Intravenous Laser Therapy in a Comprehensive Approach to the Correction of Risk Factors of Arterial Hypertension

Abstract

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.