DOI: https://doi.org/10.22141/2224-1485.3-4.64-65.2019.177850

Analysis of lipid-lowering therapy in hypertensive patients

V.V. Batushkin

Abstract


Arterial hypertension and lipid dysmetabolism are the key causes of unfavourable cardiovascular prognosis. Each of them provokes the development and progression of the diseases associated with atherosclerosis. A lot of patients have both of these factors. The article sounds the necessity of statins administration in hypertensive patients based on a case report. The paper deals with a clinical case of treatment of arterial hypertension in a 47-year-old patient with dyslipidemia at various stages with the further analysis of modern information on the combination of statins and antihypertensive agents sartans for the management of the patients with a high cardiovascular risk. After several years of effective antihypertensive therapy, the patient achieved target blood pressure parameters. He gave up smoking, improved his body mass. The patient presented with asymptomatic dyslipidemia not being controlled with any remedies. Asymptomatic non-occlusive atherosclerosis of the lower extremities was determined within the penultimate visit. Taking into account the signs of artery sclerosis, the patient is considered to be in a high-risk cardiovascular group. He needed intensive therapy with statins. This case requires the most effective and safe remedy and an adequate dose. The analysis of the clinical case of complex treatment of our patient with candesartan (Kantab) and atorvastatin (Tolevas) demonstrates two important factors provoked the peripheral artery disease development. First, a young man sought medical attention for arterial hypertension symptoms, which were the main for diagnosing and choosing the therapy. Concomitant dyslipi-demia was subclinical, and the patient discontinued the use of a medication by himself. A high level of cholesterol was a risk factor. Second, we kept up with the criteria of cardiovascular risk assessment in hypertensive patients (the Order of MH of Ukraine No 384 dated 24.05.2012), thus we did not insist on some stages of intensive statin therapy as the European and North American guidelines, 2017, recommend.

Keywords


hypertension in middle-aged patient; subclinical atherosclerosis; features of treatment

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