Comparative analysis of the results of 3-hour esophageal-gastric-pH monitoring in patients with combined course of gastroesophageal reflux disease and arterial hypertension depending on the available antihypertensive pharmacotherapy
Annotation. Hypotensive drugs, which patients with arterial hypertension take, can have a negative impact on the motility of the esophagus and lower esophageal sphincter, increasing the likelihood of gastroesophageal reflux disease, and worsen it. The aim is to study the features of acid gastroesophageal refluxes and gastric secretory function in patients with combined course of gastroesophageal reflux disease and arterial hypertension, depending on the available anti-hypertensive pharmacotherapy. Patients were divided into four groups, depending on available monotherapy with valsartan, lisinopril, bisoprolol, and amlodipine. Patients were subjected to 3-hour esophageal-gastric-pH monitoring. We conducted a comparative analysis of the following indicators: the number of acid refluxes, the presence of refluxes lasting more than 5 minutes, the average and maximum duration of episodes of reflux. The values of the minimum pH, maximum pH, average pH and median pH in the esophagus, cardiac part of stomach and stomach body were also compared. The results showed that in the group of patients taking valsartan, there was a significant increase in the number of episodes of acid reflux, an increase in the minimum pH in the esophagus, and an increase in % of time with a pH <4 in the esophagus, unlike patients taking lisinopril or amlodipine. There were no differences in gastro-pH monitoring between patients treated with valsartan, lisinopril, bisoprolol, and amlodipine monotherapy. It indicates that increase of gastroesophageal reflux in the valsartan group was not caused by the acid-induced effect of valsartan, but other factors that lead to a decrease and/or disorganization of esophageal motility.
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