Tarasova V. Comorbidity of hypertension and irritable bowel syndrome, clinical and pathogenetic features, optimization of treatment.

An integral concept of comparison of clinical manifestations of the comorbidity pathology of hypertension (HNT) and irritable bowel syndrome (IBS) with pathogenetic mechanisms of its development, progression and complications has been created. It has been established that the prevalence of IBS in patients with HTN is 54.1%. The features of the comorbidity of HNT and IBS are determined. In the experiment, it has been shown that IBS is associated with arterial hypertension. The data are supplemented in favor to the scientific hypothesis about the association of adverse cardiovascular prognosis in the patients with HNT in combination with IBS in the presence of connective tissue dysplasia. It has been demonstrated that the autonomic status of the patients with HNT is characterized by prevalence of sympatheticonia which is typical to 79.2% of the patients. A dynamic decrease of the activity of the neuropeptide Y and the vasointestinal peptide in hypertensive patients was associated with the severity of the disease and the clinical variant of the IBS. The expediency of stratification of HNT patients with concomitant IBS was grounded to determine the prognosis of the disease based on new data on the prognostic significance of autonomic status, the presence of connective tissue dysplasia, the content of ionized calcium and magnesium in the serum of patients and levels of neuropeptide Y and vasointestinal peptide in plasma. Improvement in the treatment of the hypertensive patients by inclusion a combination of metoprolol with magnesium to the scheme of standard hypotensive therapy with comorbiditive IBS.