ВЛИЯНИЕ ГИПОТЕНЗИВНОЙ ТЕРАПИИ НА ПОКАЗАТЕЛИ ГЕМОДИНАМИКИ У БОЛЬНЫХ ГИПЕРТОНИЧЕСКОЙ БОЛЕЗНЬЮ В СОЧЕТАНИИ С РЕВМАТОИДНЫМ АРТРИТОМ

Abstract

Introduction. The appointment of antihypertensive therapy in patients with comorbidity of primary hypertension and rheumatoid arthritis, considering the activity of rheumatoid arthritis is not always specified, and therefore is an urgent issue that may cause a discrepancy between the hemodynamic influence of the prescribed therapy and the nature of existing hemodynamic shifts in this category of patients. Aim. Impact evaluation of the 6-month antihypertensive therapy with drugs of various classes on the hemodynamic parameters of the circulatory system in patients with hypertension stage II combined with rheumatoid arthritis, including its activity. Material and methods. Patients complying the inclusion criteria by age (58.6±6.4 years), hypertension duration (11.2±1.6 years), debut (aged 45-64 years) and rheumatoid arthritis experience (7.2±2.1 years) were formed into three groups: Group I included 277 patients with hypertension stage II (136 men, 141 women); Group II consists of 142 patients (28 men, 114 women) with hypertension stage II and rheumatoid arthritis (in the stage of clinical and laboratory remission); and in Group III there were 112 patients (20 men, 92 women) with hypertension stage II and rheumatoid arthritis (in the stage of clinical and laboratory exacerbation). Antihypertensive therapy was administered by polyclinic physicians. Lisinopril, nebivolol, losartan, amlodipine, indapamide and an unfixed combination of lisinopril and indapamide were prescribed as monotherapy drugs. The follow up period has lasted for 6 months. Results and discussion. Effectiveness control of the prescribed therapy in 6 months was presented in patients in Groups I and II with positive dynamics of morphometric and velocity parameters, in patients in Group III, the indicators were less significant and more delayed. Conclusion. Rheumatoid arthritis presence adds additional changes in the dynamics of the hemodynamic influence of the prescribed antihypertensive therapy, and is determined by the activity degree of the disease and the adequacy of basic anti- inflammatory therapy.