Features of the Course and Treatment of Hypertension in Combination with Chronicis Chemic Heart Disease in Patients with Gastroesophagel Refluxdisease. Role of Proton Pump Inhibitors Test in the Diagnosis and Treatment of Different Forms of GERD
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Abstract
The analysis of epidemiological data shows that the prevalence of GERD in Ukraine is 11.1. Prevalence of GERD increases with the age of respondents, which leads to changes in the structure of clinical disease and dominance of extraesophageal manifestations of disease.
The objective: To study features of arterial hypertension (AH) combined with chronic coronary heart disease (CHD) in patients with GERD. Establish a connection presence of gastroesophageal reflux with possible clinical manifestations of coronary heart disease (arrhythmias, ischemic episodes according to the daily ECG monitoring, assessment of the severity of pain in the chest), and parameters of blood pressure and its lability.
Patients and methods. As part of the fragment study examined 50 patients with hypertension I–II art. combined with chronic ischemic heart disease. Methods of examination: antopometric, biochemical blood tests, ambulatory blood pressure monitoring. Holter ECG, upper endoscopy, echocardiography, tests on a scale GerdQ.
Results. Comorbidity of hypertension and chronic ischemic heart disease and GERD is associated with a higher frequency of abdominal type of obesity and metabolic syndrome, which increases the level of cardiovascular risk in patients with GERD. The presence of gastroesophageal reflux disease in patients with hypertension with chronic coronary artery disease causes an increase in the frequency and severity of arrhythmias. Patients on the background of GERD is more common atrial fibrillation (AF). When concomitant GERD in patients with chronic ischemic heart disease was significantly greater frequency and duration of ischemic episodes. Comorbidity with GERD worsens hypertension and characterized by higher rates of SBP and DBP at night and high variability in SBP and DBP during the day.
Conclusion. The presence of GERD in patients with hypertension and chronic ischemic heart disease is associated with more severe clinical manifestations of the underlying disease and can therefore be regarded as complicating CHD- and AH-factor.
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