VLIYaNIE KOMBINIROVANNOY ANTIGIPERTENZIVNOY TERAPII NA OSNOVNYE POKAZATELI STUKTURNO-FUNKTsIONAL'NOGO SOSTOYaNIYa MIOKARDA LEVOGO ZhELUDOChKA V ZAVISIMOSTI OT FENOMENA SOLEChUVSTVITEL'NOSTI U PATsIENTOV S REFRAKTERNOY ARTERIAL'NOY GIPERTENZIEY

The study was aimed to the evaluation of the effect of combined antihypertensive therapy, including direct renin inhibitor (DRI), on the basic structural and functional parameters of the myocardium of the left ventricle (LV), depending on the salt sensitivity in patients with refractory hypertension (RAH). The study included 192 patients with RAH (102 with salt sensitivity, 90 with salt resistance), who received angiotensin converting enzyme inhibitor, dihydropyridine calcium channel blocker, thiazide diuretic and DRI aliskiren or β-blocker. Echocardiography was performed at baseline and 48 weeks after treatment. In salt-sensitive patients receiving both options of combined antihypertensive therapy, statistically significant positive dynamics of the main structural and functional parameters of the myocardium of left ventricle was observed during treatment, as well as improvement of diastolic function, increase of the number of subjects with normalized geometry and diastolic LV function. Comparative analysis of the cardioprotective effects of combined quaternary therapy in patients with salt resistance showed that the addition of DRI leads to the significantly greater regression of LV hypertrophy and increase of the number of individuals with normal geometry and diastolic LV function compared with β-blocker therapy.

arterial hypertension, salt sensitivity, salt resistance, antihypertensive therapy, direct renin inhibitor, β-blocker