Вплив терапії артеріальної гіпертензії в залежності від класів препаратів на рівні нових біомаркерів запалення РФД-15, Р-селектину та галектину-3

Abstract

The purpose of the study was to assess the impact of antihypertensive therapy depending on the classes of drugs on the level of new biomarkers of inflammation: GDF-15, P-selectin and Galectin-3 in blood plasma in patients with hypertension in combination with type 2 diabetes. Material and methods. The study included 121 patients, including 59 women and 62 men aged 40 to 87 years (mean age 64.7±10.6 years). We determined the levels of new biomarkers of inflammation (GDF-15, P-selectin, Galectin-3), and a reference marker of systemic inflammation (high-sensitive CRP (hs-CRP) using standard kits in patients who participated in the study. We also evaluated the effect of different classes of antihypertensive drugs at the level of new biomarkers. Results and discussion. In the group of patients with unattainable target blood pressure, the level of GDF-15 was significantly higher compared with the group of patients whose target level of "office" blood pressure was achieved at the time of inclusion in the study (3286.10±1523.02 and 2326.60±1581.70 ng / ml, p <0.05, respectively). At the same time, plasma levels of P-selectin and Galectin-3 in patients did not differ significantly. After 12 months of hypertension treatment, depending on the achievement of blood pressure control showed that in the group of patients who managed to achieve the target "office" blood pressure, the level of GDF-15 was significantly lower than in the group of patients who did not reach the target level of "office" blood pressure after 12 months of treatment (3129.67±1134.87 and 2543.12±976.54 ng / ml, p <0.05, respectively). Changes of P-selectin, Galectin-3 and hs-CRP were insignificant after 12 months of treatment of hypertension. Baseline plasma levels GDF-15, P-selectin, Galectin-3 and hs-CRP in patients who received or did not receive RAAS blockers had no significant difference. There was a significantly lower baseline level of GDF-15 in the group of patients receiving CCB (2343.42±1280.70 and 3248.29±1178.56 pg / ml, p = 0.05, respectively). Baseline plasma levels of P-selectin, Galectin-3 and hs-CRP in patients who took or did not take CCB did not have a significant difference. According to the meta-analysis of the chances of taking the drugs had a significant effect on the level of GDF-15, while some groups of drugs did not show a significant additional risk of affecting the level of GDF-15 in patients. Conclusion. The dependence of the GDF-15 level on the achievement of the "target" level of blood pressure can be explained by the positive impact on hemodynamics and structural changes in the cardiovascular system due to better control of blood pressure per se. Antihypertensive drugs affect different pathogenetic mechanisms of inflammation in different ways. According to the analysis of the chances, CCB had the greatest impact on reducing the level of GDF-15. None of the classes of antihypertensive drugs had a significant effect on the level of Galectin-3, and there was a tendency to lower levels of hs-CRP in patients taking blockers of RAS and CCB. The level of P-selectin decreased in patients taking β-blockers due to concomitant use of antiplatelets and anticoagulants