and those that arose due to various causes, in particular those associated with the treatment of the disease. Due to the fact that these lesions required different approaches in both treatment and anti-epidemic or precautionary measures, we, based on the experience of all these months of observation of patients, propose a classification of skin lesions associated with COVID-19. lay out like this
Primary arterial hypertension (AH) or essential hypertension (AH) remains one of the most common cardiovascular diseases. A prolonged and persistent increase in blood pressure (BP) leads to damage to target organs, contributing to the development of severe cardiovascular complications (cerebral stroke, myocardial infarction, life-threatening arrhythmias and heart failure), kidney damage (renal failure) and vision and causes high mortality and disability of the working-age population. Annually in the world hypertension is the cause of death of more than 10 million people. In Ukraine, more than 12.6 million people are registered with this disease, or more than 35% of the population. But, among people with high blood pressure (BP), only 52% of patients know about the presence of the disease, less than a third of them are treated, and no more than 15% of patients are effectively treated.
When transitioning to biological therapy, subcutaneous administration should be considered to limit patient contact with the healthcare facility. Selective switching from intravenous infliximab to subcutaneous anti-TNF is not recommended as it may increase the risk of relapse. If the patient is in contact with a COVID-19 person, withdrawal of anti-TNF therapy for 2 weeks should be considered.
The first and mandatory step in the treatment of hypertension is lifestyle modification (LS), which is aimed at correcting the above risk factors, primarily modifiable ones. A big problem is the choice of the most optimal treatment for hypertension, which can slow down the progression of lesions of the heart, blood vessels, kidneys, brain and eyes. The vast majority of hypertensive patients who seek medical help require combination antihypertensive therapy. At the same time, the most appropriate at the present level is the use of fixed combinations of such drugs.
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