RESUMO
Aim of the study was to investigate function of endothelium and utero feto placental blood flow in pregnant women with various degree of arterial hypertension as well as effect of nifedipine SR/GITS and bisoprolol on arterial pressure level, brachial artery endothelium dependent vasodilation (EDVD), level of von Willebrand factor (FW) and resistance index, characterizing the state of utero feto placental blood flow. Examination and treatment for 4 weeks with nifedipine SR/GITS and bisoprolol (more often in combination) was carried out in 47 pregnant women with stage II hypertension during trimester II of gestation. At baseline we found significant lowering of EDVD progressing with elevation of degree of hypertension, elevation of FW level and resistance index in umbilical arteries. In dynamics at the background of treatment parallel with normalization of arterial pressure we noted significant improvement of endothelial function manifested by elevation of EDVD and lowering of FW level, as well as elevation of blood flow in arteries of umbilical cord.
Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Endotélio Vascular/fisiopatologia , Hipertensão/fisiopatologia , Circulação Placentária/fisiologia , Complicações Cardiovasculares na Gravidez/fisiopatologia , Resistência Vascular/fisiologia , Vasodilatação/fisiologia , Adulto , Artéria Braquial/fisiopatologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Gravidez , Fatores de Risco , Adulto JovemRESUMO
Study aim was assessment of clinical efficacy of mono therapy with nifedipine SR/GITS and combination of nifedipine SR/GITS and bisoprolol as well as investigation of functional state of sympathoadrenal system (SAS) in pregnant women with arterial hypertension. Examination and treatment with nifedipine SR/GITS 30 mg/day and bisoprolol 2,5 - 5 mg/day was carried out in 21 patients with stage II hypertensive disease (HD) during trimester II of pregnancy. Initially all women including 20 practically healthy pregnant women (control group) had elevation of functional activity of SAS what was determined by high values of b-adrenoception of membranes of erythrocytes. In patients with stage II HD this parameter significantly exceeded that of control group. Administration of antihypertensive drugs for 3 weeks promoted significant lowering of all parameters of 24 hour blood pressure monitoring down to optimal level, lessening of pathological types of 24 hour blood pressure profile and lowering of functional activity of SAS.