Issue №5-93, 2019

Complex technology of treatment of patients with arterial hypertension with concomitant coronary artery disease

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1 Knyazeva T.A., 1 Nikiforova T.I.

1 National medical research center for rehabilitation and balneology, Moscow, Russia


ABSTRACT

Arterial hypertension (AH) is the most important component in the structure of cardiovascular morbidity (CVD) and mortality(CVS). Arterial hypertension with concomitant coronary heart disease (CHD), due to its mutual burden, is a very urgentproblem in terms of therapeutic eff ects. In international studies [1], a bimodal dependence of the prognosis of a disease inpatients with arterial hypertension with concomitant coronary heart disease on the level of blood pressure (BP), structuraland functional disorders of the myocardium and lipid profi le, and the risk of developing cardiovascular complications andmortality was proved. In this connection, a comprehensive approach to the treatment of patients with arterial hypertensionwith concomitant coronary heart disease is a priority, suggesting its greatest eff ectiveness in the multi-factor pathogenesisof cardiovascular diseases. The purpose of this study is the scientifi c justifi cation for the use of complex technologies fortreating patients with arterial hypertension in combination with coronary heart disease, which belong to the weighted categoryof cardiological patients, aimed at reducing the risk of developing cardiovascular complications and thereby improvingthe prognosis of the disease. The study included 90 patients with stage Г AH, 2 degrees of increased blood pressure, veryhigh cardiovascular risk, with combined coronary heart disease, angina pectoris Ι-ΙΙΙ FC. Patients with a 1: 1 randomizationmethod were divided into 2 groups, comparable in age, main clinical manifestations and drug treatment: group 1 (40 patients)received common siliceous baths, infrared laser therapy and speleoclimatotherapy; Group 2 (50 patients) – commonsiliceous-carbon baths, infrared laser therapy and speleoclimatotherapy. All patients were on constant optimally selecteddrug therapy, which has not changed over the past 2 months. BP was measured daily in the morning and evening hours, andechocardiography was performed twice (before and after the course of treatment) to assess the dynamics of the structuraland functional state of the myocardium and a blood test to assess the dynamics of the lipid spectrum. The results obtainedwere statistically processed using the EXEL and STATISTICA 10 programs. The level of statistical signifi cance was assumedto be p <0.05. The obtained results of the integrated use of the above physiological, balneological, and climatic factors inthe treatment of patients with arterial hypertension and associated coronary heart disease indicate the correction of themain factors of cardiovascular risk of complications: elevated blood pressure, structural and functional myocardial disorders,blood lipid spectrum, warning, as established further progression of the disease.


KEYWORDS: arterial hypertension, very high risk of cardiovascular complications, coronary heart disease, structural and functional disorders of myocardium, lipid spectrum of blood, complex treatment technologies, general siliceous baths, general siliceous-carbon dioxide baths, infrared laser therapy, speleotherapy.



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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.