DOI: https://doi.org/10.26641/2307-0404.2018.3(part1).142333

Endothelial function of vessels in patients with chronic kidney disease combined with subclinical hypothyroidism under the influence of combined antihypertensive therapy.

I. P. Garmish

Abstract


The aim of the study: to evaluate the endothelial function of the vessels under the influence of combined antihypertensive therapy (valsartan 160 mg / amlodipine 5 mg vs valsartan 160 mg / hydrochlorothiazide 12,5 mg) in patients with CKD and subclinical hypothyroidism. 80 patients with CKD I-II stages and AH 1 and 2 degrees were examined. According to TSH level patients were divided into 2 groups. Than patients with SH were separated into 2 subgroups: 1a – patients that received valsartan 160mg/ amlodipine 5 mg and 1b - patients that received valsartan 160mg/ hydrochlorothiazide 12,5 mg). More often violation of brachial artery flow-mediated dilation was found among the main group. The use of two-component antihypertensive therapy based on valsartan 160 mg and amlodipine 5 mg or valsartan 160 mg and hydrochlorothiazide 12,5 mg ensured the achievement of target blood pressure levels in 83,3% and 84% of patients, respectively. The more significant improvement of brachial artery flow-mediated dilation was observed in patients that received fixed combination valsartan 160 mg/amlodipine 5 mg.


Keywords


chronic kidney disease; arterial hypertension; subclinical hypothyroidism; combined antihypertensive therapy; brachial artery flow-mediated dilation

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References


Kuryata OV, Karavanska IL, Frolova EO, Mitro­china OS, Кushnir JS, Garmish IP. [Secondary (sympto­matic) arterial hypertension: a teaching manual]. Dnipro, Gerda. 2017;124. Ukrainian.

Kuryata OV, Garmish IP. [The effectiveness of combined antihypertensive therapy in patients with chro­nic kidney disease combined with subclinical hypothy­roidism]. Semeynaya meditsina. 2017;3(71):22-27. Ukrainian.

Kuryata OV, Garmish IP. [Proteinuria level and state of endothelial function of blood vessels in patients with chronic kidney disease combined with subclinical hypothyroidism under the influence of combined anti­hypertensive therapy]. Medicni perspektivi. 2018;23(2 part 1):19-25. Ukrainian.

Кushnir JS. [Hemodynamics, functional state of the endothelium, kidneys and platelets depending on the body mass index in patients with chronic heart failure with preserved systolic function]. Medicni perspektivi. 2014;19(1):29-36. Ukrainian.

Cooper D, Biondi B. Subclinical thyroid disease. Lancet. 2012;379(9821):1142-54.

Hylander В, Ekelund LG, Rosenqvist U. The cardiovascular response at rest and during exercise in hy­pothyroid subjects to thyroxine substitution Clin. Cardiol. 2013;3:116-24.

Ivanov DD, Kuryata OV, Garmish IP. Renin an­giotensin-aldosteron system blockers: chronic kidney disease and cardiovascular risk. Kidneys. 2018;2:13-22

Chongol M, Lippi G, Salvagno G, Zoppini G, Michele M, Giovanni T. Prevalence of Subclinical hy­pothyroidism in patients with chronic kidney disease Clin J Am Soc Nephrol. 2008;3(5):1296-300.

Rimoldi SF, Scherrer U, Messerli FH. Secondary arterial hypertension: when, who, and how to screen? Eur. Heart J. 2013;35(19):1245-54.


GOST Style Citations


  1. Вторинна (симптоматична) артеріальна гіпер­тензія: навчально-методичний посібник / О.В. Курята, І.Л. Караванська, Є. О. Фролова [та ін.] – Дніпро: Гер­да, 2017. – 124 с. 
  2. Курята О.В. Ефективність комбінованої анти­гіпертензивної терапії у пацієнтів з хронічною хво­робою нирок у поєднанні з субклінічним гіпо­тиреозом / О.В. Курята, І.П. Гарміш. // Сімейна медицина. – 2017. – №3. – С. 22–27.  
  3. Курята О.В. Рівень протеїнурії та стан ендо­теліальної функції судин у хворих на хронічну хворобу нирок у поєднанні з субклінічним гіпо­тиреозом під впливом комбінованої антигіпертен­зивної терапії / О.В. Курята, І.П. Гарміш // Медичні перспективи. – 2018. – Т. 23, № 2, ч.1. – С. 19-24.
  4. Кушнір Ю.С. Гемодинаміка, функціональний стан ендотелію судин, нирок та тромбоцитів залежно від індексу маси тіла при хронічній серцевій не- достатності зі збереженою систолічною функцією / Ю.С. Кушнір // Медичні перспективи. – 2014. – Т. ХІХ, N 1. – С. 29-36.
  5. Cooper D. Subclinical thyroid disease / D. Cooper, B. Biondi // Lancet. - 2012. - Vol. 379, N 9821. - P. 1142-1154.  
  6. Hylander В. The cardiovascular response at rest and during exercise in hypothyroid subjects to thyroxine substitution / Hylander В., Ekelund L.G., Rosenqvist U. // Clin. Cardiol. – 2013. N 3. – P. 116-124.
  7. Ivanov D.D. Renin angiotensin-aldosteron system blockers: chronic kidney disease and cardiovascular risk / D.D. Ivanov, O.V. Kuryata, I.P. Garmish. // Kidneys. – 2018. – Vol. 2. – P. 13-22.
  8. Prevalence of Subclinical hypothyroidism in pa­tients with chronic kidney disease / M. Chongol, G. Lippi, G.Salvagno, G. Zoppini // Clin. J. Am. Soc. Nephrol. – 2008. – Vol. 3, N 5. – P. 1296-1300.
  9. Rimoldi S.F. Secondary arterial hypertension: when, who, and how to screen? / S.F. Rimoldi, U. Scher­rer, F.H. Messerli // Eur. Heart J. – 2013. – Vol. 35, N 19. – P. 1245-1254.