The dissertation is devoted to increasing the effectiveness of diagnosis and treatment of patients with arterial hypertension (AG) of the I-II stage, 1-2 degrees when using combined antihypertensive drugs in combination with metabolic therapy - quercetin.
The purpose of the study was to increase the effectiveness of treatment of patients with hypertension stage I-II based on the study of the dynamics of daily monitoring of blood pressure and ECG, echocardiography, blood lipid spectrum, markers of systemic inflammation and endothelial dysfunction against the background of quercetin use for 12 weeks with combined antihypertensive therapy (ramipril with amlodipine).
The objectives of the study were to study the dynamics of the daily profile of blood pressure in people with hypertension according to DMAT indicators, to analyze the dynamics of Echocardiogram and Holter-ECG indicators, blood lipid spectrum, systemic inflammation and endothelial dysfunction depending on the additional use of quercetin, to establish correlations between these indicators, determination of predictors of not reaching the BP target values and the role of quercetin in the predictor effect.
The object of the study is hypertension of the I-II stages, 1-2 degrees.
The subject of the research: peculiarities of the course of hypertension of the I-II stage, 1-2 degrees, dynamics of DMAT indicators, Echocardiography, Holter-ECG, blood lipid spectrum, indicators of non-specific systemic inflammation: PSA, IL-1, IL-6, TNF-α; vascular endothelium adhesion molecules (s-VCAM) and type I intercellular adhesion molecules (s-ICAM-1); ET-1.In accordance with the tasks set, 120 patients (66 women and 54 men) with hypertension of the I-II stages, 1-2 degrees were examined, who, after explaining the main stages of diagnosis, treatment and signing the informed consent, took part in the scientific study.
During the clinical study, depending on the treatment method, patients were divided into 2 groups: Group I (main) – 58 patients who, in addition to basic therapy, received quercetin (Corvityn®), average age 57.87 ± 13.6 years; II group (comparison) – 62 patients who received only basic antihypertensive therapy, average age 59.09 ± 12.47 years.
For the first time, it was demonstrated that 12-week use of quercetin in the complex of combined antihypertensive therapy contributes to better control of all indicators of blood pressure regulation in a significantly larger proportion of patients with hypertension due to a significantly more intense and faster decrease in the average values of SBP, DBP, and PAT. and achieving their target levels, a more significant reduction of IR SBP and IR DBP, variability of SBP and DBP, SRP SBP and DBP and normalization of pathological types of the diurnal BP profile.
For the first time, it has been proven that the additional use of quercetin in the treatment scheme of hypertension is accompanied by a more pronounced improvement in the structural and functional state of the myocardium, evidenced by a significantly more intense decrease in the average values of LVMI, TMSHP and, as a result, a decrease in the frequency of episodes of ventricular, supraventricular extrasystole and paroxysms of AF.Added data on the hypolipidemic ability of quercetin, the use of which in hypertensive patients with dyslipidemia leads to a significantly faster and significantly more intense decrease in the average levels of proatherogenic fractions of lipids (cholesterol, LDL-C, LDL-C, TG), as well as the percentage of individuals exceeding the target or reference levels these indicators.
For the first time, it has been proven that taking quercetin by patients with hypertension for 12 weeks, in addition to the basic combined antihypertensive therapy, is accompanied by a significantly more significant decrease in the average levels of the main indicators of systemic inflammation, adhesion molecules and endothelial dysfunction, and a more significant decrease in the percentage of individuals exceeding their reference values, compared to patients basic treatment groups.
For the first time, predictors of not reaching the target values of ser.SAT were established, and a multivariate regression model was built, which allows predicting the risks of not reaching the target BP indicators when the reference values of individual DMAT indicators, markers of inflammation, endothelial dysfunction, and blood lipid spectrum are exceeded.
