Dynamics of endothelial function violation in patients with arterial hypertension with moderate cardiovascular risk and antihypertensive therapy treatment influence

Authors

  • T. S. Turlyun Dnipropetrovsk Medical Academy of the Health Ministry of Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2016.4.79699

Keywords:

Hypertension, Losartan, Endothelin-1, Thrombomodulin, von Willebrand Factor

Abstract

Aim. To assess the impact of one-year monitored different groups’ antihypertensive therapy on markers of endothelial dysfunction.

Materials and methods. We examined 48 hypertensive patients with moderate cardiovascular risk. Among them: 1a subgroup took losartan potassium, 1b – standard antihypertensive drugs without sartans. During the year all patients except of general clinical examination were studied by such special clinical and laboratory parameters as concentration of endothelial dysfunction markers in serum (endothelin-1, thrombomodulin and von Willebrand factor).

Results. With constant monitoring of pressure on the background of a statistically comparable levels of SBP in the subgroups at the beginning of the study (p<0.05), during the fourth visit SBP was significantly decreased in subgroup 1a compared with the control subgroup (p<0.05). Dynamics of DBP levels with antihypertensive therapy in both subgroups was also statistically significant (p<0.001, compared to baseline). Positive changes of lipid metabolism indices were observed during 12 months of monitoring in both subgroups of patients from the second visit (from p<0.05 to p<0.001), indicating a reduction of cardiovascular events risk. There is a significant difference of indicators with comparable baseline levels of ET-1 and vWF in subgroups (p<0.05) after a year of monitoring – in patients treated with losartan potassium, rates are lower than in the control subgroup. Thrombomodulin levels in the subgroup of patients treated with losartan potassium were significantly decreased in a year (p<0.05), whereas subgroup 1b on antihypertensive therapy without angiotensin II receptors antagonist using, this indicator almost has not changed. Reduction of all ED markers indicates the tendency to establishing of pro- and anti-platelet systems balance, especially expressed in patients who were treated with losartan potassium.

Conclusion. Cardiovascular events risk reduction is caused by stabilization of blood pressure, indices of lipid profile lowering, the tendency to endothelial function improvement, especially with losartan potassium therapy.

References

Mancia, G., Fagard, R., Narkiewicz, K., Redón, J., Zanchetti, A., Böhm, M., et al. (2013) ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC ). J. Hypertens. 31(7), 1281–357. doi: 10.1097/01.hjh.0000431740.32696.cc.

(2012) Arterial'na hipertenziya. Onovlena ta adaptovana klinichna nastanova, zasnovana na dokazakh. Dodatok do Nakazu MOZ Ukrayiny «Pro zatverdzhennya ta vprovadzhennya medyko-tekhnolohichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomohy pry arterial'niy hipertenziyi» vid 24.05.2012 №384 [Arterial hypertension. Updated and adapted clinical guidelines based on evidence. Annex to the Order of the MOH Ukraine On approval and introduction of medical and technological documents for standardization of medical care in hypertension from May, 24, 2012 №384]. [in Ukrainian]. Retrieved from www.moz.gov.ua/ua/portal/dn_20120524_384.html.

Sirenko, Yu. M.(2011) Otsinka ryzyku u khvoroho na AH [Risk assessment in patients with hypertension] Hipertonichna khvoroba i arterialni hipertenzii, (P. 28–31). Kyiv. [in Ukrainian]

Zadionchenko, V. S., Adasheva T. V., & Sondomirskaya, A. P. (2002) Disfunkciya e´ndoteliya i arterial´naya gipertoniya: terapevticheskie vozmozhnosti [Endothelial dysfunction and arterial hypertension: therapeutic options] Russkij medicinskij zhurnal, 10(1), 34–41. [in Russian].

Jezovnik M.K. (2011) How to assess endothelial function for detection of pre-clinical atherosclerosis. E-journal Cardiology Practice, 10(22), 10.

Martynov, A. I., Avetyak, N. G., Akatova, E. V., Gorokhovskaya, G. N., & Romanovskaya, G. A. (2005) E´ndotelialnaya disfunkciya i metody ee opredeleniya [Endothelial dysfunction and methods for its diagnostics]. Rossijskij kardiologicheskij zhurnal, 54(4), 94–98. [in Russian].

How to Cite

1.
Turlyun TS. Dynamics of endothelial function violation in patients with arterial hypertension with moderate cardiovascular risk and antihypertensive therapy treatment influence. Zaporozhye medical journal [Internet]. 2016Oct.13 [cited 2024Mar.28];18(4). Available from: http://zmj.zsmu.edu.ua/article/view/79699

Issue

Section

Original research