Features of vegetative regulation in cardiovascular pathology and gastroesophageal reflux disease comorbidity patients
DOI:
https://doi.org/10.22141/2306-2436.6.1-2.2017.122031Keywords:
arterial hypertension, chronic ischemic heart disease, gastroesophageal reflux disease, A. M. Vayn questionnaire, vegetative regulation, antireflux therapyAbstract
One of the not yet fully understood of issues of combined flow of arterial hypertension (AH), chronic ischemic heart disease (IHD) and gastroesophageal reflux disease (GERD) is the role of autonomic regulation in complex interactions and interferences, which are formed when comorbidity within and contribute to the formation of certain vegetative status in this group of patients. The objective: to determine the status of autonomic regulation in patients with hypertension combined with chronic ischemic heart disease with comorbidity with GERD and to evaluate the effect of concomitant antihypertensive and anti-anginal antireflux treatment on changes in the indices of autonomic function. Materials and methods. We examined 107 patients aged 44 to 78 years, with an established diagnosis of hypertension stage I and II in combination with chronic ischemic heart disease. Research methods included anthropometric study; biochemical blood analysis, ambulatory blood pressure monitoring; daily monitoring ECG with the definition of the temporal characteristics of heart rate variability (HRV): SDANN, SDNNi, rMSSD; esophagogastroduodenoscopy (EGD), echocardiography survey by questionnaire to identify signs of autonomic A. M. Veyn changes. Results. In patients with hypertension combined with chronic ischemic heart disease on the background of GERD found a higher level of autonomic dysfunction on the results of the survey questionnaire according to A.M.Vein. The analysis of HRV time proved the existence of a lower HRV parameters in the group with concomitant GERD, as in the age category 44-59 years and 60-78 years of age and the prevalence in this group of patients relative sympathicotonia. Combined therapy to 12 weeks has proven effective in the normalization of the vegetative status of patients with comorbidity of GERD, which is reflected both in the results of the survey by A.M.Vayn questionnaire and in the analysis of HRV. Conclusion. 1. Patients with hypertension combined with chronic ischemic heart disease on the background of GERD characterized by higher levels of autonomic dysfunction with prevalence of relative sympathicotonia. 2. Within 12 weeks combined antianginal therapy with antihypertensive and antireflux therapy in GERD patients with comorbidity has proven effective in the normalization of the vegetative status in this group of patients. 3. Regulation of autonomic function with a decrease in reflex influences caused by GERD contributed to the normalization of daily profiles of blood pressure and reduce blood pressure variability, reduce the frequency and duration of detection of myocardial ischemia in patients with hypertension combined with chronic ischemic heart disease.References
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