Estimation of the influence of photobiomodulation on the endothelial function in patients with arterial hypertension under the conditions of hyperuricemia
Abstract
Introduction. In 2015, the global prevalence of hypertension in the world was estimated at 1.13 billion.
The European Association for the Treatment of Hypertension (ESH) updated its recommendations in 2018 and
officially added to the already existing risk factors of hypertension hyperuricemia. In patients with comorbidity
of hyperuricemia and hypertension, endothelial dysfunction is observed.
The aim of the study is to establish correlation between uric acid level and pulse wave velocity, Tei index,
endothelium-dependent vasodilation of the brachial artery and evaluate the effect of photobiomodulation on
endothelial dysfunction in patients with hypertension.
Materials and methods. The study included 102 patients with hypertension: 48 without hyperuricemia
(group 1) and 54 with comorbidity of hypertension and hyperuricemia (group 2). Groups 1A and 2A received antihypertensive
therapy. Groups 1B and 2B — antihypertensive therapy with a course of intravenous laser therapy
with a wavelength of 635 nm, course 10 procedures. Endothelium-dependent vasodilation of the brachial artery
was determined by a breakdown with reactive hyperemia. Tei index was calculated during echocardiography.
The pulse wave velocity was measured with a SonoScape S6 Pro.
Results. Antihypertensive therapy in group 1A reduced the rate of the pulse wave by 7.8 %. Antihypertensive
therapy and intravenous laser therapy in Group 1 reduced uric acid by 5.7 %, pulse rate by 12.2 %, Tei index by
9.5 %, increased endothelium dependent vasodilation of the brachial artery by 19.1 % (p < 0,05). Antihypertensive
therapy in Group 2A reduced uric acid by 4.7 %, pulse rate by 8.5 % and increased endothelium-dependent
brachial artery vasodilation by 31.7 %. Combined use of antihypertensive therapy and intravenous laser therapy
in group 2B reduced uric acid by 19.2 %, pulse wave speed by 21.9 %, Tei index by 29.0 %, increased endothelium-
dependent vasodilation of the brachial artery by 97.7 % < 0.05). A correlation was established between
uric acid level and endothelium dependent vasodilation of the brachial artery r = - 0.62 (p < 0.001) and between
uric acid level and pulse wave velocity r = + 0.68, uric acid level and systolic blood pressure (day ) r = + 0.48
(p < 0.001), uric acid level and Tei index r = + 0.47 (p < 0.05).
Conclusion. Given the established negative correlation between the mean strength between uric acid
level and endothelium-dependent vasodilation of the brachial artery, it is appropriate to use in clinical practice
a combination of antihypertensive therapy with intravenous laser therapy, which significantly reduces the level
of uterine fibrillation hypertension and in patients with comorbidity of hypertension and hyperuricemia.
Key words: hypertension, hyperuricemia, endothelial dysfunction, photobiomodulation, intravenous
laser therapy.
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References
Zhou B, Bentham J, Di Cesare M, Bixby H, Danaei G, Cowan
MJ, et al. Worldwide trends in blood pressure from
to2015: a pooled analysis of 1479 population-based
measurement studies with 19·1 million participants.
Lancet. 2017 Jan 7;389(10064):37-55. doi: 10.1016/
S0140-6736(16)31919-5 Available from: https://www.
ncbi.nlm.nih.gov/pmc/articles/PMC5220163/
Williams B, Mancia G, Spiering W, Agabiti Rosei E,
Azizi M, Burnier M et al. 2018 Practice Guidelines for
the management of arterial hypertension of the European
Society of Hypertension and the European Society of
Cardiology: ESH/ESC Task Force for the Management of
Arterial Hypertension. J Hypertens. 2018;36(12):2284-
doi: 10.1097/HJH.0000000000001961. Available
from: https://www.ncbi.nlm.nih.gov/pubmed/30380928
Tomiyama H, Shiina K, Vlachopoulos C, Iwasaki Y,
Matsumoto C, Kimura K et al. Vlachopoulos, et al.
Involvement of Arterial Stiffness and Inflammation in
Hyperuricemia-Related Development of Hypertension
Hypertension. 2018 Sep;72(3):739-745. doi: 10.1161/
HYPERTENSIONAHA.118.11390
Han, C., Xian, Z., Zou Y et al. Flow-mediated dilation
can be used to predict incident hypertension in patients
with hyperuricemia. Archives of Medical Science 2019
Mar;15(2):343-349. doi: 10.5114/aoms.2018.73856.
Available from: https://www.ncbi.nlm.nih.gov/
p u b m e d / ? t e r m = V l a c h o p o u l o s % 2 C + e t + a l . + I n -
volvement+of+Arterial+Stiffness+and+Inflammation+
in+Hyperuricemia-Related+Development+of+Hypertension
Tham EB, Silverman NH. Measurement of the Tei index:
a comparison of M-mode and pulse Doppler methods.
Journal of the American Society of Echocardiography.
December Volume 17 Issue 12 Pages 1259-1265.
Available from: https://www.ncbi.nlm.nih.gov/pubmed/?
term=Measurement+of+the+Tei+index%3A+a+-
comparison+of+M-mode+and+pulse+Doppler+methods
Ramirez, AJ, Christen, AI, Sanchez RA. Serum uric acid
elevation is associated to arterial stiffness in hypertensive
patients with metabolic disturbances. Curr. Hypertens
Rev. 2018;14(2):154-160. doi: 10.2174/1573402114
Available from: cbi.nlm.nih.gov/
pubmed/?term=).+Serum+Uric+Acid+Elevation+Is+Associated+
To+Arterial+Stiffness+In+Hypertensive+Patients+
With+Metabolic+Disturbances
Gu J, Fan YQ, Zhang HL, Zhang JF, Wang CQ. Serum
uric acid is associated with incidence of heart failure
with preserved ejection fraction and cardiovascular
events in patients with arterial hypertension. J Clin Hypertens.
; 20:560–567. https://doi.org/10.1111/
jch.13210. Available from: https://www.ncbi.nlm.
nih.gov/pubmed/?term=Serum+uric+acid+is+associated+
with+incidence+of+heart+failure+with+pres
e r v e d + e j e c t i o n + f r a c t i o n + a n d + c a r d i o v a s c u -
lar+events+in+patients+with+arterial+hypertension
Helms CC, Liu X, Kim-Shapiro DB. Recent insights
into nitrite signaling processes in blood. Biol Chem.
;398(3):319–329. doi:10.1515/hsz-2016-0263
Available from: https://www.ncbi.nlm.nih.gov/
pubmed/27611767
Wajih N, Basu S, Ucer KB, et al. Erythrocytic bioactivation
of nitrite and its potentiation by far-red light. Redox Biol.;
:442–450. doi:10.1016/j.redox. 2018.11.001
Wajih N, Basu S, Ucer K.B, Rigal F, Shakya A, Rahbar
E. Pathophysiology of circulating xanthine oxidoreductase:
New emerging roles for a multi-tasking enzyme,
Biochimica et Biophysica Acta (BBA) -Molecular
Basis of Disease,Volume1842, Issue 9,2014, Pages
-1517, ISSN 0925-4439,https://doi.org/10.1016/j.
bbadis.2014.05.022. Available from: https://www.ncbi.
nlm.nih.gov/pubmed/?term=Erythrocytic+bioactivation+
of+nitrite+and+its+potentiation+by+far-red+light