The effectiveness of multicomponent antihypertensive therapy in patients with chronic kidney disease in combinations with subclinical hypothyroidism
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Abstract
The objective: to evaluate the effectiveness of multicomponent antihypertensive therapy in patients with chronic kidney disease (CKD), depending on the functional state of the thyroid gland.
Patients and methods. The study included 60 patients with CKD in combination with hypertension, which were divided into two groups, depending on the presence of subclinical hypothyroidism (SG). In order to control blood pressure, both groups were assigned two and three component antihypertensive therapy (AGT), depending on the degree of arterial hypertension: valsartan 160 mg, amlodipine 10 mg and valsartan 160 mg, amlodipine 10 mg, hydrochlorothiazide 12,5 mg (Kombisart and Kombisart H, Kyiv Vitamin Factory).
Results. Mean systolic and diastolic pressure in patients with CKD and SG at the beginning of the study were 164,8±27,6 and 97,2±11,2 mm Hg. according; in patients with preserved thyroid function – 162,3±23,7 and 94,3±10,6. Target values of blood pressure reached 76,67% of patients who were assigned bicomponent AGT, and 80% of patients who received a three component AGT. Both combinations of antihypertensive drugs positively influenced on the daily monitoring of blood pressure: among patients with CKD with SG, the number of «non dipper» decreased by 36,6%, and among patients with preserved thyroid function – by 40%. In the end of observation there was a significant improvement of endothelium dependent vasodilatation in both groups.
Conclusion. The use of two and three component AGT (Kombisart and Kombisart H) in patients with CKD and SG ensured achievement of target values of arterial pressure, improvement of endothelial function and normalization of the 24 hour BP profile.
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