@article{Tofan_Tykhonova_Iablonska_Khyzhnyak_2021, title={Evalution of the effect of obesity-associated inflammation on the response to complex therapy in hypertensive elderly patients with coronary artery disease}, volume={11}, url={https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.06.015}, DOI={10.12775/JEHS.2021.11.06.015}, abstractNote={<p><strong>Object: </strong>to<strong> </strong>identify factors that limit the effectiveness of pharmacotherapy of hypertension (HT) with comorbid coronary artery disease (CAD) in elderly obese patients by determining laboratory and spectroscopy features related to inflammation. <strong></strong></p><p class="2"><strong>Material and methods:</strong> 60 patients (68.2 ± 5.9 y.o.) were observed and treated in Internal Medicine Department of University Clinic of Odessa National Medical University. Patients were divided into 2 groups. The 1<sup>st</sup> group included patients (n = 30) with body mass index (BMI) ≤25 kg/m2, HT and co-morbid CAD; the 2<sup>nd</sup> group (n = 30) - patients with BMI≥30 kg/m2, HT and with co-morbid CAD. For each patient’s group antihypertensive combination of Lisinopril and Bisoprolol was prescribed. The Laser correlation spectroscopy (LCS) was a special method for investigation. <strong></strong></p><p class="2"><strong>Results:</strong> before pharmacotherapy (PT) in both groups according to LCS 11-150 nm particles are prevailing. But in obese patients 75<sup>th</sup> percentile of 31-70 nm particles exceeds that one in non-obese group (56.7% vs 30.5%). During PT systolic blood pressure (SBP) value normalized in the patients of 1<sup>st</sup> group (without obesity), while in the obese patients (2<sup>nd</sup> group) SBP remained above target level. Creatinine level increased in patients of  1<sup>st</sup> group (without obesity) by 16.5 μmol / L (p <0.05) with a decrease in GFR by 17.1 ml/min/1.73 m<sup>2</sup> (P <0.05). LCS data during PT show increase of 11-30 nm and decrease of 75-150 nm particles in non-obese patients, while in obese patients 71-150 nm particles are prevailing and 150 nm particles have appeared (p<0.05). <strong></strong></p><p class="2"><strong>Conclusions:</strong> <strong>1</strong>. In elderly hypertensive patients with concomitant CAD, obesity is a factor limiting the effectiveness of complex antihypertensive therapy. <strong>2</strong>. An increase of proportion of allergic-directed and appearance of autoimmune-directed homeostatic shifts in serum according to LCS are associated with a decrease of antihypertensive therapy efficacy in elderly hypertensive patients with CAD and obesity.  <strong>3</strong>. In hypertensive non-obese patients with CAD under the influence of complex antihypertensive therapy deteriorating of renal function is observed while in obesity renal function is not changed. <strong>4.</strong> Homeostatic changes revealed in the second group by LCS values probably reflect manifestation of  low grade inflammatory process caused by excessive activity of adipose tissue.</p>}, number={6}, journal={Journal of Education, Health and Sport}, author={Tofan, N. and Tykhonova, S. and Iablonska, V. and Khyzhnyak, O.}, year={2021}, month={Jun.}, pages={143–154} }