Research Article
Volume 7 Issue 6 - 2020
The Dynamics of Central Aortic Pressure Indicators in Hypertensive Patients with Hypothyroidism after One Year of Therapy with Different Fixed Combinations of Antihypertensive Drugs
Vira Y Tseluyko1, Iurii I Karachentsev1,2 and Daria A Korchagina1,2*
1Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
2State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the NAMS of Ukraine”, Kharkiv, Ukraine
*Corresponding Author: Daria A Korchagina, Postgraduate Student of the Department of Cardiology and Functional Diagnostics, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine.
Received: April 26, 2020; Published: May 29, 2020




Abstract

Introduction: The comorbid course of hypertension and hypothyroidism (HT), a recognized risk factor for cardiovascular diseases (CVDs), is characterized by a more severe hypertension and prognosis. Measurement of CAP is required for stratification of CVD risk in hypertensive patients with concurrent HT. At the same time, the possibilities and features of the effect of fixed antihypertensive combinations on the CAP indicators in patients with hypertension and hypothyroidism have not been studied.

Aim of the Study: The aim of our study was to assess the efficacy of various fixed double combinations of antihypertensive drugs and to evaluate their effects on central and peripheral BP in hypertensive patients with concurrent hypothyroidism.

Methods and Results: Patients enrolled in the study (n = 41) were divided into 2 groups using the sealed envelope method. At enrollment, the groups were statistically matched by age, body mass index, duration of hormone replacement therapy (HRT), duration of hypertension, level of office systolic blood pressure, SBP, and DBP. Patients of the first group (n = 21) received a fixed double combination of perindopril with indapamide, patients of the second group (n = 20) received a fixed double combination of perindopril with amlodipine. Based on the obtained regression model, the independent factors associated with the reduction in CAP are BMI, duration of hypertension, TSH level, systolic BP mean in the daytime and diastolic BP mean at night.

Conclusion: Based on the results of both ambulatory blood pressure monitoring and measurement of central aortic pressure, it has been found that the studied fixed combinations of antihypertensive drugs, namely perindopril with indapamide and perindopril with amlodipine, reduce blood pressure (p < 0.05) and central aortic pressure (p < 0.05) in hypertensive patients with concurrent hypothyroidism. Although the fixed combination of perindopril with indapamide led to a more significant reduction in blood pressure, the combination of perindopril with amlodipine showed a greater reduction in central aortic pressure (p < 0.05) in hypertensive patients with concurrent hypothyroidism.

Keywords: Central Aortic Pressure; Ambulatory Blood Pressure Monitoring; Arterial Hypertension; Hypothyroidism; Fixed Antihypertensive Combinations

References

  1. Berta Eszter., et al. “Hypertension in thyroid disorders”. Frontiers in Endocrinology 10 (2019): 482.
  2. Williams Bryan., et al. “2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH)”. European Heart Journal 39.33 (2018): 3021-3104.
  3. Fouad Doaa A.., et al. “Comparison between central and ambulatory blood pressure measurements in early detection of end organ damage: a single-center prospective non-randomized controlled trial”. The Egyptian Heart Journal 71.1 (2019): 14.
  4. Zuo Junli., et al. “Central aortic pressure improves prediction of cardiovascular events compared to peripheral blood pressure in short-term follow-up of a hypertensive cohort”. Clinical and Experimental Hypertension 42.1 (2020): 16-23.
  5. Andreeva Lyaisan., et al. "PS 05-75 Сentral aortic pressure and arterial stiffness assessment using 24-hour ambulatory monitoring in hypertensive subjects with metabolic syndrome and hypothyroidism”. Journal of Hypertension 34 (2016): e161-e162.
  6. Safar Michel E. "Effect of angiotensin II blockade on central blood pressure and arterial stiffness in subjects with hypertension”. International Journal of Nephrology and Renovascular Disease 3 (2010): 167-173.
  7. Williams Bryan., et al. “Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study”. Circulation 113.9 (2006): 1213-1225.
  8. Yildiz Canan., et al. “Arterial stiffness in hyperthyroid patients is deteriorated due to thyroid hormones”. Archives of Endocrinology and Metabolism 63.3 (2019): 258-264.
  9. Laugesen Esben., et al. “Arterial stiffness and central hemodynamics in thyroidectomized patients on long-term substitution therapy with levothyroxine”. Thyroid 26.6 (2016): 779-784.
Citation: Vira Y Tseluyko., et al. “The Dynamics of Central Aortic Pressure Indicators in Hypertensive Patients with Hypothyroidism after One Year of Therapy with Different Fixed Combinations of Antihypertensive Drugs”. EC Cardiology 7.6 (2020): 68-72.

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