The effect of complex therapy on the quality of life in patients with arterial hypertension on the background of gout

Abstract

Abstract. Gout remains the most common type of inflammatory arthritis worldwide. Hypertension (AH) prevails in the structure of comorbid diseases in gout. In patients with hypertension in combination with gout, the problem of choosing treatment tactics remains quite relevant. Aim. To assess the effectiveness of the combination of basic therapy drugs for the treatment of patients with hypertension in combination with gout on quality of life indicators at the primary level of medical care. Materials and methods. Two groups of patients were formed. The first group, 36 patients who received losartan, allopurinol, atorvastatin. The second group, 36 people who received ramipril, allopurinol, atorvastatin. Quality of life was assessed using the SF-36 standardized questionnaire. The patient's functional status was assessed using the HAQ-DI health status questionnaire. Statistical analysis was performed using Statistica 6.1. Results. In the studied groups of patients, the quality of life of patients before and after treatment was evaluated. It was established that before the appointment of treatment, no significant difference was found between the groups according to the SF-36, HAQ-DI questionnaires. In patients of both groups, the indicators of the physical component of health (PCH) and the psychological component of health (PsCH) on the SF-36 scale were reduced, and a greater proportion of patients with minimal and moderate impairment of vital activity according to the HAQ-DI was registered. According to the results of the analysis, it was established that the level of quality of life according to the PCH indicator increased by 21.7 % in the first group and by 20.4 % in the second group (p < 0.01), according to the PsCH indicator – by 18.4 % and 17.5 % (p < 0.01), respectively. A probable decrease in the HAQ-DI indicator was found only in patients who received ramipril compared to the initial data before treatment by 33.3 % (р < 0.05). In patients of the I group, the share of patients with minimal disorders is increasing, and the proportion of patients with moderate disorders is decreasing, and in the II group, the prevalence of minimal and moderate disorders is increasing, which indicates the effectiveness of the prescribed therapy. Conclusions. Complex therapy (losartan or ramipril, allopurinol, atorvastatin) for 6 months in patients with hypertension in combination with gout is accompanied by a significant improvement in the quality of life according to the indicators of PCH (25.1 %, p < 0.01) and PsCH (17.7 %, p < 0.01) and degree of vital activity (25.0 %, p < 0.01).