DOI: https://doi.org/10.26641/2307-0404.2017.2.109831

Heart rate variability in patients with hypertension combined with osteoarthrosis under the impact of antihypertensive therapy.

O. S. Khmel, V. V. Rodionova

Abstract


Objective: to investigate the heart rate variability in patients with HT and OA under the influence of antihypertensive therapy. Materials and Methods: The study involved 60 persons, main group – 25 patients with HT stage II, 2nd degree, combined with knee OA of the II stage according to the Kellgren-Lawrence. The group of comparison consisted of 20 patients with HT stage II, 2nd degree. The control group consisted of 15 almost healthy individuals. During the study patients received antihypertensive therapy: Amlodipine 5 mg and Lisinopril 5 mg 1 time per day per os. The survey was carried out before and after the treatment. Results: in hypertensive patients with OA the influence of the sympathetic system and LF / HF index were reduced (before treatment – 5,64 [4,87–7,56], after treatment – 3,95 [3,74–4,54]; p<0,05); this indicates to decrease of influence of the sympathetic system on the organism. Conclusions: The presence of OA in patients with HT provides additional negative effect on the heart rate variability, which may testify to increasing mortality risk in these patients. Antihypertensive therapy with Lisinopril, 5 mg and Amlodipine, 5 mg in patients with HT and OA leads to improvement of hypertension course due to influence on sympathic system.


Keywords


heart rate variability; hypertension; osteoarthrosis

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References


[Rheumatology. Annex to the Order of the MOH Ukraine On approval and introduction of medical and technological documents for standardization of medical care in hypertension from October, 12, 2006 N 676]. Available from: http://www.moz.gov.ua/ua/portal/­dn_20061012_676.html. Ukrainian.

[Recommendations of Ukrainian Association of Cardiology on prevention and treatment of hypertension. Guide to the National Programme for prevention and treatment of hypertension]. Kyiv; 2011. Ukrainian.

Soldatenko IV,LysenkoNV. [Prognostic sig­nificance of the criteria for the effectiveness of arterial hypertension control in comorbidity with osteoarthritis. Journal ofKharkivNationalUniversitynamed after VN Karazin]. "Medicine" Series. 2010;918:60-4. Russian.

[Arterial hypertension. Updated and adapted clinical guidelines based on evidence. Annex to the Order of the MOH Ukraine On approval and introduction of medical and technological documents for standardization of medical care in hypertension from May, 24, 2012 N 384]. Available from: www.moz.gov.ua/ua/portal/­dn_20120524_384.html. Ukrainian.

Yabluchansky NI, Martynenko AV. [Heart rate variability for practitioners].Kharkov, 2010;131. Russian.

Abboud FM, Harwani SC, Chapleau MW. Autonomic neural regulation of the immune system – Implications for hypertension and cardiovascular disease. Hypertension. 2012;59:755-62.

Centers for Disease Control and Prevention. Murphy L, Bolen J, Helmick CG, Brady TJ. Comor­bi­di­ties are very common among people with arthritis. Pos­ter 43. 20th National Conference on Chronic Disease Pre­ven­tion and Control, CDC February 2009. Available from: https://cdc.gov/arthritis/data_statistics/comorbidities.htm.

Zhang W1, Doherty M, Peat G, Bierma-Zeinst­ra MA, Arden NK, Bresnihan B et al. EULAR evidence-based recommendations for the diagnosis of hand osteo­arthritis: report of a task force of ESCISIT. Ann Rheum Dis. 2010;69(3):483-9.

Grassi G, Mark A, Esler M. The sympathetic ner­vous system alterations in human hypertension. Circ Res. 2015;116(6):976-90.

Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task force of the European society of cardiology and the North American society of pacing and electrophysiology. Eur. Heart J. 1996;17:354-81.

Huston JM, Tracey KJ. The pulse of inflam­mation: heart rate variability, the cholinergic anti-inflam­matory pathway and implications for therapy. J Intern Med. 2011;269:45-53.

Li W, Olshansky B. Inflammatory cytokines and nitric oxide in heart failure and potential modulation by vagus nerve stimulation. Heart Fail Rev. 2011;16:137-45.

Kingsbury SR, Gross HJ, Isherwood G, Conaghan PG. Osteoarthritis inEurope: impact on health status, work productivity and use of pharmacotherapies in five European countries. Rheumatology. 2014;53(5):937-47.


GOST Style Citations


1.       Клінічний протокол надання медичної допо­моги хворим із остеоартрозом «Про затвердження протоколів надання медичної допомоги за спе­ціальністю «Ревматологія»: Наказ МОЗ України 12.10.2006 N 676. – Чинний від 2006-10-12. – Київ: МОЗ України, 2006. – 89 с.

2.       Рекомендації Української Асоціації Кардіо­логів з профілактики та лікування артеріальної гі­пертензії. Посібник до Національної програми про­філактики і лікування артеріальної гіпертензії. – Київ, 2011. – 80 с.

3.       Солдатенко И.В. Прогностически значимые критерии эффективности контроля коморбидной с остеоартрозом артериальной гипертензии / И.В. Сол­датенко, Н.В. Лысенко // Вестник Харьков. нац. ун-та им. В.Н. Каразина. Серия: «Медицина». – 2010. – № 20. – С. 60–64.

4.       Уніфікований клінічний протокол первинної, екстреної та вторинної (спеціалізованої) медичної до­помоги, "Артеріальна гіпертензія": Наказ МОЗ Ук­раїни від 24.05.2012 N 384. – Чинний від 2012– 05-24. – Київ: МОЗ України, 2012. – 72 с.

5.       Яблучанский Н.И. Вариабельность сердечного ритма в помощь практическому врачу / Н.И. Яблу­чанский, А.В. Мартыненко. – Харьков, 2010. – 131 с.

6.       Abboud F.M. Autonomic neural regulation of the immune system – implications for hypertension and car­diovascular disease / F.M. Abboud, S.C. Harwani, M.W. Chapleau // Hypertension. – 2012. – Vol. 59. – P. 755-762.

7.       Comorbidities Are Very Common Among People With Arthritis [Електронний ресурс] / L. Murphy, J. Bo­len, C.G. Helmick, T.J. Brady // National Health Inter­view Survey. – 2009. – Режим доступу до ресурсу: https:// cdc.gov/arthritis/data_statistics/comorbidities.htm

8.       EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT / [W. Zhang, M. Doherty, G. Peat [et al.] // Ann. Rheumatic Diseases. – 2009. – С. 8-18.

9.       Grassi G. The sympathetic nervous system alte­ra­tions in human hypertension / G. Grassi, A. Mark, M. Es­ler // Circulation Research. – 2015. – N 6. – P. 9–15.

10.    Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task force of the European society of cardiology and the North American society of pacing and electrophysiology //Eur. Heart J. – 1996. – Vol. 17. – P. 354–381.

11.    Huston J.M. The pulse of inflammation: heart rate variability, the cholinergic anti-inflammatory pathway and implications for therapy / J.M. Huston, K.J. Tracey // J. Inter. Med. – 2011. – N 269. – P. 45-53.

12.    Li W. Inflammatory cytokines and nitric oxide in heart failure and potential modulation by vagus nerve stimulation / W. Li, B. Olshansky // Heart. Fail. Review. – 2011. – N 16. – P. 137-145.

13.    Osteoarthritis in Europe: impact on health status, work productivity and use of pharmacotherapies in five European countries / S.R. Kingsbury, H.J. Gross, G. Isherwood, G. Philip // Rheumatology. – 2014. – N 5– P. 937-947.