Functional status of sympathetic-adrenal system and kidneys in perimenopausal women with arterial hypertension treated with antihypertensive therapy
https://doi.org/10.21518/2079-701X-2013-2-2-34-41
Abstract
84 women in perimenopause confirmed by medical history and hormonal status tests participated in the study; control group consisted of 64 patients with first or second degree hypertension and 20 apparently healthy women. Daily monitoring included blood pressure control, assessment of the functional status of sympathetic-adrenal system by the size of β-adrenoreceptors in erythrocyte membranes, test for microalbiminuria and glomerular filtration rate using Cockcroft-Gault formula. Group 1 included patients with first degree hypertension (23 women) which received losartan 50-100 mg/d monotherapy (Losarel, Sаndоz); group 2 patients (43 women) with second degree hypertension received combination therapy: losartan 100 mg/d and Lodoz (bisoporol 5 mg + hydrochlorothiazide 6.25 mg). Treatment lasted 12 weeks; patients were examined before inclusion in the study and after the study. Reduction in blood pressure to the target level was registered in all patients. There were no side or adverse effects. Initially elevated levels of β-adrenoreceptors in erythrocyte membranes significantly decreased in both groups, as a result of improved functional status of sympathetic-adrenal system. Renal excretion of nitrogen evaluated by glomerular filtration rate was not impaired; microalbiminuria increased manifold compared to reference values. After 12 weeks of treatment, microalbiminuria decreased in patients of all groups as a result of nephroprotective effect of antyheprtensive drug therapy.
About the Authors
Y. V. Brytkova
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Russia’s Ministry of Health
Russian Federation
Russian Federation
I. S. Gomova
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Russia’s Ministry of Health
Russian Federation
Russian Federation
O. V. Tatarinova
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Russia’s Ministry of Health
Russian Federation
Russian Federation
R. I. Stryuk
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Russia’s Ministry of Health
Russian Federation
Russian Federation
References
1. Оганов Р.Г. Развитие профилактической кардиологии в России // Кардиоваскулярная терапия и профилактика. 2004; 3(3), ч. 1: 10–14.
2. Haller H. Effective management of hypertension with dihydropyridine calcium channel blocker–based combination therapy in patients at high cardiovascular risk // Int. J. Clin. Pract., 2008; 62(5): 781–790.
3. Wolf-Maier K. et al. Hypertension treatment and control in five European countries, Canada and the United States. Hypertension, 2004; 43: 10–17.
4. Шальнова С.А., Баланова Ю.А., Константинов В.В. и др. Артериальная гипертония: распространенность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения Российской Федерации // Российский кардиологический журнал. 2006; 4: 45–50.
5. Оганов Р.Г., Масленникова Г.Я. Гендерные различия кардиоваскулярной патологии // Кардиоваскулярная терапия и профилактика. 2012; 11(4): 101–104.
6. Подзолков В.И., Брагина А.Е., Маколкин В.И. Патогенетическая роль моксонидина при лечении артериальной гипертензии у женщин в перименопаузе // Кардиология. 2002; 11: 32–35.
7. Posner B.M., Cupples L.A., Miller D.R. et al. Diet, menopause and serum cholesterol levels in women: the Framingham Study 1 //Am. Hear1 J., 1993; 125: 483–489.
8. Сметник В.П. Защитное влияние эстрогенов на сердечно-сосудистую систему // Consilium Мedicum. Экстравыпуск, 2002; 3–6.
9. Белоусов Ю.Б., Глезер М.Г., Хвостова Э.Б. и др. Влияние моэксиприла на качество жизни у женщин в постменопаузе, страдающих артериальной гипертонией // Тер. арх. 2005; 10: 75–79.
10. Чазова И.Е., Мычка В.Б. Метаболический синдром // Кардиоваск. тер. и профил. 2003; 3: 32–37.
11. Bohm M., Thoenes M., Danchin W. et al. Association of cardiovascular risk factors with microalbuminuria in hypertensive individuals: the i-SEARCH global study // J Hypertens, 2007; 25: 2317–24.
12. Scblessinger S.D., Tankersey M.R., Crtis J.J. Clinical documentatijn or end-stage renal disease due to hypertension // Am.J. Kidney Dis., 1994; 23: 655-60.
13. Стрюк Р.И., Длусская И. Г. Адренореактивность и сердечно-сосудистая система. М.: Медицина, 2003.
14. Стрюк Р.И., Бухонкина Ю.М., Брыткова Я.В., Шоикиемова Д.У., Павлова Л.Н. Бисопролол в лечении сложных нарушений сердечного ритма при беременности // Эффективная фармакотерапия в кардиологии и ангиологии. 2008; 1: 42 – 45.
15. Redon J., Baldo E., Lurbe E. et al. Vbkroalbuminuria, left ventricular mass and ambulatory blood pressure in essential hypertension // Kidney Int., 1996; 55: 81–4.
16. Jensen J.S., Borcb J.K., Jensen S. et al. Microalbuminuria reflects a generalized transvascular albumin leakiness in clinically bealtby subject // Clin. Sci. Colcb., 1995; 88: 629–33.
17. Руководство по артериальной гипертонии / под ред. акад. Е.И. Чазова и проф. И.Е. Чазовой М.: Медиа Медика, 2005
Review
For citations:
Brytkova YV, Gomova IS, Tatarinova OV, Stryuk RI. Functional status of sympathetic-adrenal system and kidneys in perimenopausal women with arterial hypertension treated with antihypertensive therapy. Meditsinskiy sovet = Medical Council. 2013;(2-2):34-41. (In Russ.) https://doi.org/10.21518/2079-701X-2013-2-2-34-41
Views:
428
Email this article 