EFFECT OF CHOLECALCIFEROL AND DIURETICS AS COMPONENTS OF COMBINATION ANTIHYPERTENSIVE THERAPY ON PLASMA RENIN ACTIVITY AND ENDOTHELIAL FUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION

Aim. To evaluate the effect of cholecalciferol and diuretics as components of combination antihypertensive therapy (CAHT) on plasma renin activity (PRA) and endothelial function in patients with arterial hypertension (AH). Materials and methods. We included in this prospective study 153 patients with II-degree AH. Duration of follow-up was 15.8 +/- 1.8 months. Patients were divided into four groups: patients of group 0 received CAHT without cholecalciferol or diuretic; of group 1-CAHT with cholecalciferol (2000 IU daily); of group 2 - CAHT with diuretic; of group 3 - CAHT with diuretic and cholecalciferol 2000 IU daily. Results. After treatment, the highest level of 25-hydroxy vitamin D (25 (OH)D) (48.9 [34.3; 67.9] ng/ml) and its greatest dynamics (Delta) - (27.5 [6.2; 48.8] ng/mL) were observed in group 1. With diuretics blood level of 25 (OH)D and its Delta were lower (p<0.05), than without diuretics. Reduction of plasma renin activity (PRA) compared to baseline occurred only in Group 1. It became lower (p=0.0005) than in group 2, in which we observed elevation of PRA (Delta PRA 0.24 [0.42; 1.54] ng/ml/h). There were no significant changes of PRA in group 3. Lowering of systolic and diastolic BP (SBP and DBP) occurred in all groups. Greatest BP reduction was observed in group 3 (Delta SBP -30.0 [-40.0, -10.0] mm Hg, Delta DBP -10.0 [-20.0; 0.0] mm Hg). Combined intake of cholecalciferol and diuretic was associated with positive Delta of serum nitrate/nitrite levels (beta=1.38; p=0.02). Conclusions. Cholecalciferol and diuretics used as components of CAHT promoted greatest lowering of both SBP and DBP, elevated serum levels of nitrates/nitrites, and influenced PRA and serum level of 25(OH)D.