PECULIARITIES OF PHARMACOTHERAPY IN ARTERIAL HYPERTENSION AND COMORBID PATHOLOGY

Area of Science:

• Cardiology
• Nephrology
• Pharmacology

Background:

• Arterial hypertension (AH) pharmacotherapy is often ineffective due to comorbid conditions.
• Understanding hemodynamic and metabolic processes is crucial for effective AH management.
• Comorbidities like coronary artery disease and obesity complicate AH treatment.

Purpose of the Study:

• To investigate the impact of different antihypertensive regimens on hemodynamic and metabolic parameters in patients with AH, coronary artery disease, and obesity.
• To identify treatment strategies that improve life quality and prognosis in complex AH cases.

Main Methods:

• A study involving 60 patients with AH, coronary artery disease, and obesity.
• Three treatment regimens were compared: Regimen I (lisinopril + atorvastatin + aspirin), Regimen II (lisinopril + atorvastatin + bisoprolol + aspirin), and Regimen III (lisinopril + bisoprolol + indapamide + atorvastatin + aspirin).
• Laser correlation spectrometry (LCS) was employed to assess homeostatic alterations.

Main Results:

• All regimens effectively normalized systolic blood pressure without affecting ejection fraction.
• Regimen III demonstrated a significant increase in glomerular filtration rate (92.73 ± 2.12 vs 79.62 ± 13.62 ml/min/1.73m²).
• LCS revealed elevated light scattering particles in Regimen III, suggesting anabolic process activation, with less pronounced spectral alterations in other groups.

Conclusions:

• Antihypertensive therapy induces homeostatic and metabolic alterations that can influence treatment efficacy.
• Combination therapy including lisinopril, bisoprolol, indapamide, and atorvastatin shows promise for improving renal function in complex AH.
• Further research into metabolic effects of antihypertensives is warranted for personalized treatment strategies.