Effect of concomitant gastroesophageal reflux disease on the course of arterial hypertension and chronic coronary artery disease in elderly patients
Keywords:elderly patients, arterial hypertension, coronary heart disease, gastroesophageal reflux disease
Background. The purpose was to study the characteristics of the course of arterial hypertension (AH) and coronary artery disease (CAD) in the presence of concomitant gastroesophageal reflux disease (GERD) in elderly patients. Materials and methods. A total of 107 patients at the age of 44 to 78 years with hypertension and chronic coronary artery disease were examined, of which 65 patients had concomitant GERD. A comprehensive survey was conducted on the background of the constant conventional treatment of hypertension and coronary artery disease, as well as after joining a parallel 12-week treatment of GERD. Results. When combined with hypertension and coronary artery disease with GERD 41 (63.1%) patients with GERD had a background hernia of the esophageal opening of the diaphragm (HHL). Among GERD patients, 32.3% had obesity II and III degrees. In the presence of HHL, patients more often had burn at night and belching sour. Patients with AH and CAD with GERD were more likely to have atrial fibrillation (AF), supraventricular and ventricular extrasistolia, and episodes of S-T segment depression with daily ECG monitoring, as well as a greater increase in blood pressure. After adhering to a course of treatment for GERD, along with a decrease in clinical and morphological manifestations of GERD, there was a decrease in the severity of hypertension, the frequency of detection of polytopic extrasystoles and episodes of depression of the S-T segment during ECG monitoring. The improvement in the course of CAD and hypertension with adequate treatment of concomitant GERD can be explained by the prevention of vagal-vagal reflexes. Conclusions. To improve the effectiveness of treatment of hypertension and CAD it is important to timely identify the concomitant GERH and adequately treat it.
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