To reveal hemodynamic, laboratory changes and subfractional structure of serum after prescription of combined pharmacotherapy (PT) in elderly with arterial hypertension (AH) and coronary artery disease (CAD) depending on obesity presence.Design and method:
60 elderly patients with AH and CAD patients were divided into 2 groups. The 1st group included patients with AH, CAD. And the 2nd group consisted of patients with AH, CAD and obesity (BMI>30). Average age of the 1st group was 67.2 ± 7.7 years old and of the 2nd – 63.8 ± 10.4. N = 30 in each group. The patients were examined according to ESH/ESC 2013 recommendations in Odessa University Clinic. They were prescribed lisinopril, bisoprolol and aspirin. For estimation of subfractional redistribution in serum was used laser correlation spectrometry (LCS). Blood serum was taken before PT and on the 10th day of treatment.Results:
BMI in the 1st group was 23.4 kg/m2 and in the 2nd 31.9 kg/m2. In the 2nd group was observed hyperglycemia before pharmacotherapy (PT) – 6.8 (5.9; 8.9) mmol/L. After the treatment systolic and diastolic blood pressure reached target goal <150/90 mmHg in both groups (p < 0.05). In the 1st group was observed increase of creatinine level (100.0 vs 83.5 mcmol/l) and decrease of glomerular filtration rate (58.2 vs 75.3 ml/min/1.73m2). In LCS data of the 1st group increase of II discrete dynamic zone (DDZ) particles by 13% (29 vs 16%) and simultaneous growth of IV DDZ particles by 12% (28 vs 16%) was revealed. II DDZ particles are correspondent to catabolic reactions and IV DDZ particles are detected at dominance of allergy processes.Conclusions:
Functional renal insufficiency developed in the 1-st group after the treatment. This kidney dysfunction was accompanied by LCS dynamic such as growth of catabolic and allergy reactions. There was no any negative impact on kidney function in the 2nd group (with obesity) which associated also with absence of LCS dynamic. That can be caused by deposition of drugs in adipose tissue. LCS is rather sensitive method for monitoring of subfractional alterations associated with PT influence and allow to control safety of PT.