Aim. To study the influence of hyperuricemia (HU) on the functional capacity of the myocardium and erythrocytes morphology in patients with arterial hypertension (AH) and to estimate the possibility of their correction using low-level laser therapy (LLLT). Materials and methods. A total of 82 patients with AH were divided into two groups depending on the level of uric acid (UA): group AH-40 patients with AH and normal UA level; group HU + AH-42 patients with AH in combination with HU. Scanning electron microscopy, 24-hour blood pressure monitoring and echocardiography were performed. LLLT course was performed for the therapeutic purpose. Results. A significantly increased degree of poikilocytosis up to 24.4 % of patients in the AH + HU group was caused by HU compared with 17.7 % of patients in the AH group. A moderate direct correlation was established between the level of UA, poi
HYPERURICEMIA AS A RISK FACTOR OF ARTERIAL HYPERTENSION. Introduction. Among the population of Central and Eastern Europe, hyperuricemia (HU) prevalence is 28 % in female and 23 % in male. In 2018, European Society of Hypertension has officially included HU to the independent risk factors for AH. Objective: to integrate literature and own data that reflect contemporary views on the role of hyperuricemia in the progression of arterial hypertension and study the early effects of hyperuricemia on endothelial dysfunction. Materials and methods. Total of 382 persons were analyzed to evaluate the prevalence of hyperuricemia in Sumy region. To study the early effects of hyperuricemia on endothelial dysfunction in normotensive patients two groups were formed: 31 patients with UA < 400 μmol/l (1 st group) and 29 patients with UA > 400 μmol/l (2 nd group). The groups were comparable in age and sex. Test with reactive hyperemia for estimation of endotheliumdependent vasodilation (EDVD) was performed using the ultrasound system SonoScape S6. Increasing of brachial artery diameter less than 10 % during the test with reactive hyperemia was considered as a criterion of endothelial dysfunction. Results: the prevalence of hyperuricemia in Sumy region is about 42 % for normotensive patients and 51 %in hypertension patients from total cohort 382. Daily BP monitoring demonstrated daytime systolic blood pressure (DaySBP) 118 mmHg and daytime diastolic blood pressure (DayDBP) 72 mmHg in the 1 st group; and in the 2 nd group these were: DaySBP 130 mmHg, DayDBP 80 mmHg (р < 0.05). Analysis of baseline levels of EDVD shows significant difference between groups: 12.9 % and 9.6 % in the 1 st group and 2 nd group, respectively (р < 0.05). The average UA level in the 1 st group was 328 ± 24 μmol/l; in the 2 nd group-469 ± 34 μmol/l. The negative correlation was obtained between the level of UA and EDVD:-0.32 in the 1st group and-0.48 in the 2nd group (p < 0.05). Conclusion. Study results demonstrated high prevalence of HU both in hypertensive and normotensive patients. Statistically significant relationship between endothelium-dependent vasodilation and uric acid levels in patients was established.
Introduction. According to Akl C et al. by 2025, the number of people with arterial hypertension (AH) will increase by 15–20% and reach 1.5 billion people. Since hyperuricemia (HU) is closely related to other AH risk factors, there is a need to study the relationship between HU and other AH risk factors. Objective of this work is to develop rational approaches to modifying individual AH risk factor using intravenous laser therapy (IVLT). Materials and methods. The study included 184 people: Group 1 (n = 30) – normotensive individuals without HU; Group 2 (n = 52) – normotensive patients with HU; Group 3 (n = 48) – patients with essential AH (stage I, 1-2 degree) without HU; Group 4 (n = 54) – patients with essential AH (stage I, 1-2 degree) with HU. Patients in Group 3 and 4 were divided into subgroups according to the treatment regimens: 3A (n = 24), 4A (n = 26) (standard antihypertensive therapy (AHT)) and 3B (n = 24), 4B (n = 28) (combination treatment with AHT and IVLT). The IVLT course was performed with a wavelength of 635 nm, a power of 1.5 mW, a radiation power density of 0.2 W/cm2, a fluence of 0.2 J/cm2, an exposure of 900 seconds, the course – daily, with a total of 10 procedures. Study results. The association between the level of uric acid (UA), systolic blood pressure (SBP), diastolic blood pressure (DBP), endothelial dysfunction (ED), left ventricular myocardial dysfunction, excess increase in arterial wall stiffness, and poikilocytosis in the study groups was established. The use of IVLT in combination with AHT allows to achieve a statistically significant (р < 0.05), compared to AHT reduction in SBPd by 4.2%, DBPd by 2.4%, DBPn by 2.5%, time index (TI) SBPd by 5.1%, TI DBPd by 2.7%, TI SBPn by 19%, rate of morning rise (RMR) SBP by 33.8%, RMR DBP by 31%, early morning blood pressure surge (EMBPS) SBP by 17.3%, EMBPS DBP by 12.8%, puilse wave velosity (PWV) by 4.1%, manifestations of endothelial dysfunction by 1.4%, myocardial dysfunction by 4.5%, poikilocytosis by 2.9%, uric acid level by 3.1% in patients with AH. In AH and HU comorbidity, addition of ILT to AHT allows to achieve an additional reduction in SBPd by 9.3%, DBPd by 7.4%, SBPn by 11,5%, DBPn by 2.7%, TI SBPd by 18.8%, TI DBPd by 18.9%, TI SBPn by 1.8%, TI DBPn by 8,7%, RMR SBP by 25.8%, RMR DBP by 28.5%, EMBPS SBP by 8.2%, EMBPS DBP by 6.0%, PWV by 13.4%, endothelial dysfunction by 3.5%, myocardial dysfunction by 18.8%, poikilocytosis by 5.7%, uric acid level by 11.6% compared to AHT. In patients with normal blood pressure and HU values, the use of IVLT can reduce DBPM, EDVD, poikilocytosis, and UA level parameters (p < 0.05). Conclusions. The presence of direct correlations of average strength between HU and endothelial dysfunction, systolic diastolic dysfunction, excessive increase in arterial wall stiffness, and poikilocytosis was found. The use of IVLT in normotensive and hypertensive patients with AH with an effective method of UA level correction, excessive arterial wall stiffness, myocardial dysfunction, ED and poikilocytosis.
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