The dynamics of 24-hour ambulatory blood pressure monitoring parameters, subclinical damage and endothelial function of vessels in patients with arterial hypertension and chronic obstructive pulmonary disease treated with S-amlodipine, Nebivolol and Enala
DOI:
https://doi.org/10.14739/2310-1210.2017.1.91614Keywords:
arterial hypertension, chronic obstructive pulmonary disease, S-amlodipine, nebivolol, enalapril, treatmentAbstract
Aim of the research was to investigate additional prescription of S-amlodipine or Nebivolol to Enalapril treatment on the 24-h blood pressure monitoring (BPM) parameters, subclinical damage and endothelial function of vessels, and to make of proposing of treatment of the arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD).
Material and Methods. 95 patients (64 males and 31 females) with AH II stage and COPD III stage in remission were observed. The average age was (54.7 ± 9.5) years. The 24-h BPM by devices “АВРМ-04” (“Meditech”, Hungary) and “EBPM” (“Innomed”, Hungary) was provided to all patients. Stiffness index of aorta (ASI) was evaluated by Yu.M. Sirenko and G.D. Radchenko method (2009). Reactive hyperemia test was performed by D.S. Celermajer, K.E. Sorensen et al. method (1992). Computer spirography was made by “SpiroCom” (HAI-Medica, Ukraine). The serum level of endothelin -1 (ET 1) was detected by ELISA (“Peninsula Laboratories”, USA).
Results. It was established, that additional prescription of S-amlodipine or Nebivolol to Enalapril and standard therapy of COPD during 6 month had strong antihypertensive effect, normalized 24-hours blood pressure profile, decreased blood pressure loading and subclinical damage indices, such as: pulse blood pressure, heart rate and ASI.
Conclusion. Treatment of patients with AH and COPD should be differentiated. In case of prevalence of the clinical, laboratory and instrumental signs of broncho-obsctructive syndrome, presence of subclinical damages and elastic qualities of vessels and endothelial dysfunction in patients with AH and COPD S-amlodipine should be prescribed additionally to Enalapril and basic therapy of CODP. In case of AH and COPD with hypersympatheticotonia, sings of blood pressure loading, increase of pulse BP and tachycardia beta-blocker Nebivolol should be added to the treatment.
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