Relationship between cardiac rhythm disorders, serum urotensin ІІ and angiotensin ІІ levels in patients with stage ii hypertension and carotid atherosclerosis in dynamics of treatment with candesartan and lercanidipine

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Arterial hypertension is one of the most common diseases of the cardiovascular system. Objective – to study dynamics of cardiac rhythm disorders, serum urotensin II and angiotensin II levels in patients with stage II hypertension associated with carotid atherosclerosis during treatment with candesartan and lercanidipine. Methods of the study. Under our observation there were 122 patients with stage 2 hypertension aged between 36–75 years. Average age of the patients was 51.52±1.27 years, including men – 52 (43 %), women – 70 (57 %). Cardiac arrhythmias and conduction disorders were detected by means of Holter ECG. Serum urotensin II and angiotensin II levels in the blood serum were determined by use of an immunoenzymatic method. Statistical analysis was performed by means of the Statistica ® 6.0 for Windows (StatSoft Inc.) software using parametric and nonparametric methods. Results. It was found that the receiving of lercanidipine and candesartan showed unidirectional positive effect on cardiac rhythm disorders in most patients with stage II hypertension. The use of candesartan statistically insignificantly increased levels of angiotensin II in patients of the first group of observation by 20.8 % compared with baseline values (p>0.05). However, as a result of candesartan treatment serum angiotensin II levels in patients with stage II hypertension without carotid atherosclerosis reliably increased by 47.1 % (p<0.05). Unlike candesartan, the use of lercanidipine leads to a statistically significant decrease in the concentration of urotensin II by 30.8 % (p<0.05) in patients with stage II hypertension associated with carotid atherosclerosis. Conclusions . Lercanidipine can be recommended as a first line antihypertensive drug in case of simultaneous hypertension and atherosclerotic lesion of brachiocephalic arteries.