Efficiency of five-component therapy at refractory arterial hypertension depending on saltsensitivity phenomenon

Abstract

Objective: assess influence of five-component antihypertensive therapy on the main indicators of the daily monitoring of arterial pressure (DMAP), a structurally functional state and diastolic function of a myocardium at patients with the refractory arterial hypertension (RAH) depending on «saltsensitivity» phenomenon. Material and methods: 88 patients with RAH (54 «salt-sensitive» patients, 34 -«salt-resistant»), receiving as antihypertensive therapy ACE inhibitor, a blocker of slow calcic channels (the digidropiridiny), thiazide diuretics, beta-blocker and direct inhibitor of a renin in full doses are surveyed. To all patients DMAP and an echocardiography till 48 weeks of treatment were carried out. Results: 68,5% of «salt-sensitive» and 79,4% — «salt-resistant» of patients on five-component therapy have reached the target level (TL) the AP. Irrespective of a «saltsensivity» the combination of 5 preparations provided reliable positive changes of all indicators of DMAP and Echo, but thus at «salt-resistant» of patients more expressed positive dynamics of indicators of DMAP, the AP daily profile and a myocardium hypertrophy in comparison with «salt-sensitive» patients is noted. Conclusion: five-component therapy provided more significant antihypertensive and antiremodeling effects at «salt-resistant» of patients with RAH, in comparison with «salt-sensitive».