Comparative effectiveness of antihypertensive agents in hypothyreosis patients

Abstract

Aim. To assess various antihypertensive agents’ effects on arterial hypertension (AH) severity in hypothyrosispatients.Material and methods. In total, 81 patients with moderate primary hypothyrosis and Stage I-III AH were examined. General clinical examination, hormone level measurement, thyroid ultrasound, blood biochemistry assay(lipid profile, glucose, creatinine, potassium levels), electrocardiography, and echocardiography were performed.The participants were divided into four groups, receiving imidazoline receptor agonist rilmenidine (Group 1),ACE inhibitor spirapril (Group 2), diuretic indapamide (Group 3), and dihydropyridine calcium antagonistamlodipine (Group 4).Results. Spirapril reduced systolic and diastolic blood pressure (SBP, DBP) by 9,1% and 7,1%, amlodipine – by10,7% and 9,6%, rilmenidine – by 8,3% and 7,8%, respectively. Antihypertensive effectiveness of indapamidemonotherapy was problematic to assess, as only 1/3 of the patients received this treatment. Nevertheless, in indapamide group SBP and DBP reduction was greater (10,5% and 8,4%, respectively) than in spirapril and rilmenidine groups, where 75% and 68,4% of the subjects received monotherapy, respectively.Conclusion. Considering good antihypertensive effect of indapamide, mostly in combination with another antihypertensive agent, target BP level in hypothyrosis patients should be achieved by combined therapy, includingdiuretic.

Keywords

• arterial hypertension
• hypothyrosis
• antihypertensive agents