Endothelial dysfunction correction in patients with hypertension, dyslipidaemia, and decreased thyroid function

Abstract

Endothelial dysfunction is considered a universal predictor of numerous diseases, development of the complications and their adverse course. The study aimed to investigate the endothelium-dependent vasodilation among patients with arterial hypertension, dyslipidemia and different functional state of the thyroid gland and feasibilities of its correction by means of hypolipidaemic and metabolic therapy. 99 patients with arterial hypertension and dyslipidemia were examined, among them were 65 hypothyroid persons (group 1) and 34 individuals with normal thyroid function (group 2). The effects of lipid-lowering combination therapy with ezetimibe and rosuvastatin or monotherapy with statins, and metabolic therapy with L-arginine aspartate during 3 months on endothelium-dependent vasodilation were studied. At the beginning of the study, the values of endothelial-dependent vasodilation in group 1 compared to those in group 2 were reliably smaller by 9.38%. After 3 months of treatment, this indicator in group 1 reliably increased by 11.11%, while 19 (29.23%) patients showed its normalization. The best values of the endothelium-dependent vasodilation was demonstrated by examinees in group 2 – the indicator reliably increased by 15.76 %, while 17 (50%) patients showed its normalization. Together, the greater increase in the percentage of endothelium – dependent vasodilation was observed among subgroups of patients that in complex treatment received combination hypolipidaemic therapy with ezetimibe and rosuvastatin, and metabolic therapy with L-arginine. The best indicators of endothelium-dependent vasodilation were demonstrated by examinees of both groups who, in addition to combination hypolipidaemic therapy, received metabolic therapy. Decreased thyroid gland function negatively affected the values of endothelium-dependent vasodilation and overweighted the possibilities of endothelial dysfunction correction in this cohort of patients. The results of the study can be applied in internal medicine clinic for complex treatment of comorbid hypertensive and hypothyroid patients