E. D. Golovanova, I. V. Milyagina, D. Y. Kovalev, N. N. Silaeva
Смоленская государственная медицинская академия
Abstract. Objective. Studying endothelium-dependent flow-mediated vasodilatation (FMD), heart rate variability (HRV) and cerebral blood flow in elderly patients with arterial hypertension (AH) and coronary heart disease (CHD) receiving calcium antagonists. Total of 35 patients aged over 60 years with moderate or severe AH and CHD were examined. All patients underwent rheography on the arm, HRV and ultrasound dopplerography of the head and neck vessels. All patients received monotherapy with amlodipine ("Kardiolopin") 2,5 or 5 mg for 2 months. In patients who received amlodipine 2,5 mg, endothelial reaction to reactive hyperemia was weaker than that in patients who received amlodipine 5 mg. HRV was significantly improved in both groups. However, if sympathetic tone is elevated, then combination therapy with beta-blockers is necessary. Cerebral blood flow improved, too, indices of peripheral resistance in certain blood streams were reduced, especially in patients who received amlodipine 5 mg. The data obtained may be used as additional criteria of effectiveness of the therapy in elderly patients.
arterial hypertension, elderly patients, endothelial dysfunction, amlodipine, heart rate variability, cerebral blood flow.
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