GENDER DIFFERENCES OF ARTERIAL HYPERTENSION AND ANTIHYPERTENSIVE THERAPY
https://doi.org/10.20996/1819-6446-2008-4-1-76-80
Abstract
Aim. To study gender differences of endothelial vasomotor function and pulse wave velocity (PWV) in patients with arterial hypertension (HT) and to evaluate effects of amlodipine (Normodipine, Gedeon Richter) on these parameters.
Material and methods. 57 patients with HT of 1-2 stages were involved in the study. Patients were randomized to 4 groups: women under 50 y.o. (group 1), women older than 60 y.o. (group 2), men under 50 y.o. (group 3) and men older than 60 y.o. (group 4). Endothelium vasomotor function was estimated by ultrasonography. PWV was estimated by volume sphygmography. Patients received antihypertensive therapy with amlodipine during 12 weeks.
Results. The lowest levels of systolic blood pressure (BP), normal endothelium function and PWV were observed in women with normal menses. The highest levels of pulse BP were found in menopausal women. Amlodipine monotherapy had better antihypertensive effect in women than in men. BP target levels were reached in 60% of amlodipine treated women. Besides amlodipine improved vascular endothelial function.
Сonclusion. Disorders of endothelial function and PWV begin later in women than in men, however after menopause the rate of these disorders development in women is faster than in men of similar age.
About the Authors
L. I. KatelnitskayaRussian Federation
L. A. Haisheva
Russian Federation
References
1. Маличенко С.Б., Халидова К.К. Особенности артериальной гипертонии в постменопаузе. Атмосфера. Кардиология 2002;2: 31-4.
2. Гиляревский С.Р. Трудности использования доказательной информации при создании современных клинических рекомендаций по лечению артериальной гипертонии. Международный журнал медицинской практики 2005;2:5 – 7.
3. Карпов Ю.А. Применение антагонистов кальция у больных артериальной гипертонией и ишемической болезнью сердца: современное состояние вопроса. Кардиология 2000;10: 52-5.
4. Моисеев В. С., Кобалава Ж. Д. Артериальная гипертония у лиц старших возрастных групп. М.: АРГУС; 2002.
5. Комитет экспертов ВНОК. Диагностика и лечение стабильной стенокардии. Российские рекомендации. Кардиоваскулярная терапия и профилактика 2004; приложение: 1-20.
6. Савицкий Н.Н. Биофизические основы кровообращения и клинические методы изучения гемодинамики. Ленинград: Медицина; 1974.
7. Терещенко С.Н., Жиров И.В., Успенская О.В. Место амлодипина в лечении хронической сердечной недостаточности у женщин. Кардиология 2007;7:56-9
8. Фофанов П.Н. Учебное пособие по механокардиографии. Ленинград:ВМА имени С.М. Кирова; 1977.
9. ALLHAT Officers and Coordinators for the ALLLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288(23): 2981-97.
10. Anderson J.W. Konz E.C. Obesity and disease management: Effects of weight loss on co morbid conditions. Obes Res 2001; 9(Suppl 4): 326S- 34S.
11. Asmar R., Benetos A., Topouchian J. et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement: validation and clinical application studies. Hypertension 1995;26(3):485-90.
12. Bolego C., Cignarella A., Sanvito P., et al. The acute estrogenic dilation of rat aorta is mediated solely by selective estrogen receptor-a agonists and is abolished by estrogen deprivation. J Pharmacol Exp Ther 2005; 313(3):1203-8.
13. Corretti T.C., Anderson T.J., Benjamin E.L. et all. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 2002;39(2):257-65.
14. Goldsmith S.R. Effect of amlodipine and felodipine on sympathetic activity and baroreflex function in normal humans. Am J Hypertens 1995;8(9):902-8.
15. Kloner R., Sowers J., DiBona G., et al. Sex-and age-related antihypertensive effects of amlodipine. Am J Cardiol 1996;77(9):713-22.
16. Loeb E.D., Diamond J.A., Krakoff L.R., Phillips R.A. Sex Difference in response of blood pressure to calcium antagonism in the treatment of moderate-to-serve hypertension. Blood Press Monit 1999;4(5):209- 12.
17. Pater C. Current trends in the cardiovascular clinical trial arena (I). Curr Control Trials Cardiovasc Med 2004;5: 4-8.
18. Poirier P., Despres J.P. Exercise in weight management of obesity. Cardiol Clin 2001;19(3):459-70.
19. Sever P.S., Dahlof B., Poulter N.R., et al for the ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005;366(9489):895- 906.
20. World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation on obesity. World Health Organ Tech Rep Ser 2000; 894:i-xii, 1-253.
Review
For citations:
Katelnitskaya L.I., Haisheva L.A. GENDER DIFFERENCES OF ARTERIAL HYPERTENSION AND ANTIHYPERTENSIVE THERAPY. Rational Pharmacotherapy in Cardiology. 2008;4(1):76-80. (In Russ.) https://doi.org/10.20996/1819-6446-2008-4-1-76-80