emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2026.10.1.2774emcardio-353Research ArticleОРИГИНАЛЬНЫЕ НАУЧНЫЕ ПУБЛИКАЦИИORIGINAL SCIENTIFIC PUBLICATIONSАнтигипертензивная терапия и биомаркеры системного воспаления у пациентов с артериальной гипертензиейThe effect of antihypertensive therapy on the levels of biomarkers of systemic inflammation in patients with hypertensionЯсюкайтьН. В.YasiukaitsN. V.

Минск

Minsk

yasiukaits12@gmail.comПавловаО. С.PavlovaO. S.

Минск

Minsk

ДенисевичТ. Л.DenisevichT. L.

Минск

Minsk

БарбукО. A.BarbukO. A.

Минск

Minsk

РусскихИ. И.RusskikhI. I.

Минск

Minsk

УЗ «Республиканский научно-практический центр ”Кардиология“»БеларусьRepublican Scientific and Practical Centre “Cardiology”Belarus20262107202610127742783Copyright © Ясюкайть Н.В., Павлова О.С., Денисевич Т.Л., Барбук О.A., Русских И.И., 20262026Ясюкайть Н.В., Павлова О.С., Денисевич Т.Л., Барбук О.A., Русских И.И.Yasiukaits N.V., Pavlova O.S., Denisevich T.L., Barbuk O.A., Russkikh I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/353Цель

Цель: определить влияние блокаторов ренин-ангиотензин-альдостероновой системы в составе комбинированной терапии с блокатором кальциевых каналов на биомаркеры системного воспаления у пациентов с артериальной гипертензией.

Материал и методы

Материал и методы: в исследование были включены 105 пациентов в возрасте с артериальной гипертензией I-II степени и неэффективным контролем артериального давления (офисное артериальное давление ≥ 140/90 мм рт.ст.). Пациенты были разделены на 2 группы: 1-ая с применением периндоприла в средней дозе 5,94 ± 2,14 мг и амлодипина 6,07 ± 2,11 мг, 2-ая – телмисартана 52,89 ± 19,6 мг и амлодипина 5,89 ± 1,93 мг в сопоставимых (p = 0,075 для периндоприла и телмисартана, р = 0,645 – для амлодипина). Исходно и через год после приема назначенной антигипертензивной терапии был проведен клинический осмотр; выполнялись общий анализ крови с расчетом гематологических индексов: индекса системного иммунного воспаления; индекса системного воспалительного ответа; соотношение нейтрофилов к лимфоцитам; соотношение тромбоцитов к лимфоцитам; соотношение лимфоцитов к моноцитам; соотношение моноцитов к холестерину липопротеинов высокой плотности; липидограмма; определение концентрации высокочувствительного С-реактивного белка, цистатина С, интерлейкина-1β, интерлейкина-6, интерлейкина-8, фактора некроза опухоли-α, ангиотензина II и ангиотензинпревращающего фермента-2.

Результаты

Результаты: при проведении сравнительного проспективного анализа у пациентов из обеих групп с исходно сопоставимыми уровнями систолического и диастолического артериального давления через год на фоне антигипертензивной терапии было получено сопоставимое снижение систолического и диастолического артериального давления: в 1-й группе от 145,85 ± 19,54/93,13 ± 12,36 до 133,13 ± 12,36/83,87 ± 9,11 мм рт.ст. (p < 0,001), во 2-й – от146,10 ± 11,75/93,90 ± 9,77 до 128,44 ± 22,18/84,00 ± 9,29 мм рт.ст (p < 0,001).

У пациентов 1 группы наблюдалось снижение содержания в крови интерлейкина-1β от 3,04 (1,84; 5,11) до 1,58 (0,88; 2,72) пг/мл (р = 0,003), интерлейкина-8 от 4,88 (4,27; 7,05) до 4,11 (2,53; 5,64) пг/мл (р = 0,007), цистатина С от 1,04 (0,93; 1,15) до 0,98 (0,87; 1,09) мг/мл (р < 0,001) и ангиотензина II от 142974 (78048; 186608) до 101940 (54954; 153292) нг/мл (р = 0,016). У пациентов 2 группы наблюдалось снижение уровня интерлейкина-8 от 5,31 (3,88; 6,58) до 3,57 (2,42; 5,23) пг/мл (р < 0,001) и цистатина С от 1,03 (0,91; 1,12) до 0,95 (0,87; 1,06) мг/мл (р = 0,002).

Выводы

Выводы: у пациентов с артериальной гипертензией на фоне комбинированного лечения периндоприлом и амлодипином в течение года отмечалось снижение концентрации интерлейкина-1β, интерлейкина-8, цистатина С, ангиотензина II. У пациентов, принимавших телмисартан с амлодипином было выявлено уменьшение уровня интерлейкина-8 и цистатина С.

Objective

Objective: to determine the effect of renin-angiotensin-aldosterone system blockers in combination therapy with calcium channel blocker on the dynamics of systemic inflammatory biomarkers in patients with hypertension.

Materials and мethods

Materials and мethods: the study included 105 patients aged 18 to 60 years with stage I-II hypertension and ineffective blood pressure control (office blood pressure ≥ 140/90 mmHg). Patients were divided into 2 groups: group 1 received perindopril at an average dose of 5.94 ± 2.14 mg and amlodipine 6.07 ± 2.11 mg; group 2 received telmisartan 52.89 ± 19.6 mg and amlodipine 5.89 ± 1.93 mg in comparable doses (p = 0.075 for perindopril and telmisartan, p = 0.645 for amlodipine).

A clinical examination was performed at baseline and one year after taking the prescribed antihypertensive therapy; a complete blood count was performed with the calculation of hematological indices: systemic immune inflammation index; systemic inflammatory response index; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio; lymphocyte-to-monocyte ratio; monocyte-to-high-density lipoprotein cholesterol ratio; lipidogram; determination of the concentration of high-sensitivity C-reactive protein, cystatin C, interleukin-1β, interleukin-6, interleukin-8, tumor necrosis factor-α, angiotensin II, and angiotensin-converting enzyme-2.

Results

Results: in a comparative prospective analysis, office systolic and diastolic blood pressure levels significantly decreased in patients of both groups during antihypertensive therapy: in group 1 from 145.85 ± 19.54/93.13 ± 12.36 to 133.13 ± 12.36/83.87 ± 9.11 mmHg (p < 0.001), in the 2nd – from 146.10 ± 11.75/93.90 ± 9.77 to 128.44 ± 22.18/84.00 ± 9.29 mm Hg (p < 0.001).

In patients of group 1, there was a decrease in the blood content of interleukin-1β from 3.04 (1.84; 5.11) to 1.58 (0.88; 2.72) pg/ml (p = 0.003), interleukin-8 from 4.88 (4.27; 7.05) to 4.11 (2.53; 5.64) pg/ml (p = 0.007), cystatin C from 1.04 (0.93; 1.15) to 0.98 (0.87; 1.09) mg/ml (p < 0.001) and angiotensin II from 142974 (78048; 186608) to 101940 (54954; 153292) ng/ml (p = 0.016). In patients of group 2, there was a decrease in the level of interleukin-8 from 5.31 (3.88; 6.58) to 3.57 (2.42; 5.23) pg/ml (p < 0.001) and cystatin C from 1.03 (0.91; 1.12) to 0.95 (0.87; 1.06) mg/ml (p = 0.002).

Conclusions

Conclusions: in patients with hypertension, combined treatment with perindopril and amlodipine showed a decrease in the concentrations of interleukin-1β, interleukin-8, cystatin C, and angiotensin II over the course of a year. Patients taking telmisartan with amlodipine showed a decrease in interleukin-8 and cystatin C levels.

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The authors declare that there are no conflicts of interest present.