Effect of a combination of angiotensin-converting enzyme inhibitor and diuretic on the frequency and parameters of lower limb venous reflux in working-age men with hypertension

Abstract

Aim. To study the effect of combined antihypertensive therapy on the characteristics of venous reflux in working-age men with hypertension (HTN).Material and methods. We examined 44 men aged 30-50 years with uncontrolled HTN. The dynamics of the rate, temporal and velocity parameters of venous reflux was analyzed for a 14-15 days of combined therapy with an angiotensin-converting enzyme inhibitor (perindopril, 8 mg) and a diuretic (indapamide, 1,5 mg) both in the general group (n=44) and in groups of 22 men with/without chronic venous disease (CVD). CVD was diagnosed by physical examination according to the CEAP criteria. Reflux was assessed at rest by ultrasound of symmetric superficial, deep and perforator veins.Results. In the general group of patients (n=44), a decrease in blood pressure was associated with significant negative dynamics of the reflux rate in all veins from 0 to 37, a positive dynamics only from 7 to 0 (p=0,0001). Analysis of the dynamics of reflux duration and velocity before and after treatment did not show any differences. The use of combination therapy in patients with HTN and CVD was associated with an increase in the reflux number (p=0,0001), while in patients with HTN without CVD, no significant dynamics was recorded. The proportion of patients with reflux after treatment in the CVD group more than doubled. Comparison of the temporal and velocity reflux parameters after treatment between the groups with/without CVD did not reveal any differences.Conclusion. Two-week therapy with an angiotensin-converting enzyme inhibitor and a diuretic in working-age men with uncontrolled hypertension is accompanied by the appearance of a significant number of new venous refluxes, which is due to the presence of CVD among patients with hypertension. After treatment, the proportion of patients with reflux in the group with AH and CVD more than doubled.