The effect of complex therapy on the quality of life in patients with arterial hypertension on the background of gout
Abstract
Abstract. Gout remains the most common type of inflammatory arthritis worldwide. Hypertension (AH) prevails in the structure of comorbid diseases in gout. In patients with hypertension in combination with gout, the problem of choosing treatment tactics remains quite relevant. Aim. To assess the effectiveness of the combination of basic therapy drugs for the treatment of patients with hypertension in combination with gout on quality of life indicators at the primary level of medical care. Materials and methods. Two groups of patients were formed. The first group, 36 patients who received losartan, allopurinol, atorvastatin. The second group, 36 people who received ramipril, allopurinol, atorvastatin. Quality of life was assessed using the SF-36 standardized questionnaire. The patient's functional status was assessed using the HAQ-DI health status questionnaire. Statistical analysis was performed using Statistica 6.1. Results. In the studied groups of patients, the quality of life of patients before and after treatment was evaluated. It was established that before the appointment of treatment, no significant difference was found between the groups according to the SF-36, HAQ-DI questionnaires. In patients of both groups, the indicators of the physical component of health (PCH) and the psychological component of health (PsCH) on the SF-36 scale were reduced, and a greater proportion of patients with minimal and moderate impairment of vital activity according to the HAQ-DI was registered. According to the results of the analysis, it was established that the level of quality of life according to the PCH indicator increased by 21.7 % in the first group and by 20.4 % in the second group (p < 0.01), according to the PsCH indicator – by 18.4 % and 17.5 % (p < 0.01), respectively. A probable decrease in the HAQ-DI indicator was found only in patients who received ramipril compared to the initial data before treatment by 33.3 % (р < 0.05). In patients of the I group, the share of patients with minimal disorders is increasing, and the proportion of patients with moderate disorders is decreasing, and in the II group, the prevalence of minimal and moderate disorders is increasing, which indicates the effectiveness of the prescribed therapy. Conclusions. Complex therapy (losartan or ramipril, allopurinol, atorvastatin) for 6 months in patients with hypertension in combination with gout is accompanied by a significant improvement in the quality of life according to the indicators of PCH (25.1 %, p < 0.01) and PsCH (17.7 %, p < 0.01) and degree of vital activity (25.0 %, p < 0.01).
Downloads
References
Roddy E, Packham J, Obrenovic K, Rivett A, Ledingham JM. Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology (Oxford). 2018 May 1;57(5):826-30. doi: 10.1093/rheumatology/kex521.
Bevis M, Blagojevic-Bucknall M, Mallen C, Hider S, Roddy E. Comorbidity clusters in people with gout: an observational cohort study with linked medical record review. Rheumatology (Oxford). 2018 Aug 1;57(8):1358–63. DOI: https://doi.org/10.1093/rheumatology/key096
Braun J, Kiltz U. What is new on gout? Report from ACR 2018. Z Rheumatol. 2019 Aug;78(6):540–9. DOI: https://doi.org/10.1007/s00393-019-0667-y
Chen-Xu M, Yokose C, Rai SK, Pillinger MH, Choi HK. Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol. 2019 Jun;71(6):991-9. DOI: https://doi.org/10.1002/art.40807
Mattiuzzi C, Lippi G. Recent updates on worldwide gout epidemiology. Clin Rheumatol. 2019 Dec 13. DOI: https://doi.org/10.1007/s10067-019-04868-9
Malta DC, Goncalves RPF, Machado IE, Freitas MIF, Azeredo C, Szwarcwald CL. Prevalence of arterial hypertension according to different diagnostic criteria, National Health Survey. Rev Bras Epidemiol. 2018 Nov 29;21(suppl 1):e180021. DOI: https://doi.org/10.1590/1980-549720180021.supl.1
Kjeldsen SE. Hypertension and cardiovascular risk: General aspects. Pharmacol Res. 2018 Mar;129:95–9. DOI: https://doi.org/10.1016/j.phrs.2017.11.003
Mohsen IM. Hypertension in Developing Countries: A Major Challenge for the Future. Curr Hypertens Rep. 2018 May 1;20(5):38. DOI: https://doi.org/10.1007/s11906-018-0839-1
Sutton Burke EM, Kelly TC, Shoales LA, Nagel AK. Angiotensin Receptor Blockers Effect on Serum Uric Acid – A Class Effect? J Pharm Pract. 2019 Aug 7:897190019866315. DOI: https://doi.org/10.1177/0897190019866315
Park YA, Song YB, Yee J, Yoon HY, Gwak HS. Influence of CYP2C9 genetic polymorphisms on the pharmacokinetics of losartan and its active metabolite E-3174: a systematic review and meta-analysis. J Pers Med. 2021;11(7):617. DOI: https://doi.org/10.3390/jpm11070617
Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castaneda-Sanabria J, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017 Jan;76(1):29–42. DOI: https://doi.org/10.1136/annrheumdis-2016-209707
Evans PL, Prior JA, Belcher J, Hay CA, Mallen CD, Roddy Е. Gender-specific risk factors for gout: a systematic review of cohort studies. Advances in Rheumatology. 2019 Jun 24;59(1):24. DOI: https://doi.org/10.1186/s42358-019-0067-7
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. DOI: https://doi.org/10.1093/eurheartj/ehy339
Janssens HJEM, Fransen J, Janssen M, Neogi T, Schumacher HR, Jansen TL, et al. Performance of the 2015 ACR-EULAR classification criteria for gout in a primary care population presenting with monoarthritis. Rheumatology (Oxford). 2017 Aug 1;56(8):1335–41. DOI: https://doi.org/10.1093/
rheumatology/kex164
Ashcroft JA. Alternatives to specific uric acid lowering treatment in gout in patients with cardiovascular disease. BMJ. 2018 Sep 20;362:k3895. DOI: https://doi.org/10.1136/bmj.k3895
Keller SF, Rai SK, Lu N, Oza A, Jorge AM, Zhang Y, et al. Statin use and mortality in gout: A general population-based cohort study. Semin Arthritis Rheum. 2018 Dec;48(3):449–55. DOI: https://doi.org/
1016/j.semarthrit.2018.03.007
The Journal of V. N. Karazin Kharkiv National University, series Medicine has following copyright terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.