To reveal efficacy and safety of two treatment regimens (TR) in elderly patients with arterial hypertension (AH) combined with coronary artery disease (CAD) depending on obesity presence.Design and Method:
120 patients were examined according to medical standards in the Odessa University Clinic. Their mean age was 67.4 ± 6.7 years. They were divided into 2 groups: patients with AH and CAD (group I) and AH, CAD and obesity (group II), who were prescribed TR I “ramipril, bisoprolol, aspirin”. TR II “ramipril, bisoprolol, atorvastatin, aspirin” was given to the patients with AH and CAD (group III) and with AH, CAD and obesity (group IV). N = 30 in each group. Special investigation method was laser correlation spectrometry (LCS).Results:
Systolic and diastolic blood pressure levels reached target borders in the group I-IV (p < 0.05). In the group I increased creatinine level (115.4 ± 14.9 vs 86.1 ± 9.3 mmol/l) and decreased glomerular filtration rate (GFR), (59.8 ± 8.7 vs 79.3 ± 7.9 ml/min/1.73m2). In LCS data particles IV grew by 20.9% which associated with GFR decrease (r = 0.69). In the group II there wasn’t any significant changes (p > 0.05). TR II caused decrease of total cholesterol (TC) level (4.2 ± 1.1 vs 5.9 ± 1.7 mmol/l) and GFR (60.2 ± 8.3 vs 76.5 ± 10.5 ml/min/1.73m2) in the group III. In LCS particles II decreased by 19.4% and particles IV increased by 22.6%. In the group IV reduced TC level (4.5 ± 0.9 vs 6.7 ± 1.8). In LCS decreased particles II by 15.4% which associated with TC level reduction (r = 0.82).Conclusions:
Both treatment regimens caused hemodynamic parameters normalization. In the AH and CAD group they led to functional renal insufficiency. There was no negative influence on kidney function in the AH, CAD and obesity group. LCS method allows detect both positive and side effects of the used PT and could be informative for monitoring of the treatment efficacy and safety.