Adaptogens in normalization of hemodynamic parameters in meteosensitivity patients with arterial hypertension and ischemic heart disease with taking into

Adaptogens in normalization of hemodynamic parameters in

meteosensitivity patients with arterial hypertension and ischemic heart disease

with taking into account an influence of the earth and cosmic weather

Shcherban E.A., Zaslavskaya R.M.

Belgorod city university, Belgorod; City clinic hospital N60, Moscow.

Actuality• There are some reasons, impeding to end aim

achievement of hypotensive treatment. One of them is meteodependence.

• 1/3 of men and ½ of women are sensitive to weather changes.

• 65-75% patients with cardiovascular diseases suffere from painful meteosensitivity.

• 10-13% people of earth suffer from magnetic storms.• 2/3 of all strokes and infarcts takes place in these

dangerous days.• In magnetic storm infarcts number increase by 76,4%;

strokes number – by 30,8%.

Actuality

Investigation of meteo- and magnitosensitivity in patients with arterial hypertension (AH) and ischemic heart disease (IHD) as well as search in pharmacological defence from pathologic influence of weather on hemodynamics is actuality.

The aim of present work are:

• to study influence meteorological and geomagnetic activity on hemodynamic parameters in patients with different level of arterial blood pressure (ABP), including AH with IHD.

• to investigate meteoprotective action of drugs with adaptogenic properties (melaxen, mebicar, eltacin).

The objectives of investigation are:1. to study correlations between weather factors

and main hemodynamic parameters in patients with normal, decreased and increased ABP.

2. to investigate correlations dependence between meteorological, geomagnetic factors and basic hemodynamic parameters in patients with AH stage II-III, grade II-III in complex with IHD of the background traditional therapy (TT) as well as in include in TT drugs with adaptogen activity (melaxen, mebicar, eltacin).

The objectives of investigation are:3. to examine TT on ABP 24-hours monitoring (24hMBP),

echocardiography (EchoCG) and transcranial dopplerography (TCDG) of cerebral vessels with taking into account influence of meteorological and geomagnetic factors on hemodynamics in patients with AH stage II-III, grade II-III in complex with IHD.

4. to study influence of melaxen, mebicar and eltacin on the background of TT on 24hMBP, EchoCG parameters and TCDG of cerebral vessels with taking into account meteo- and magnitosensitivity in patients with AH stage II-III, grade II-III in complex with IHD.

General characteristics of examined patientsPatients with different level of BP

1 group pts with normal or decreased BP level

2 group pts with small increased BP level

3 group pts with AH, grand II-III

All patients 14 13 16

Men from them 4 5 3

Women from them 10 8 13

Middle age, y.o. 51,2±1,4 лет 50,1±1,6 лет 55,3±1,9 лет

ABP level (mm Hg) less 129/84

14 - -

High normal BP (not more 139/89)

- 10 -

АH grad I (not more 159/99) - 3 -

АH grad II (not more 179/109) - - 7

АH grad III (not more 180/110) - - 9

General characteristics of examined patientsPts with AH and IHD

4 group of pts, obtained ТТ

5 group of pts, receiving melaxen on the basis of TT

6 group of pts, receiving mebicar on the basis of TT

7 group of pts, receiving eltacin on the basis of TT

All patients 38 36 36 35

Men from them 15 19 11 18

Women from them 23 17 25 17

Middle age, y.o. 58,6±1,5 55,5±1,4 63,5±1,5 61,1±1,8

АH, grad II 25 28 12 13

АH, grad III 13 8 24 22

АH, stage I 2 4 7 -

АH, stage II 22 25 22 18

АH, stage III 14 7 7 17

Stenocardia efford 29 28 18 24

Postinfarction cardiosclerosis

16 15 9 12

Traditional therapy • -adrenoblockers

(atenolol 25 mg 2 times a day)• calcium antagonists

(verapamil 40 mg 3 times a day)• ACE- ingibitors

(enap 5 mg 2 times a day)• antiagregants

(aspirin 125 mg a day in the evening)• diuretics

(hypotiazid 12,5 мг in the morning)• nitrates

(monocinque 20 mg 2 times a day)

Adaptogens

• Melaxen (melatonin, «Unipharm, Inc.», USA) 3 mg at 22.00• Mebicar («Таtchempharmdrugs») 0,3 mg 3 times a day• Eltacin (Science institute of citochemia and

molecular pharmacology, Moscow) – complex amino acids – glicin, glutamin acid, cistin 220 mg 3 times a day.

Instrumental methods of investigation

• BP and HR examination in the morning and evening during 3 weeks

• 24-hours monitoring BP• Echocardiography • Transcranial dopplerography cerebral vessels.

Weather factors

• air temperature• atmospheric pressure• relative humidity• dew point• cloudiness• direction and velocity of wind• geomagnetic activity index (Кр-index)

Data of meteofactors were obtained from server «Russian weather» (meteo.infospace.ru).

Results of investigations Correlation between BP and weather

factors (р<0,05)

Correlations between BP and Kp-index (р<0,05)

24-hours MBPSBP,

mm HgDBP,

mm HgGrad of night

depression SBP, %

Grad of night depression

DBP, %

ТТ +from 152,4±5,0

to 130,5±2,7 (р<0,001)

- - -

Melaxen on the basis of TT

+from 144,1±2,7

to 128,6±2,5 (р<0,001)

+from 89,3±1,9 to 79,8±1,8

(р<0,001)

+from 7,5±1,3

to 12,8±1,0(р<0,002)

+from 10,8±1,6

to 19,0±1,2(р<0,001)

Mebicar on the basis of TT

+from 154,1±3,9

to 129,9±3,0 (р<0,001)

+from 97,6±2,7 to 82,1±1,8

(р<0,001)

- -

Eltacin on the basis of TT

+from 151,5±4,0

to 126,7±4,5 (р<0,001)

+from 97,1±3,7 to 80,6±2,7

(р<0,001)

- -

Correlations between 24-hours MBP parameters and weather factors (р<0,05)

Correlations between 24hMBP parameters and Kp-index (р<0,05)

Correlations between EchoCG parameters and weather factors (р<0,05)

Correlations between EchoCG parameters and Kp-index (р<0,05)

Dynamics of EchoCG parameters in TT with take into account meteofactors

Before treatment After treatment Р

ESD, сm 3,6±0,05 3,5±0,04 0,04

ESV, ml 54,3±1,7 52,7±1,5 0,04

Е/А 0,68±0,04 0,73±0,03 0,05

Before treatment After treatment

Influence on parameters middle cloudiness, atmosphere pressure, wind velocity

middle cloudiness, atmosphere pressure, wind direction and velocity

The most sensitive to meteofactors

Е/А Peak Е,Е/А↓.There are no correlations to ESV

Dynamics of EchoCG parameters in therapy of melaxen with taking into account meteofactors


ESD, cm 3,6±0,03 3,5±0,03 0,01

ESV, ml 54,7±0,7 50,7±1,1 0,002

EF, % 56,2±0,8 58,3±1,0 0,03

TPVR, din/s/cm-5 1715,6±65,1 1478,8±65,0 0,001

SPVR, din/s/cm-5/m2 909,8±34,9 801,4±29,2 0,001

Peak Е, m/с 0,47±0,01 0,51±0,01 0,02

Peak А, m/с 0,69±0,03 0,65±0,03 0,04

Е/А 0,72±0,04 0,83±0,04 0,005


Influence on parameters Lower cloudiness,wind direction

atmosphere pressure, middle cloudiness; Influence of lower cloudiness, wind direction, geomagnetic activity are decreased.


All parameters are equal ↓Peak Е, There are no correlations to ESD, peak А.

Dynamics of EchoCG parameters in therapy of mebicar with taking into account meteofactors


ESD, cm 3,53±0,04 3,48±0,03 0,05

ESV, ml 51,4±1,5 49,8±1,4 0,03

TPVR, din/s/cm-5 1756,1±74,7 1603,6±65,7 0,009

SPVR, din/s/cm-5/m2 921,9±37,5 853,4±33,7 0,009

Peak Е, m/с 0,48±0,02 0,52±0,01 0,02

Е/А 0,79±0,05 0,90±0,05 0,02

IVRT, mc 110,8±1,4 107,9±1,7 0,04


Influence on parameters wind direction and velocity atmosphere pressure, upper cloudiness; Influence of wind direction and velocity, geomagnetic activity are decreased.


EF, DFLV paramrtres

↓ESD, EF, peak Е, IVRT

Dynamics of EchoCG parameters in therapy of eltacin with taking into account meteofactors


ESD, cm 3,47±0,04 3,39±0,04 0,01

ESV, ml 50,7±1,0 46,7±0,9 0,001

EDV, ml 118,9±2,1 115,4±1,7 0,04

EF, % 57,3±0,8 59,3±0,9 0,04

MVC, l/min 5,7±0,2 5,1±0,2 0,007

CI, l/min/m2 3,1±0,1 2,8±0,1 0,01

Peak Е, m/с 0,52±0,02 0,57±0,02 0,03


Influence on parameters Wind velocity Influence of all meteofactors, the most grad - atmosphere pressure, wind velocity are decreased


All parameters are equal, the most peak Е

↓ESD, ESV, EDV, EF, МVС, СI, peak Е

Correlations between TCDG parameters and weather factors (р<0,05)

Dynamics of TCDG parameters in TT with take into account meteofactors


Ved (l), см/c 29,8±0,6 31,6±0,8 0,02

TAMAX (l), см/c 50,8±0,6 54,2±1,4 0,01


Influence on parameters cloudiness lower cloudiness, wind direction


right MCA parameters left MCA parameters,Number of correlations with right MCA parameters are decreased.

Dynamics of TCDG parameters in therapy of melaxen with taking into account meteofactors


Vps (l), см/c 91,6±1,2 95,2±1,7 0,05

Ved (l), см/c 42,3±1,2 45,1±1,0 0,04

Ved (r), см/c 37,8±0,8 40,6±0,9 0,02

TAMAX (r), см/c 59,0±0,9 61,0±0,9 0,03


Influence on parameters atmosphere pressure, wind velocity

atmosphere pressure, wind velocity


The two MCA in equal grad Number of correlations with left and right MCA parameters are decreased.

Dynamics of TCDG parameters in therapy of mebicar with taking into account meteofactors


Ved (l), см/c 39,8±1,0 42,2±1,0 0,02

PI (l) 0,91±0,03 0,85±0,03 0,05

Ved (r), см/c 42,4±0,9 45,0±0,9 0,02

TAMAX (r), см/c 63,0±0,8 65,0±0,9 0,03

PI (r) 0,90±0,03 0,85±0,04 0,05


Influence on parameters atmosphere pressure, wind velocity

atmosphere pressure, wind velocity


The two MCA in equal grad, more – Ved both MCA

Number of correlations with Ved, PI of left and right MCA parameters are decreased.

Dynamics of TCDG parameters in therapy of eltacin with taking into account meteofactors


Vps (r), см/c 94,1±1,2 97,6±1,2 0,04

Ved (r), см/c 32,4±0,6 34,1±0,7 0,03

TAMAX (r), см/c 61,9±0,6 63,4±0,8 0,05


Influence on parameters atmosphere pressure, wind direction

Cloudiness, Influence of atmosphere pressure, wind are decreased.


left MCA (Vps, PI) Right MCA (indexes), ↓Ved, ТАМАХ of right MCA

(+) Adaptogens in correction of influence of weather factors in meteo- and magnetosensitive patients with AH and IHD

ТТ ТТ+ melaxen ТТ+ mebicar ТТ+ eltacin

SBP + (↓ influence of dew point)

+ (↓ influence of upper cloudiness, geomagnetic activity)

+(↓ influence of geomagnetic activity)

+(↓ influence of atmospheric pressure, cloudiness)

DBP + (↓ influence of upper cloudiness, geomagnetic activity)

+(↓ influence of geomagnetic activity)

+(↓ influence of atmospheric pressure, cloudiness)

Systolic function + + (↓ influence of lower cloudiness, wind direction)

+(↓ influence of atmospheric pressure, wind)

Diastolic function + + (↓ influence of lower cloudiness, wind direction, geomagnetic activity)

+(↓ influence of wind, geomagnetic activity)

Cerebral circulation velocity parameters

+ +(↓ influence of middle cloudiness, wind)

+(↓ influence of wind direction)

+(↓ influence of atmospheric pressure, wind)

Peripheral cerebral vessels resistance indexes

+(↓ influence of cloudiness)

Conclusions1. On the basis of correlation analysis there are established, that

patients with normal, decreased and moderate increased ABP are exposed to influence of meteofactors in equal grad; number correlations between BP and weather factors are increased by 3 times in high grad AH.

2. Patients, suffering from AH, stage II-III, grad II-III with IHD and receiving TT, are exposed to influence many weather factors. Including in TT mebicar did not decrease correlations number between BP and weather factors; under the influence melaxen and eltacin influence of weather factors on hemodynamic are decreased.

3. TT in patients with AH, stage II-III, grad II-III with IHD produce hypotensive effect, influencing on SBP; TT exerts antianginal action, positive influencing on systolic and diastolic function of LV, normalizes cerebral blood circulation velocity parameters, but TT does not reduce influence of weather factors on hemodynamics.

Conclusions4. Including in TT melaxen increases hypotensive action of

TT, reducing SBP, DBP level, normalizing daily profile of BP, myocardial contractive and relaxing functions of LV improvements, cerebral circulation velocity parameters normalize. There are revealed reduction influence of meteo- and geomagnetic activity on BP and EchoCG parameters.

5. Including in TT mebicar increases hypotensive action of TT, reducing SBP, DBP, influences on diastolic function of LV, normalizes cerebral circulation velocity and indexes peripheral vessel resistance, what are according by reduction of influence of geomagnetic activity on BP and EchoCG parameters, reduction of influence of meteofactors on TCDG cerebral vessel parameters.

Conclusions

6. Including in TT eltacin increases TT hypotensive action, decreasing SBP, DBP, myocardial contractive functions of LV improvements, cerebral circulation velocity normalizes. There are reduction of influence of meteofactors on BP and EchoCG parameters.

7. There are revealed meteoprotective action of drugs with adaptogen properties (melaxen, mebicar, eltacin) and magneticprotective action of melaxen and mebicar, which may be used for treatment of meteo- and magnetosensitive patients with AH and IHD.

Thank you for your attention

Documents

Adaptogens in normalization of hemodynamic parameters in meteosensitivity patients with arterial hypertension and ischemic heart disease with taking into