DIFFERENTIATED USE OF ANTIHYPERTENSIVE DRUGS: FOCUS ON ENDOTHELIUM AND ERYTHROCYTES DAMAGE
Objectives. To substantiate the differentiated use of antihypertensive drugs with endothelium and erythrocytes damage taken into account. Material and Methods. The number of circulating endothelial cells, the level of free hemoglobin were measured in 74 patients with arterial hypertension of the 2nd degree when applying various combinations of antihypertensive agents. The number of adverse cardiovascular events within 6,4±1,7 years of observation was determined. Results. The increase in the number of circulating endothelial cells, the level of free hemoglobin is associated with an increased risk of myocardial infarctions, strokes, deaths in patients with hypertension of the 2nd degree within 6,4±1,7 years. The use of the combination «lisinopril+hydrochlorothiazide+amlodipine» was accompanied by the most pronounced reduction in the prognostically unfavorable number of circulating endothelial cells and the level of free hemoglobin in comparison with two-component combination «lisinopril+hydrochlorothiazide» (p<0,05). Conclusions. The increase in the level of markers of endothelium and erythrocytes damage is a predictor of unfavorable medium-term prognosis in arterial hypertension and a determinant of the possibility to use antihypertensive agents differentially.