RENAL HEMODYNAMICS EVALUATION IN PATIENTS SUFFERING FROM RHEUMATOID ARTHRITIS WITH AND WITHOUT COMORBID HYPERTENSION

Aim. To study the features of renal arterial blood flow in patients suffering from rheumatoid arthritis, its interaction with visual markers of atherosclerosis in the presence of comorbid hypertension.Materials and methods. 113 patients with rheumatoid arthritis (RA) were enrolled into this study. Depending on the comorbidity of hypertension the patients were divided into two groups: without (n=53) and with hypertension (n=60). The comparison group consisted of 41 patients with arterial hypertension without RA. Clinical characteristics and blood biochemistry of all the patients were measured. Renal arterial resistance index (RI), presence of atherosclerotic plaques (ASP) in the carotid arteries were assessed by ultrasound scan.Results. In this investigation we report the correlation of the of renal resistive index (RI) and ultrasound signs of carotid atherosclerosis with hypertension in patients with RA. It was found out that there is the increase of RI in RA associated with the age of patients, the onset of the disease at a later age, the presence of atherosclerotic plaques in the carotid arteries and hypertension. In addition, patients with RA had a high frequency of bilateral RI increase by more than 0.7 (64%). Patients with bilateral high RI had a two-fold increase in the registration rate of atherosclerotic plaques in both group of patients with RA.Conclusion. Increased renal arteries RI in patients with RA is a factor associated with the comorbid hypertension and accompanied by more significant atherosclerotic changes in the carotid arteries in the form of an increased incidence of atherosclerotic plaques

Indapamide microhemodynamic effects in patients with essential arterial hypertension

The aim of this study was to investigate microcirculatory (M) changes and andothelin-1 levels in 3-month indapamide treatment. The study included 22patients with essential arterial hypertension (EAH), Stage I-II, and 12 normotensive controls. Microcirculation was assessed by laser Dopplerflowmetry, endothelin-1 level - by enzyme immunoassay method. The EAH patients demonstrated M heterogeneity, with high prevalence of pathologic M types. Indapamide was effective and safe in EAH treatment, improving M status. Serum levels of endothelin-1 correlated with Doppler flowmetric indices - Aa/IM, alpha-rhythm amplitude, as well as with blood pressure levels

Enalapril microhemodynamic effects in patients with essential arterial hypertension

The study included 38 patients with essential arterial hypertension (EAH), Stage I-II, and 10 healthy individuals (control group). Microcirculation was assessed by laser Doppler flowmetry (IDF), endothelin-1 concentration - by immunoenzyme assay. In EAH patients, microcirculation was heterogeneous, with the prevalence of pathological static type. Enalapril was an effective and safe antihypertensive medication, beneficial for microcirculation system. Serum endothelin-1 concentration correlated with systolic blood pressure (BP), as well as with IDF endothelial activity