Scientific journal
European Journal of Natural History
ISSN 2073-4972

POSSIBILE WAYS OF BLOOD PRESSURE CORRECTION AT PATIENTS WITH DIABETES MELLITUS ASSOCIATED WITH COPD

Aksenov K.V., Trusov V.V., Ivanov A.G.

The aim of our research was to evaluate the effectiveness of the imidazoline receptor agonist - moxonidine («Physiotens») in the treatment for high blood pressure at patients with diabetes mellitus type 2 associated with the chronic obstructive pulmonary disease (COPD).

Materials and methods: our study group included 28 patients with diabetes mellitus type 2 (average age - 53,7±3,1 years old, duration of diabetes mellitus - 9,8±1,1 years) associated with COPD of I-II stages (GOLD, 2003). Mild COPD was diagnosed at 21 patients, moderate - at 7 patients. All patients received Physiotens as a monotherapy in dose 0,2 mg/day with titration till 0,6 mg/day. The therapy duration was 24 weeks. All patients received the earlier prescribed broncholytic therapy. The examination of the test persons included the following aspects: daily monitoring of blood pressure; evaluation of microcirculation by bulbar biomicroscopy method including estimation of perivascular space, vessels and intravascular blood flow and determination of conjunctival indices; examination of endothelium-dependent vasodilation; measuring insulin resistance according to HOMA IR. The function of external respiration was studied using lung-tester «Spiro S-100».

Results: after the treatment, the average daily systolic blood pressure reduced by 13,3% (p<0,01), and diastolic by 10,1% (p<0,05). Daily blood pressure profiles showed a positive dynamics; variability, value and velocity of the morning rise in blood pressure reduced (p<0,01). All studied parameters of the microcircular blood flow improved: we observed a diminution of perivascular edema, higher velocity of microcircular blood flow and disappearing of «sludge syndrome». Perivascular conjunctival index reduced from 2,12±0,08 till 1,85±0,09 (p<0,05); vascular - from 14,13±1,11 till 10,12±0,91 (p<0,01); intravascular - from 6,94±0,44 till 5,39±0,31 (p<0,05). Evaluating the endothelium-dependent vasodilation, we could see a reliable growth of brachial artery diameter (p<0,05). The HOMA IR index reduced reliably (p<0,05) after taking Physiotens. We have not observed any statistically significant changes in external respiration during the conducted study.

Conclusion: Physiotens (moxonidine) can be recommended as a basic therapeutic medication to correct blood pressure at patients with diabetes mellitus type 2 associated with COPD.

The work was submitted to the International Scientific Conference «Medical, social and economic problems of population health preservation», Kemer (Turkey), May 20-27, 2009. Came to the editorial office on 30.04.2009.