Effect of angiotensin-converting enzyme inhibitor combined with diuretic on hemodynamics under physical load in men with arterial hypertension and chronic venous diseases
S.V. LETYAGINA1, V.M. BAEV2, T.Yu. AGAFONOVA2
1Medical-Sanitary Unit of the Ministry of Internal Affairs of Russia for Реrm Region, Реrm2Реrm State Medical University named after Acad. Е.А. Wagner, Реrm
Contact:
Baev V.M. ― MD, Professor of the Department of Anesthesiology, Resuscitation and Еmеrgеnсу Medical Саrе
Address: 26 Petropavlovskaya Str., Реrm, Russian Federation, 614990, tel. (342) 249-91-14, e-mail: vmbaev@hotmail.com
In 44 men aged 30-50 years with uncontrolled arterial hypertension (AH) during antihypertensive therapy, a comparative assessment was made of the dynamics of SBP, DBP, heart rate, hip venous pressure, diameter and lumen area, blood flow velocity of the superficial and deep veins of the left leg in response to physical activity. The parameters of patients of two groups were evaluated: 22 patients with hypertension without chronic venous disease (CVD), 22 patients with CVD. The response to the load between groups before and after 14 days of antihypertensive therapy in a hospital using an ACE inhibitor (Perindopril) and a diuretic (Indapamide) was compared. The use of a combination of an ACE inhibitor and a diuretic in men with hypertension both in the presence of CVD and in the absence of CVD, during physical load is characterized by an increase in SBP and heart rate, an increase in the diameter and lumen area of superficial and deep veins, a decrease in venous pressure on the leg and blood flow velocity. A characteristic feature of antihypertensive therapy in patients with chronic venous insufficiency is a decrease in the diameter of the superficial veins and a lack of a DBP response to the load, which leads to a lower level of DBP than in patients with hypertension without CVD. These signs can be assessed as hemodynamic disadaptation in response to physical activity.
Key words: men, arterial hypertension, chronic vein diseases, antihypertensive therapy.
(For citation: Letyagina S.V., Baev V.M., Agafonova T.Yu. Effect of angiotensin-converting enzyme inhibitor combined with diuretic on hemodynamics under physical load in men with arterial hypertension and chronic venous diseases. Practical medicine. 2020. Vol. 18, №1, P. 70-76 )
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