Сучасні дані щодо напрямів терапії есенціальної гіпертензії у хворих із метаболічним синдромом і COVID-19 та визначення можливостей запобігання розвитку віддалених ускладнень

Abstract

The review article includes information on data on the treatment of patients with essential hypertension and manifestations of metabolic syndrome and their effectiveness in preventing the development of long-term complications of COVID-19. The pandemic of acute respiratory syndrome caused by SARS-CoV-2 requires changes in the approach to the treatment and prevention of metabolic syndrome and essential hypertension, as the presence of these comorbidities worsens the course and prognosis of infectious disease. Some pathogenetic links have been identified that affect these pathological conditions. Emphasis is placed on the key role of a balanced and healthy diet, as a component of a healthy lifestyle, in maintaining the optimal functional state of the cardiovascular system. It is also noted that the course of infectious disease caused by SARS-CoV-2 in patients with metabolic syndrome is more severe and more often leads to complications. Since COVID-19 is recognized as a multi-organ disease with a wide range of manifestations and long-term symptoms, data on the course of this disease in patients with hypertension and metabolic syndrome were analyzed. Endothelial dysfunction is highlighted as one of the pathogenetic links that combines essential hypertension, insulin resistance and atherosclerosis, and options for its correction are considered. Standards for the treatment of essential hypertension and metabolic syndrome in view of the COVID-19 pandemic are presented. Information on the ability of statins to increase glycemia with long-term use, especially in patients with metabolic syndrome, is given. Conclusion. A number of drugs that have antioxidant, vasodilator and anti-inflammatory properties that do not cause an increase in glycemia, including quercetin, have been proposed. Its positive effect on the level of blood pressure has been revealed, which implies its use as an adjunct to antihypertensive therapy. The combination of quercetin and vitamin C is considered as an adjunct to basic therapy for COVID-19 disease and its long-term complications. Further studies are planned to determine the clinical value of quercetin supplements in therapy of essential hypertension, rehabilitation of patients after COVID-19, stabilization of dyslipidemia and insulin resistance, as well as dose adjustment and study of possible drug interactions between quercetin and antihypertensive drugs