Influence of differentiated metabolic therapy on dynamics of quality of life in patients with rheumatoid arthritis in combination with arterial hypertension
DOI:
https://doi.org/10.15587/2519-4798.2019.184068Keywords:
arterial hypertension, rheumatoid arthritis, quality of life, metabolic therapy, meldonium, L-arginine aspartateAbstract
The combination of arterial hypertension (AH) with rheumatoid arthritis (RA) significantly aggravates the course of each person. The constant use of drugs, chronic pain, disability and social connections leads to a decrease in the quality of life (QOL).
Materials and methods. We examined 96 patients with stage II hypertension in combination with RA, 45 patients with stage II hypertension, and 31 healthy patients. To assess QOL, we used the MOS SF-36 questionnaire (Medical Outcomes Study-Short Form). An assessment of anxiety and depression was performed using the Hospital Anxiety and Depression Scale (HADS). RA activity was determined according to the DAS28 scale, pain assessment according to the visual analogue scale (VAS). Patients with hypertension in combination with RA received basic therapy: 83 patients ─ methotrexate, 10 patients leflunomide, 79 of them were glucocorticoids 6 (6, 8) mg methylprednisolone, all patients received ramipril 10 mg per day, amlodipine 5 (5, 10) mg per day, atorvastatin 20 mg, and differentiated metabolic therapy using meldonium 500 mg per day and L-arginine aspartate 6 g per day for twelve weeks.
Aim of the research. In order to improve approaches to the treatment of patients with hypertension in combination with RA, to study the dynamics of the quality of life, the severity of anxiety and depressive disorders during complex treatment, with the inclusion of differentiated metabolic therapy, for twelve weeks.
Conclusions. In the subgroups of patients receiving metabolic therapy, there was a significantly pronounced improvement in QOL for all indicators of the MOS SF-36 scale and a decrease in anxiety manifestations in terms of the HADS scale (p<0.05). The largest decrease in activity by 7 % on a DAS 28 scale of 2.65 (2.52; 2.75) points was noted in the subgroup of patients receiving meldonium, compared with the performance of the subgroup without metabolic therapy (p=0.01)
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