Estimation of the influence of photobiomodulation on the endothelial function in patients with arterial hypertension under the conditions of hyperuricemia

Abstract

Introduction. In 2015, the global prevalence of hypertension in the world was estimated at 1.13 billion. The European Association for the Treatment of Hypertension (ESH) updated its recommendations in 2018 and officially added to the already existing risk factors of hypertension hyperuricemia. In patients with comorbidity of hyperuricemia and hypertension, endothelial dysfunction is observed. The aim of the study is to establish correlation between uric acid level and pulse wave velocity, Tei index, endothelium-dependent vasodilation of the brachial artery and evaluate the effect of photobiomodulation on endothelial dysfunction in patients with hypertension. Materials and methods. The study included 102 patients with hypertension: 48 without hyperuricemia (group 1) and 54 with comorbidity of hypertension and hyperuricemia (group 2). Groups 1A and 2A received antihypertensive therapy. Groups 1B and 2B — antihypertensive therapy with a course of intravenous laser therapy with a wavelength of 635 nm, course 10 procedures. Endothelium-dependent vasodilation of the brachial artery was determined by a breakdown with reactive hyperemia. Tei index was calculated during echocardiography. The pulse wave velocity was measured with a SonoScape S6 Pro. Results. Antihypertensive therapy in group 1A reduced the rate of the pulse wave by 7.8 %. Antihypertensive therapy and intravenous laser therapy in Group 1 reduced uric acid by 5.7 %, pulse rate by 12.2 %, Tei index by 9.5 %, increased endothelium dependent vasodilation of the brachial artery by 19.1 % (p < 0,05). Antihypertensive therapy in Group 2A reduced uric acid by 4.7 %, pulse rate by 8.5 % and increased endothelium-dependent brachial artery vasodilation by 31.7 %. Combined use of antihypertensive therapy and intravenous laser therapy in group 2B reduced uric acid by 19.2 %, pulse wave speed by 21.9 %, Tei index by 29.0 %, increased endothelium- dependent vasodilation of the brachial artery by 97.7 % < 0.05). A correlation was established between uric acid level and endothelium dependent vasodilation of the brachial artery r = - 0.62 (p < 0.001) and between uric acid level and pulse wave velocity r = + 0.68, uric acid level and systolic blood pressure (day ) r = + 0.48 (p < 0.001), uric acid level and Tei index r = + 0.47 (p < 0.05). Conclusion. Given the established negative correlation between the mean strength between uric acid level and endothelium-dependent vasodilation of the brachial artery, it is appropriate to use in clinical practice a combination of antihypertensive therapy with intravenous laser therapy, which significantly reduces the level of uterine fibrillation hypertension and in patients with comorbidity of hypertension and hyperuricemia.