Сенсомоторные эффекты применения сульпирида в комплексной антигипертензивной терапии первичной артериальной гипертензии

Abstract

Primary arterial hypertension (PAH) is one of the most widespread cardiovascular diseases. High blood pressure affects the structures of target organs, especially neurons in the brain cortex, neuro-muscular synapses and autonomic ganglia. Their damage causes various neurological disorders and dysfunction of sensory function in patients with PAH. At the University Clinic of Odessa National Medical University (Center of Restorative and Reconstructive Medicine) were examined and treated 80 patients (men and women in equal numbers) diagnosed PAH II stage 2-3 degree. The patients were divided into two groups, randomized by sex, age and clinical manifestations of PAH: 1st group (n=40) was prescribed the following pharmacotherapy – Bisiprolol 2.5 mg (once a day at 8 PM), Perindopril arginine 2.5 mg (once a day at 8 AM) and Indapamidum 625 mkg (once a day at 8 AM); 2nd group (n=40) in addition to the abovementioned antihypertensive medicines was prescribed Sulpiridum 30 mg (once a day at 7 PM). All patients were tested with Computer measuring movements – 3 (CMM-3) before, 10 and 20 days after the beginning of the regular antihypertensive therapy. Then the obtained data was mathematically analyzed and the conclusion about the state of sensorimotor structures at the central, peripheral and synaptic levels was made. Each patient had one or more of the next complaints: insomnia, depression, tearfulness, mood lability, anxiety and muscle fatigue during moderate physical activity. These disturbances were more expressed in the patients of the 2nd group. At the end of the period of clinical observation the state of patients much more improved, especially in the 2nd group. This may be due to the normalization of dopaminergic transmission caused by Sulpiridum. Furthermore, the anxiolytic effect of this neuroleptic allowed to achieve normal levels of blood pressure in 75% patients in the 2nd group, while in the 1st group it was gained only in 60% of patients. PAH causes the dysregulation of central, peripheral and synaptic structures of sensorimotor function: the first of them are accelerated, the second - balanced, and the third – slower. This explains the clinical manifestations of PAH – anxiety, emotional lability and slowness of movements. High speed of neuromuscular transmission, combined with the normal synaptic function, makes it possible to classify patients with PAH as “overtired type”. Clinically it manifests as exercise intolerance, which was not caused by cardiovascular and musculoskeletal problems. Dynamics of CMM-3 parameters in the process of clinical observation demonstrates that addition of Sulpiridum to the complex pharmacotherapy of PAH eliminates the psychopathological symptoms, improves synaptic and slower neuromuscular transmission. Low doses of Sulpiridum (30 mg) allow to improve the clinical state of patients and do not cause serious side effects. Thus, prescription of the studied neuroleptic in the complex antihypertensive treatment of persons with anxiety and depression helps achieve normal level of blood pressure, normalize nervous activity and the sensorimotor function.