Open AccessFeatures of Treatment of Hypertensive Patients with Concomitant Obesity: Unknown about the Known
Author(s) -
V. G. Lizogub,
Viktoriia Sobol,
J Moshkovskaya,
А Р Луценко
Publication year - 2020
Publication title -
kardiologiâ: ot nauki k praktike
Language(s) - English
Resource type - Journals
ISSN - 2312-7015
DOI - 10.30702/card:sp.2020.10.039/0404154
Subject(s) - medicine , bromocriptine , endocrinology , blood pressure , concomitant , endothelial dysfunction , dopamine agonist , dopamine , dopaminergic , essential hypertension , hormone , prolactin
. Arterial Hypertension is the most common disease of the circulatory system. Today we can talk about it as a non-infectious epidemic. Obesity is a risk factor and a frequent comorbid condition in hypertension. The aim. Given the role of dopamine metabolism as one of the pathogenetic triggers of hypertension and obesity, to study the effect of a dopamine receptor agonist bromocriptine in this category of patients. Materials and methods. We examined 111 hypertensive patients with concomitant obesity and 18 hypertensive patients without obesity with dopamine (DA) metabolism disorders. 24 patients with concomitant obesity received the dopamine receptor agonist bromocriptine and the calcium antagonist amlodipine to correct their DA metabolism disorders. The level of DA was determined according to the daily excretion of DA in the urine by fluorometric method. Determination of angiotensin II (ATII) was performed using enzyme-linked immunosorbent assay. The concentration of lipids was determined using the enzymatic colorimetric method, blood pressure was assessed using Daily Monitoring of Blood Pressure (ABPM), the condition of the endothelium was determined using D.S Celermajer’s endothelium-dependent vasodilation assessment. Results. Concomitant obesity leads to a deeper impairment in the dopaminergic system, RAAS, lipid spectrum and endothelial status. Bromocriptine and amlodipine treatment resulted in a significant increase in urinary DA excretion by 1.77 times (77.4%) and a trend towards blood ATII increase, which confirms the assumption of similar mechanism of action of dopamine agonists and angiotensin II receptor antagonist; positivization of lipid spectrum parameters: significant reduction of total cholesterol by 5.7%, TG by 14.01%, LDL by 5.5%. Regarding other lipid metabolism, such as HDL, there was a trend towards increase by 4.6%, combined with a significant improvement in endothelium-dependent vasodilation by 54.8%, lower blood pressure and a positive modulating effect of the combination of these drugs on the daily blood pressure profile against the background of a significant decrease in body weight by 8.8%.