THE EFFECTIVENESS OF VARIOUS COMBINATIONS OF ANTIHYPERTENSIVE DRUGS IN PATIENTS WITH HIGH BLOOD PRESSURE ON THE BACKGROUND OF OBESITY AND IRRITABLE BOWEL SYNDROME WITH CONSTIPATION
DOI:
https://doi.org/10.11603/2415-8798.2019.1.9996Keywords:
obesity, arterial hypertension, irritable bowel syndrome, urapidilAbstract
Obesity is one of the main causes of increased blood pressure, and its combination with irritable bowel syndrome with constipation contributes to its higher rates and unfavorable daily profits. The multifactorial nature of pathogenesis and the inability to identify the leading mechanisms for its development require the search for new combinations of antihypertensive drugs.
The aim of the study – to investigate the efficacy of α1-adrenergic blocker (urapidil) on daily blood pressure, lipid profile and serotonin levels in patients with this comorbidity.
Materials and Methods. We examined 89 patients with obesity, arterial hypertension and irritable bowel syndrome with constipation, divided into 4 groups depending on the combination of antihypertensive drugs.
Results and Discussion. The most pronounced therapeutic effect was established following the administration of urapidil 30 mg twice a day, which was manifested by the most significant reduction in daily systolic and diastolic blood pressure, left ventricular myocardial mass, terminal systolic and diastolic volume, and increased ejection fraction compared with Patients receiving the angiotensin converting enzyme inhibitor, calcium channel blockers and thiazide diuretic in combination with statins and patients who received vita-melatonin 3 mg per before sleeping in addition to this therapy.
Conclusions. After a course antihypertensive therapy with urapidil, the lipidograms improved significantly, the frequency of defecation increased, and serotonin levels in the blood close to normal values.
References
Greegg, E.W., & Shaw, J.E. (2017). Health Effects of Overweight and Obesity in 195 Countries over 25 Years. The GBD 2015 Obesity Collaborations. N Engl J Med., 377, 13-27. DOI: 10.1056/NEJMoa1614362
Żukiewicz-Sobczak, W., Wróblewska, P., Zwoliński, J., Chmielewska-Badora, J., Adamczuk, P., Krasowska, E., … & Silny, W. (2014). Obesity and poverty paradox in developed countries. Ann Agric Environ Med., 21 (3), 590-594 DOI:https://doi.org/10.5604/12321966.1120608.
Sur, G., Sur, M., Kudor-Szabadi, L., Sur, L., Sporis, D., & Sur, D. (2010). Arterial hypertension – prevalence of risk factors and morbide associations that increase cardiovascular risk. Maedica (Buchar), 5 (1), 34-40.
Bloch, K.V., Klein, C.H., Szklo, M., Kuschnir, M.C.C., de Azevedo Abreu, G., … & Beres Lederer Goldberg, T. (2016). ERICA: prevalences of hypertension and obesity in Brazilian adolescents. Rev Saude Publica, 50 (1), 9. doi: 10.1590/S01518-8787.2016050006685.
Zuev, K.O. (2014). Osobennosti arterialnoy gipertenzii v zavisimosti ot kolichestva i raspredeleniya zhirovoy tkani u bolnykh sakharnym diabetom II tipa [Features of arterial hypertension, depending on the amount and distribution of adipose tissue in patients with type II diabetes mellitus]. Mizhnarodnyi endokrynolohichnyi zhurnal – International Endocrinology Journal, 8 (64). Doi:https://doi.org/10.2214/2224-0721.8.04.2014.77859.
Mishchuk, V.G., Grygoruk, G.V., Stupnytska, H.Y., & Levchuk, R.D. (2018). Ghrelin level and types of eating behavior when combined with irritable bowel syndrome, arterial hypertension and obesity. Archives of the Balkan Medical Union, 53 (3), 324-329. https://doi.org/10.31688/ABMU.2018.53.3.02.
Colosia, A,D,, Palencia, R., & Khan, S. (2013). Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. Diabetes Metab Syndr Obes, 6, 327-338. doi: 10.2147/DMSO.S51325.
Kovaleva, A.O., Panova, E.I., Morozova, E.P., Zhdankina, N.V., Karpunina, O.N., & Petrov, S.A. (2017). Osobennosti gormonalno-metabolicheskikh pokazateley u muzhchin s arterialnoy gipertenziyey, protekayushchey na fone androidnogo ozhireniya [Features of hormonal and metabolic parameters in men with arterial hypertension, leaking against android obesity]. Vestnik sovremennoy klinicheskoy meditsiny – Bulletin of modern clinical medicine, 10 (4), 37-43. Doi:1020969/VSKM.2017/10(4).37-43 [in Russian].
Nedogoda, S.V., Salasyuk, A.S, Baryikina, I.N., Tsoma, V.V., Chumachek, E.V., & Hripaeva, V.Yu. (2014). [Features of antihypertensive therapy in obesity]. Meditsinskiy sovet – Medical Council, 17, 42-49. Retrieved from: https://doi.org/10.21518/2079-701X-2014-17-42-49 [in Russian].
Tseluyko, V.I. (2015). Urapidil v lechenii patsiyentov s arterialnoy gipertenziyey: effektivnoye snizheniye arterialnogo davleniya i zashchita organov-misheney [Urapidil in the treatment of patients with arterial hypertension: effective reduction of blood pressure and protection of target organs]. Zdorovia Ukrainy – Zdorovya Ukrainy, 22 (371), UA(EB)1115/0001 [in Russian].
Skybchyk, V.A., & Babliak, S.D. (2011). Problemy u likuvanni arterialnoi hipertenzii: renesans urapidylu [Problems in the treatment of arterial hypertension: Renaissance Urapidil]. Liky Ukrainy – Drugs of Ukraine, 1 (5), 6-10 [in Ukrainian].
Buch, J. (2010). Urapidil a Dual-Acting Antihypertensive Agent: Current Usage Considerations. AdvTher, 27 (7), 1-18. DOI 10.1007/s12325-010-0039-0.
Gaponova, N.I., Abdrahmanov, V.R., Kadyishev, V.A., & Sokolov, A.Yu. (2014). Antigipertenzivnyy preparat kombinirovannogo deystviya urapidil: effektivnost i bezopasnost primeneniya v klinicheskoy praktike [Antihypertensive drug of combined action of urapidil: efficacy and safety of use in clinical practice]. Kardiovaskulyarnaya terapiya i profilaktika – Cardiovascular therapy and prophylaxis, 13 (1), 57-63. https://doi.org/10.15829/1728-8800-2014-1-57-63 [in Russian].
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., … & Kahan, T. (2018). The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. European Heart Journal, 39, 3021-3104. doi:10.1093/eurheartj/ehe339.
Nurmakova, M.A., Zarubekova, N.Z., & Mahanova, B.D. (2014). Opyt primeneniya “Ebrantila” (“Urapidila”) pri terapii bolnykh s arterialnoy gipertenziyey [Experience with Ebrantil (urapidil) in the treatment of patients with arterial hypertension]. Vestnik Kazahskogo Natsionalnogo meditsinskogo universiteta – Bulletin of the Kazakh National Medical University, 2 (2), 197-198 [in Russian].
Diaconu, C.C., Dragoi, C.M., Bratu, O.G., Neagu, T.P., Stoian, A.P., & Cobelschi, P.C. (2018). New approaches and perspectives for pharmacological treatment of arterial hypertension. Farmacia, 66, 3408. DOI:10.31925/farmacia.2018.3.4.
Wats, S.W., Morrison, S.F., Davis, R.P., & Barman, S.M. (2012). Serotonin and Blood Pressure Regulation. Pharmacol, 64 (2), 359-388. Doi:10.1124/pr.111.004697.
Aflyatumova, G.N., Nigmatullina, R., Sadykova, D.I., Chibireva, M.D., Fugetto, F., & Serra, K. (2018). Endothelin-1, nitric oxide, serotonin and high blood pressure in male adolescents. Vascular Healht and Risk Management, 14, 213-223.
Davis, R.P., Szasz, T., Garver, H., Brunett, R., Tykoski, N.R. & Watts, S.W. (2013). One-Month Serotonin Infusion Results in a Prolonged Fall in Blood Pressure in the Deoxycorticosterone Acetate (DOCA) Salt Hypertensive Rat. ACS Chem. Neurosci, 4 (1), 141-148. Doi.10.1021/cn.300114a.
Downloads
Published
How to Cite
Issue
Section
License
Authors who sent their manuscript to "Вісник наукових досліджень. Bulletin of Scientific Research" Surgery agree to the following terms:
a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)