Sona Gahramanova
Azerbaijan Medical University, AzerbaijanTitle: Efficacy of treatment with azilsartan in combination with vitamin D3 in patients with arterial hypertension and low levels of vitamin D3
Abstract
Vitamin D3 improves the function of the vascular endothelium, due to which it has a vasoprotective effect, lowers blood pressure, improves vascular and myocardial remodeling, reduces the risk of left ventricular hypertrophy, slows down fibrosis, the risk of atherosclerosis, reduces insulin resistance and inflammation, improves immunity. With a normal level of vitamin D3, the concentration of renin and aldosterone decreases, which positively affects the course of hypertension against the background of antihypertensive treatment.
The purpose of this study was to study the effectiveness of treatment with azilsartan in combination with vitamin D3 in 61 patients with arterial hypertension of 1-2 degrees and low levels of vitamin D3 (0-30 ng / ml). All patients were prescribed azilsartan at an average dose of 60.2±1.2 mg once a day and vitamin D3 according to the standard regimen at a dose of 50,000 IU per week for 8 weeks. At the end of the 8-week course of treatment, vitamin D3 levels were re-measured in all patients, on the basis of which the patients were divided into 2 groups. The first group included 23 patients in whom the level of vitamin D3 did not reach the optimal values (more than 30 ng/ml). These patients continued treatment with vitamin D3 in combination with sartans for an additional 8 weeks at a standard dose of 50,000 IU per week. The second group included 38 patients whose vitamin D3 levels reached optimal values (more than 30 ng/ml) and who continued treatment with azilsartan in combination with vitamin D3 at a daily maintenance dose of 600 IU per day for another 8 weeks.
Results. Group I patients with vitamin D3 deficiency required a large dose of azilsartan (67.5±0.9 mg) to normalize blood pressure levels. In patients from group II, in contrast to patients from group I, with vitamin D3 deficiency in the blood, significantly lower doses of the antihypertensive drug azilsartan were used (51.8±1.2, P<0.01).
After 16 weeks of active treatment with vitamin D3 in combination with azilsartan in patients of group I, there was a significant increase in the level of vitamin D3 in the blood to 47.5±1.3 ng/ml (6.8 times, P<0.001 compared with the results before treatment and 2.1 times, P<0.01 compared with the data of 8 weeks of treatment), which was accompanied by an effective decrease in blood pressure to optimal values (130.3±0.9/85.2±1.1 mm Hg .) at a constant dose of azilsartan (by 13.9% for SBP and 9.1% for DBP, P<0.01 compared with the results before treatment). In patients from group II, after 16 weeks of azilsartan therapy in combination with a daily maintenance dose of vitamin D3, there was also a significant increase in vitamin D3 levels up to 41.6±0.8 ng/ml (4.1 times, P<0.001 compared with data before treatment and 1.1 times, P<0.05 compared with the results of 8 weeks of therapy), which was combined with an effective decrease in blood pressure to optimal values (127.4±1.5/78.4±1.6 mm Hg) at a constant dose of azilsartan by 14.1% for SBP and 17.2% for DBP P<0.01 compared with values before treatment). Group I patients with vitamin D3 deficiency required a large dose of azilsartan (67.5±0.9 mg) to normalize blood pressure levels. In patients from group II, in contrast to patients from group I, with vitamin D3 deficiency in the blood, significantly lower doses of the antihypertensive drug azilsartan were used (51.8±1.2, P<0.01).
As a result, the effectiveness of azilsartan treatment in patients with hypertension and low vitamin D3 levels was determined not only by the dose of sartan, but also by the correction of vitamin D3 levels, which made it possible to use the antihypertensive drug at a lower dosage with fewer side effects.
Biography
Gahramanova Sona was born on November 27, 1972 in Baku, Azerbaijan. In 1995 she graduated with honors the medical and preventive faculty of the Azerbaijan Medical University. In the period from 1995 to 1997, she underwent clinical internship, and from 1997 to 2000, postgraduate studies at the Department of Pharmacotherapy of the Azerbaijan Medical University.
In 2001 she defended her dissertation for the degree of Doctor of Philosophy in Medicine. In 2015 she defended her dissertation for the degree of Doctor of Medical Sciences. In 2015 she received the title of Associate Professor in Cardiology.
She is the author of more than 100 scientific articles, guidelines, books. In the period from 2006 to 2021 she was the Scientific Secretary of the Scientific Research Institute of Cardiology, from 2001 to the present day Associate Professor of the Department of Pharmacotherapy of the Azerbaijan Medical University.
Married, has 2 daughters who are students of the University of South Florida, USA.
Scientific interest: improvement of diagnostic methods, treatment and prevention of cardiovascular diseases (arterial hypertension, coronary heart disease, arrhythmias, heart failure).
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