Безопасность применения β-адреномиметиков разной длительности действия у пациентов с артериальной гипертонией в сочетании с бронхообструктивными заболеваниями

Abstract

Objective. To examine the safety of beta-agonists (BA) with different duration of action in patients with arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) or bronchial asthma (BA).Materials and methods: 40 patients (22 - male, 18 - female) with AH and COPD and AH and asthma aged 18 years were enrolled and examined initially. At the next three month, patients were treated with 3 types of BA: at the 1st month - with salbutamol (SABA), at the 2nd - with formoterol (LABA), at the 3rd - with indacaterol (ULABA). Initially, after one week and at the end of each month blood pressure (BP) and heart rate (HR) on the visit, oxygen saturation of peripheral blood, computer spirometry, serum potassium in blood, electrocardiogram, were evaluate. Initially, after one week and at the end of three month of treatment with SABA, LABA and ULABA all patients underwent holter monitoring and ambulatory blood pressure 24-monitoring.Results. Baseline, 1-month, 2-month, 3-month BP and HR levels on the visit were similar among all patients ( p =NS). At the end of the 3rd month of treatment with BA different duration of action in patients with AH and COPD daily average systolic BP (SBP) was lowered than initially ( p <0,05), daily average diastolic BP (DBP) during treatment ULABA lower compared to DBP during treatment SABA ( p <0,05) and during treatment LABA for weeks ( p <0,05). On the contrary in patients with AH and asthma daily average SBP became increased than initially ( p <0,05), nightly average SBP during treatment SABA and ULABA for weeks higher compared to nightly average SBP initially. Treatment with BA caused significant serum potassium change in blood in both group. In patients with AH and asthma three patients had hypokalemia.Conclusion. Treatment with BA in patients with AH and bronchoobstructive diseases accompanied by significantly changes BP and significantly decreased levels of serum potassium in the blood in both group. Our results suggested the need for a different treatment of patients with AH and COPD or asthma.