Arterial hypertension features in the elderly and their correction

Abstract

Aim. To study vasomotor endothelial function (EF) in the elderly patients with arterial hypertension (AH), during its pharmaceutical correction. Material and methods. In total, 66 individuals aged over 60 years, with isolated systolic and systole-diastolic AH (ISAH, SDAH) were examined. All patients underwent 24-hour blood pressure monitoring (BMP), ultrasound assessment of EF and intima-media thickness (IMT), endotelin-1 level (ET-1) measurement, and lipid profile assessment. All participants received Nifecard® XL (Lek, Slovenia), for 6 months. Results. In ISAH patients, endothelial reaction to reactive hyperemia was significantly weaker than that in SDAH participants. AH patients had insufficient brachial artery vasodilatation in nitroglycerin test, as well as increased ET-1 levels. Maximal ET-1 levels were registered in SDAH individuals. After six-month Nifecard® ХL treatment, vascular EF substantially improved. According to 24-hour BPM data, BP circadian rhythm disturbances were quite common, being observed in 80% of ISAH patients, and 44.4% of SDAH subjects. During 6-month therapy, Nifecard® ХL demonstrated high antihypertensive activity: BP circadian rhythm normalized, number of patients with normal circadian rhythms doubled, and number of patients with unsatisfactory nighttime BP decrease, or nighttime AH, decreased. Conclusion: EF normalization and target BP level achievement are the main tasks of AH treatment. Long-acting, extended-release calcium antagonists are effective in the elderly patients.