Dynamics of endothelial function violation in patients with arterial hypertension with moderate cardiovascular risk and antihypertensive therapy treatment influence

Abstract

Aim. To assess the impact of one-year monitored different groups’ antihypertensive therapy on markers of endothelial dysfunction. Materials and methods. We examined 48 hypertensive patients with moderate cardiovascular risk. Among them: 1a subgroup took losartan potassium, 1b – standard antihypertensive drugs without sartans. During the year all patients except of general clinical examination were studied by such special clinical and laboratory parameters as concentration of endothelial dysfunction markers in serum (endothelin-1, thrombomodulin and von Willebrand factor). Results. With constant monitoring of pressure on the background of a statistically comparable levels of SBP in the subgroups at the beginning of the study (p<0.05), during the fourth visit SBP was significantly decreased in subgroup 1a compared with the control subgroup (p<0.05). Dynamics of DBP levels with antihypertensive therapy in both subgroups was also statistically significant (p<0.001, compared to baseline). Positive changes of lipid metabolism indices were observed during 12 months of monitoring in both subgroups of patients from the second visit (from p<0.05 to p<0.001), indicating a reduction of cardiovascular events risk. There is a significant difference of indicators with comparable baseline levels of ET-1 and vWF in subgroups (p<0.05) after a year of monitoring – in patients treated with losartan potassium, rates are lower than in the control subgroup. Thrombomodulin levels in the subgroup of patients treated with losartan potassium were significantly decreased in a year (p<0.05), whereas subgroup 1b on antihypertensive therapy without angiotensin II receptors antagonist using, this indicator almost has not changed. Reduction of all ED markers indicates the tendency to establishing of pro- and anti-platelet systems balance, especially expressed in patients who were treated with losartan potassium. Conclusion. Cardiovascular events risk reduction is caused by stabilization of blood pressure, indices of lipid profile lowering, the tendency to endothelial function improvement, especially with losartan potassium therapy.