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№2' 2014
CARDIOLOGYInternational Medical Journal, Vol. 20., Iss. 2, 2014, P. 20−24.
BLOOD PRESSURE RESPONSE TO LOAD WITH SALT AS AN INDICATOR OF ANTIHYPERTENSIVE THERAPY EFFECTIVENESS IN PATIENTS WITH DIABETIC NEPHROPATHY
N.N. Burdenko Voronezh state medical academy, Voronezh City outpatient clinics No. 4, Russian Federation
Correction of arterial hypertension in patients with diabetes mellitus is as important as compensation of metabolic disorders. The majority of researchers consider hyperinsulinemia, insulin resistance, and arterial hypertension associated states. Primary functional disorders responsible for association of salt intake and increased blood pressure are located in the kidneys. Therefore, one of important factors influencing arterial hypertension therapy efficacy in patients with renal diseases is salt−sensitive character of arterial hypertension. With this purpose we analyzed the results of combination antihypertensive therapy in patients with diabetic nephropathy based on investigation of hemodynamic and metabolic parameters. As excessive salt amount is caused by decreased taste sensitivity of the tongue receptors to sodium chloride, which results in its increased in the food, daily urine excretion of electrolytes and salt sensitivity of arterial hypertension as well as their association with the indices of daily arterial pressure monitoring were determined. Therapy with Noliprel A and combination of Valsartan and Indapamide was the most effective in patients with salt−sensitive arterial hypertension. The patients who took Noliprel, normalization of circadian profile of antihypertensive therapy occurred more often.
Key words: diabetic nephropathy, hypertension, therapy, salt sensitivity of blood pressure.