Why the study?
The study assessed the influence of five-component antihypertensive therapy on daily arterial pressure monitoring and myocardial structure and diastolic function in refractory arterial hypertension depending on salt sensitivity.
Does five-component antihypertensive therapy improve blood pressure and myocardial remodeling in patients with refractory arterial hypertension depending on salt sensitivity?
Does five-component antihypertensive therapy improve blood pressure and myocardial remodeling in patients with refractory arterial hypertension depending on salt sensitivity?
Five-component antihypertensive therapy including aliskiren provides significant blood pressure reduction and anti-remodeling effects in refractory hypertension, with greater efficacy in salt-resistant patients.
Five-component therapy yielded greater effects in salt-resistant RAH; leaves open salt-sensitivity-guided regimens pending randomized data.
Objective : assess influence of five-component antihypertensive therapy on the main indicators of the daily monitoring of arterial pressure (DMAP), a structurally functional state and diastolic function of a myocardium at patients with the refractory arterial hypertension (RAH) depending on «saltsensitivity» phenomenon. Material and methods : 88 patients with RAH (54 «salt-sensitive» patients, 34 -«salt-resistant»), receiving as antihypertensive therapy ACE inhibitor, a blocker of slow calcic channels (the digidropiridiny), thiazide diuretics, beta-blocker and direct inhibitor of a renin in full doses are surveyed. To all patients DMAP and an echocardiography till 48 weeks of treatment were carried out. Results : 68,5% of «salt-sensitive» and 79,4% — «salt-resistant» of patients on five-component therapy have reached the target level (TL) the AP. Irrespective of a «saltsensivity» the combination of 5 preparations provided reliable positive changes of all indicators of DMAP and Echo, but thus at «salt-resistant» of patients more expressed positive dynamics of indicators of DMAP, the AP daily profile and a myocardium hypertrophy in comparison with «salt-sensitive» patients is noted. Conclusion : five-component therapy provided more significant antihypertensive and antiremodeling effects at «salt-resistant» of patients with RAH, in comparison with «salt-sensitive».
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Skibitsky et al. (2022) studied this question.
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