Psychological Continuum of Elderly Patients Suffering from Arterial Hypertension with Metabolic Syndrome, Against the Background of Chronotherapy with a Fixed Combination of Amlodipine, Lisinopril and Rosuvastatin
https://doi.org/10.18087/cardio.2021.3.n1509
Abstract
Aim To study the psychological continuum in elderly patients with arterial hypertension associated with metabolic syndrome during the chronotherapy with a fixed combination (FC) of amlodipine, lisinopril, and rosuvastatin.
Material and methods In the inpatient conditions, 63 patients aged 60–74 years with arterial hypertension associated with metabolic syndrome were treated with chronotherapy with a FC of amlodipine, lisinopril, and rosuvastatin (5 / 10 / 10 mg/day in the evening). These patients composed the main group. The control group (58 patients aged 60–74 years with arterial hypertension associated with metabolic syndrome) was treated with the FC of amlodipine, lisinopril, and rosuvastatin at the same dose of 5 / 10 / 10 mg/day in the morning.
Results At one year, the disorders of psychological continuum were significantly decreased with the chronotherapy (evening dosing) with the antihypertensive FC of amlodipine, lisinopril, and rosuvastatin compared to the traditional treatment (morning dosing) at the same dose of 5 / 10 / 10 mg/day in both groups. With the chronotherapeutic approach, the dynamic of cognitive disorders in patients aged 60–74 years with arterial hypertension associated with metabolic syndrome was characterized by a significant increase in the Mini-Mental-State-Examination scale score from 17.8±0.3 at baseline to 23.5±0.4 with the evening dosing (р<0.001) vs. the increase from 16.9±0.3 to 20.4±0.4 (р<0.001) with the morning dosing. The situational anxiety score decreased from 40.0±2.2 to 30.6±1.8 (р<0.05) and from 40.8±2.5 to 33.5±1.9 (р<0.05), and the trait anxiety score decreased from 48.8±2.0 to 26.4±1.9 (р<0.001) and from 44.9±1.9 to 30.7±1.7 (р<0.01) with the evening and morning dosing, respectively. Depressive disorders slightly decreased with the chronotherapy by 14.1 % vs. 7.7 % with the traditional regimen; nevertheless, they were consistent with depressive spectrum disorders in both groups.
Conclusion The study results showed a higher effectiveness of the chronotherapeutic treatment compared to the traditional treatment with FC of amlodipine, lisinopril, and rosuvastatin in arterial hypertension with metabolic syndrome.
Keywords
About the Authors
N. M. AgarkovRussian Federation
MD, professor
O. I. Okhotnikov
Russian Federation
MD, professor
S. I. Korneeva
Russian Federation
assistent, kandidate of medical science
E. O. Moskaleva
Russian Federation
student
A. A. Moskalev
Russian Federation
student
V. I. Kolomiets
Russian Federation
post graduate student
A. M. Markelova
Russian Federation
student
E. A. Markelova
Russian Federation
employee
References
1. Andryushchenko A.V., Drobizhev M.Yu., Dobrovolsky A.V. Comparative evaluation of the CES-D, BDI and HADS(D) scale in the diagnosis of depression in General medical practice. Journal of neurology and psychiatry named after S. S. Korsakov. 2003;5:11-18. [Russian: Андрющенко А.В., Дробижев М.Ю., Добровольский А.В. Сравнительная оценка шкал CES-D, BDI и HADS(D) в диагностике депрессий в общемедицинской практике. Журнал неврологии и психиатрии им. С.С. Корсакова. 2003;5:11-18].
2. Gasparyan A.Yu. Features of metabolic syndrome in elderly and senile people, residents of besieged Leningrad. Systemic hypertension. 2008;5;263-269. [Russian: Гаспарян А.Ю. Особенности метаболического синдрома у лиц пожилого и старческого возраста, жителей блокадного Ленинграда. Системные гипертензии. 2008;5;263-269].
3. Dzherieva I.S. Association between depression and metabolic syndrome. Clinical Medicine. 2015;93(1):62-65. [Russian: Джериева И.С. Ассоциация между депрессией и метаболическим синдромом. Клиническая медицина. 2015;93(1):62-65].
4. Mikhailovskaya N.S. Relationship of anxiety and depressive disorders with the course of coronary heart disease, comorbid with metabolic syndrome. Zaporozhye Medical Journal. 2015;5:23-27. [Russian: Михайловская Н.С. Взаимосвязь тревожно-депрессивных расстройств с течением ишемической болезни сердца, коморбидной с метаболическим синдромом. Запорожский медицинский журнал. 2015;5:23-27].
5. National recommendations of experts of the All-Russian Scientific Society of Cardiology on the diagnosis and treatment of arterial hypertension (4th revision). Systemic hypertension. 2010;3:5-26. [Russian: Национальные рекомендации экспертов Всероссийского научного общества кардиологов по диагностике и лечению артериальной гипертензии (4-й пересмотр). Системные гипертензии. 2010;3:5-26].
6. Ostroumova O.D. Effect of drugs with anticholinergic activity on the cognitive functions of patients 80 years and older with essential arterial hypertension. Arterial Hypertension. 2019;25(3):246-257. [Russian: Остроумова О.Д. Влияние лекарственных препаратов с антихолинергической активностью на когнитивные функции пациентов 80 лет и старше с эссенциальной артериальной гипертензией. Артериальная гипертензия. 2019;25(3):246-257].
7. Recommendations of experts of the All-Russian Scientific Society of Cardiology on the diagnosis and treatment of metabolic syndrome (second revision). Practical Medicine. 2010;44(5):81-101. [Russian: Рекомендации экспертов Всероссийского научного общества кардиологов по диагностике и лечению метаболического синдрома (второй пересмотр). Практическая медицина. 2010;44(5):81-101].
8. Satybaldieva A.D. Features of the course of essential arterial hypertension in the elderly and senile age. Bulletin of the Almaty State Institute of Advanced Training of Doctors. 2017;1:22-28. [Russian: Сатыбалдиева А.Д. Особенности течения эссенциальной артериальной гипертензии у лиц пожилого и старческого возраста. Вестник Алматинского государственного института усовершенствования врачей. 2017;1:22-28].
9. Sergeeva V.A. Principles of antihypertensive therapy in metabolic syndrome. Clinical Medicine. 2013;91(6):4-8. [Russian: Сергеева В.А. Принципы антигипертензивной терапии при метаболическом синдроме. Клиническая медицина. 2013;91(6):4-8].
10. Khanin Yu.L. Research on anxiety in sports. Questions of psychology. 1978;6:92-99. [Russian: Ханин Ю.Л. Исследование тревоги в спорте. Вопросы психологии. 1978;6:92-99].
11. World Medical Association, Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013; 310(20): 2191–2194. doi:10.1001/jama.2013.281053
12. Ascaso JF. Prevalence of metabolic syndrome and cardiovascular disease in a hypertriglyceridemic population. Eur. J. Intern Med. 2011;22(2):177-181. DOI: 10.1016/j.ejim.2010.12.011
13. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975;12(3):189-198. DOI: 10.1016/0022-3956(75)90026-6
14. Ibrahim MS. Risk models and scores for metabolic syndrome: systematic review protocol. BMJ OPEN. 2019;9(9):e027326. DOI: 10.1136/bmjopen-2018-027326
15. Toshima T. Risk factors for the metabolic syndrome components of hypertension, diabetes mellitus, and dyslipidemia after living donor liver transplantation. HPB (Oxford). 2019;1365(182):30695-30701. DOI: 10.1016/j.hpb.2019.08.008
16. Zhang J, Wang WL. Risk factors of metabolic syndrome after liver transplantation. Hepatobiliary Pancreat Dis. Int. 2015;14(6):582-587. DOI: 10.1016/s1499-3872(15)60037-6
17. Zhang J, Liu N, Yang Ch. Effects of rosuvastatin in comdination with nimodipine in patients with mild cognitive impairment caused by cerebral small vessel disease. Panminerra Med. 2019;61(4):439-443. DOI: 10.23736/S0031-0808.18.034
Review
For citations:
Agarkov N.M., Okhotnikov O.I., Korneeva S.I., Moskaleva E.O., Moskalev A.A., Kolomiets V.I., Markelova A.M., Markelova E.A. Psychological Continuum of Elderly Patients Suffering from Arterial Hypertension with Metabolic Syndrome, Against the Background of Chronotherapy with a Fixed Combination of Amlodipine, Lisinopril and Rosuvastatin. Kardiologiia. 2021;61(3):36-41. https://doi.org/10.18087/cardio.2021.3.n1509