Evaluation of the effectiveness of inpatient treatment of lipotension in patients with comorbid arterial hypertension stage 3

Introduction. Difficulties in achieving the target level of blood pressure (BP) and lipidograms in patients with arterial hypertension (AH) of the 3rd stage require accounting for comorbidity, low-intensity inflammation, variability of blood pressure, as well as effective combinations of drugs both in the inpatient and outpatient stages of treatment.
Aim. To evaluate the effectiveness therapy of lipotension, reflective synthropy of arterial hypertension (AH) and dyslipidemia, in patients with stage 3 arterial hypertension (AH) and high comorbidity depending on clinical and metabolic characteristics, circadian rhythms of blood pressure (BP) and residual inflammation.
Materials and methods. Retrospective analysis of 87 medical records of patients with stage 3 AH (54 men and 33 women) with an average age of 60,0 ± 7,8 years, related to the controlled (1st group) and uncontrolled (2nd group) AH, included an assessment of the degree of comorbidity, control of blood pressure (BP), BP variability, body mass index, inflammation markers (CRP), lipidogram, as well as an analysis of separate and fixed antihypertensive and lipid-lowering therapy.
Results. Obesity was detected in 58 patients, and grade 3 obesity was found in 17. The median trans-syndromic comorbidity was 5.0 diseases per patient. The non-dipper circadian rhythm was predominant in 77% of patients with controlled hypertension and in all patients with hypertension with comorbid type 2 diabetes mellitus and stage 3 obesity, in which the CRP level correlated with the degree of obesity. Antihypertensive therapy with one and two drugs was prescribed to 16 and 21 patients, respectively, and the target LDL-C level (<1.4 mmol/l) was achieved only in nine out of 87 patients.
Conclusion. High polymorbidity and obesity are associated with impaired circadian rhythms of blood pressure and elevated CRP levels. Insufficient control of blood pressure and dyslipidemia indicate the need for fixed combinations of antihypertensive drugs, combined lipid-lowering therapy taking into account daily blood pressure profiles and residual inflammation.

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