regulatory adaptive status in determining the effectiveness of nebivololum and sotalolum in patients with hypertensive disease and paroxysmal supraventricular tachycardia

Abstract

Objective. Compare the effectiveness of treatment with nebivololum or sotalolum in patients with paroxysmal supraventricular tachycardia (SVT) on a background of essential hypertension (EH) taking into account quantitative evaluation of the regulatory adaptive status (RAS). Materials and methods. 49 patients with paroxysmal SVT against the background of EH of stages II–III took part in the research, they were randomized into two groups for treatment with nebivololum (7.4±1.9 mg/day n=25) or sotalolum (162.5±46.2 mg/day n=24). As part of combination therapy, patients were administered lisinoprilum (14.4±4.4 and 14.3±4.7 mg/day), when required also atorvastatinum (15.9±4.1 mg/day, n=9 and 16.0±4.8 mg/day, n=10), acetylsalicylic acid (93.1±16.2 mg/day, n=14 и 94.1±16.5 mg/day, n=14). Initially and 6 months after therapy, the following was done: quantitative assessment of RAS (by cardio-respiratory synchronism test), echocardiography, triplex scanning of brachiocephalic arteries, treadmill test, six-minute walk test, all-day monitoring of blood pressure and electrocardiogram, subjective assessment of quality of life. Results. Both drug regimens comparably improved structural and functional condition of the heart, controlled arterial hypertension, effectively suppressed paroxysms of SVT, improved the quality of life. At the same time, the use of nebivololum increased the RAS and increased exercise tolerance to a greater degree than the use of sotalolum. Conclusion. In patients with paroxysmal SVT against the background of EH of stages II–III, the use of nebivololum as part of combination therapy may be preferable to sotalolum due to its positive impact on the RAS.