Роль інтегральної оцінки гемодинаміки та функціональної активності нирок у лікуванні хворих на есенційну гіпертензію II ступеню

Abstract

The complex assessment of integrated indicators of hemodynamic and ion-regulating function of kidneys was performed in 58 patients with EH II st., which were divided according to their daily index (DI) into such groups: Dippers, Non dippers and Night pickers. This was done with a purpose to identify some new aspects of pathogenically grounded treatment of EH with first-line drugs. It was found, that those patients with EH II st. and with II—III st. of BP growth, accompanied with low DI (< 10 %), which have increased velocity of pulse wave propagation mainly in an elastic type vessels; overweight (BMI > 30 kg/m2); increased or high central venous pressure (> 120 mm H2O); low threshold of taste sensitivity to salt (> 0,16 % NaCl solution); they are in a high risk group of EH progression and its possible complications. According to data of ion-regulating activity of kidneys, a great part of these patients has a volume-dependent variant of EH accompanied with reactive hypokalemia. This fact substantiates the use of 2 and/or 3 component anti-hypertensive therapy, including potassium-retaining diuretics, in the treatment of such patients.