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VASCULAR BED PECULIAR PROPERTIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND ARTERIAL HYPERTENSION. ROLE OF ANTIPLATELET THERAPY

https://doi.org/10.20996/1819-6446-2011-7-4-437-441

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Abstract

Aim. To study state of vascular wall within different levels of vascular bed in patients with arterial hypertension (HT) and ischemic heart disease (IHD), and the possibility of the correction of revealed disorders with antiplatelet agent — clopidogrel 75 mg/day. Material and methods. 40 patients with HT of 1-2 degree and IHD (stable angina of I-II functional class) were included into the study. 20 healthy volunteers were included into the control group. Pulse wave velocity (PWV) was evaluated by volumetric sphygmography. Microvasculature (MC) was evaluated by computerized ultrasound Doppler velocimetry. Plasma activity of von Willebrand factor (vWF) was evaluated by direct quantitative enzyme-linked immunosorbent chemical analysis. Results. Patients with HT and IHD have abnormalities of all levels of the vascular bed compared with subjects of control group: endothelial function (increased vWF), MC disorders (lack of the linear flow velocity augmentation 1.4% vs 23.7%), as well as increase in PWV in elastic type vessels (13.27±0.53 vs 8.37±0.76 m/s). Strong positive correlation (r=0.71; p<0.05) between HT duration and average linear velocity of blood flow was detected. Disease duration had direct correlation with MC disorders and PWV. There is correlation between MC changes and PWV in elastic vessels. Increase in vWF (168.7±9.1%) was detected in 28 (70%) patients of the main group. Blood flow velocity augmentation >20% during the test was observed in 27 (67.5%) patients treated with clopidogrel. Conclusion. Clopidogrel has effects on MC disorders and significantly reduces the vWF activity level.

About the Authors

L. A. Haisheva
Rostov State Medical University
Russian Federation


S. V. Shlyk
Rostov State Medical University
Russian Federation


References

1. Information and statistics collection. The results of the first phase of monitoring the epidemiology of hypertension in the Russian Federation (2003-2004) conducted within the federal target program "Prevention and treatment of hypertension in the Russian Federation". Moscow; 2005. Russian (Информационно-статистический сборник. Результаты первого этапа мониторирования эпидемиологической ситуации по артериальной гипертонии в Российской Федерации (2003-2004 гг.) проведенного в рамках федеральной целевой программы «Профилактика и лечение артериальной гипертонии в Российской Федерации». М.; 2005).

2. Dzau V., Braunwald E. Resolved and unresolved issues in the prevention and treatment of coronary artery disease: a workshop consensus statement. Am Heart J 1991; 121(4 Pt 1):1244–1263

3. Shal'nova S.A., Deev A.D., Karpov Yu.A. Arterial hypertension and coronary heart disease in real practice of a cardiologist. Kardiovaskulyarnaya terapiya i profilaktika 2006;5(2):73-80. Russian (Шальнова С.А., Деев А.Д., Карпов Ю.А. Артериальная гипертония и ишемическая болезнь сердца в реальной практике врача-кардиолога. Кардиоваскулярная терапия и профилактика 2006;5(2):73-80).

4. Steg P.G., Bhatt D.L., Wilson P.W. et al. REACH Registry Investigators. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007;297(11):1197-206.

5. Krempf M, Parhofer KG, Steg PG, et al. Cardiovascular Event Rates in Diabetic and Nondiabetic Individuals With and Without Established Atherothrombosis (From the REduction of Atherothrombosis for Continued Health [REACH] Registry). Amer J Cardiol 2010; 105(5): 667-671

6. Celermajer D.S. Endothelial dysfunction: does it matter? Is it reversible? J Am Coll Cardiol 1997; 30 (3): 325–33.

7. National guidelines for diagnosis and treatment of hypertension. The Experts Committee of RMSAH and RSSC. Kardiovaskulyarnaya terapiya i profilaktika 2008; 7(6) prilozhenie 2:1-32. Russian (Национальные рекомендации по диагностике и лечению артериальной гипертонии. Комитет экспертов РМОАГ и ВНОК. Кардиоваскулярная терапия и профилактика 2008; 7(6) приложение 2:1-32).

8. Asmar R., Benetos A., Topouchian J. et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement: validation and clinical application studies. Hypertension 1995;26(3):485-490.

9. Makolkin V.I., editor. Microcirculation in cardiology. Moscow: Vizart; 2004. Russian (Маколкин В.И., редактор. Микроциркуляция в кардиологии. М.: Визарт; 2004).

10. Petriwev N.N., Smirnov A.V., Panina I.Ju., et al. Features a form of vasomotor endothelial dysfunction in hypertension in patients with chronic kidney disease. Regional'noe krovoobrawenie i mikrocirkuljacija 2007;1:120-123. Russian (Петрищев Н.Н., Смирнов А.В., Панина И.Ю., и др. Особенности вазомоторной формы эндотелиальной дисфункции при артериальной гипертензии у больных хронической болезнью почек. Региональное кровообращение и микроциркуляция 2007;1:120-123).

11. Oleĭnikov V.E., Matrosova I.B. Clinical study of arterial rigidity. Part II. Remodeling of vessels in arterial hypertension and metabolic syndrome. Рossibilities of correction with drugs. Kardiologiia. 2009;49(12):51-

12. Russian (Олейников В.Э., Матросова И.Б. Клиническое исследование артериальной ригидности. Часть II. Ремоделирование сосудов при артериальной гипертонии и метаболическом синдроме. Возможности медикаментозной коррекции. Кардиология 2009;49(12):51-7).

13. Lee K.W., Lip G.Y., Tayabjee M. et al. Circulating endothelial cells, Willebrand von factor, interleukin-6, and prognosis in patients with acute coronary syndroms. Blood 2005; 105:526-532.

14. Funiak S., Kubisze P., Kventensky J. et al. Von Willebrand factor and endothelial damage in essential hypertension. J Hum Hypertension 1995; 8: 705-707.

15. National guidelines for antithrombotic therapy in patients with stable manifestations of atherothrombosis. Kardiovaskulyarnaya terapiya i profilaktika 2009; 6 (suppl 6): 5-20. Russian (Антитромботическая терапия у больных со стабильными проявлениями атеротромбоза. Российские рекомендации. Кардиоваскулярная терапия и профилактика 2009;6 (Приложение 6): 5-20).

16. Gaisenok O.V. The role of modern antiplatelet therapy in prevention of atherothrombosis: the importance of clopidogrel and its generic drugs. Rational Pharmacother Card 2011; 7(1) :89-93. Russian (Гайсенок О.В. О роли соверменной анитромбоцитраной терапии в профилактике атеротромбоза: место клопидогрела и его дженерических препаратов. РФК 2011; 7(1): 89-93).

17. Jarvis B., Simpson K. Clopidogrel: a review of its use in the prevention of atherothrombosis. Drugs 2000;60:347-77.

18. Storey R.F. New developments in antiplatelet therapy. Eur Heart J Supplements 2008; 10: D30-D37.

19. Kochkina M.S., Zateĭshchikov D.A., Sidorenko B.A. Measurement of arterial stiffness and its clinical value. Kardiologiia 2005;45(1):63-71. Russian (Кочкина М.С., Затейщиков Д.А., Сидоренко Б.А. Измерение жёсткости артерий и её клиническое значение. Кардиология 2005; 1: 63-71).

20. Panina I.Ju. The effect of statins on the reactivity of microcirculatory vessels at the chronic kidney disease. Regionalnoie krovoobrashenie i mikrocirkulacia 2006; 5(2): 37-41. Russian (Панина И.Ю. Влияние статинов на реактивность сосудов микроциркуляторного русла при хронической болезни почек. Региональное кровообращение и микроциркуляция 2006;5(2):37-41).


For citation:


Haisheva L.A., Shlyk S.V. VASCULAR BED PECULIAR PROPERTIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND ARTERIAL HYPERTENSION. ROLE OF ANTIPLATELET THERAPY. Rational Pharmacotherapy in Cardiology. 2011;7(4):437-441. (In Russ.) https://doi.org/10.20996/1819-6446-2011-7-4-437-441

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