Evaluation Of Hypotensive Therapy In Patients With Cardiorenal Syndrome

Abstract

Рurpose. To study the effect of sacubitril/valsartan on the circadian rhythm of circadian blood pressure in patients with stage III CKD diabetic nephropathy and chronic heart failure. Material and methods. The study included 129 patients with type 2 diabetes mellitus with chronic kidney disease and chronic heart failure with an EF less than 40%. They were divided into two groups. The first group of patients took sacubitril/valsartan 200 mg/day, the second group took valsartan at a dose of 160 mg /day during 3 months. Daily monitoring of blood pressure was carried out by a portable automatic monitor for measuring blood pressure "Cardiotic 4000-AD" of the Incart company. The radio-technical device is an automatic blood pressure monitor and ECG, in which blood pressure measurement is carried out in parallel with the Korotkov method and the oscillometric method. The results. Systolic and diastolic arterial blood pressure in patients of group 1 and group 2 in our study decreased reliably (ρ<0,001) after 3 months in groups taking sacubitril/valsartan and valsartan. We observed that patients taking sacubitril/valsartan had a higher level of reliability with lower arterial blood pressure values (ρ<0,01). And the number of non-dippers and nite-pickers decreased to a large extent in the first group taking sacubitril/valsartan compared to the second group taking valsartan Conclusion. Thus, according to the results, we observed a more pronounced positive effect with long-term treatment with sacubitril/valsartan. It can be assumed that such positive changes contribute to a decrease in the manifestations of cardiorenal syndrome in patients with diabetic nephropathy.