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Background. The purpose of the study was to calculate the cost of lowering blood pressure (BP) in the complex antihypertensive therapy of arterial hypertension (AH) with and without Cholecalciferol. Materials and methods. 154 patients with grade II AH were divided into the AH(+)CH group receiving combined antihypertensive therapy plus Cholecalciferol in a dose of 2000 IU / day and into the comparison group —
AH(–)CH. Office BP and total Vitamin D levels were measured. The costs of medication were calculated. Results. During the follow-up examination, the blood level of Vtamin D increased; in the AH(+)CH group getting higher (p = 0.0000001) than in the AH(–)CH group. The per capita cost of medication in the AH(+)CH group was higher than in the AH(–)CH group ($ 106.8 and $91.5, respectively); however, the cost of SBP reduction by 1 mmHg in the AH(+)CH group was $ 3.9 lower than in the AH(–)CH group. The Cholecalciferol dose of 2000 IU/day for 3 months results in an optimum level of Vitamin D for 83 % cases, irrespective of antihypertensive therapy. The Cholecalciferol dose of 2000 IU/day from 6.5 to 12 months results in an optimum level of Vitamin D for 100 % cases. The greatest dynamics of increase in the level of 25(OH)D achieved in response to taking cholecalciferol occurs when its initial level is < 20 ng/ml. Conclusions. The economic costs of reducing SBP, with a more frequent achievement of its target values, were the lowest in combination therapy with Cholecalciferol, especially in combination with a diuretic. In addition, with complex therapy, we received not only a correction of blood pressure, but also of the Vitamin D status.
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Chow CK, Teo KK, Rangarajan S, et al; PURE (Prospective Urban Rural Epidemiology) Study investigators. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013 Sep 4;310(9):959-68. https://doi.org/10.1001/jama.2013.184182.
Banegas JR, López-García E, Dallongeville J, et al. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study. Eur Heart J. 2011 Sep;32(17):2143-52. https://doi.org/10.1093/eurheartj/ehr080.
Forouzanfar MH, Liu P, Roth GA, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015. JAMA. 2017 Jan 10;317(2):165-182. https://doi.org/10.1001/jama.2016.19043.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14;360(9349):1903-13. https://doi.org/10.1016/s0140-6736(02)11911-8.
Lip GYH, Coca A, Kahan T, et al. Hypertension and cardiac arrhythmias: executive summary of a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). Eur Heart J Cardiovasc Pharmacother. 2017 Oct 1;3(4):235-250. https://doi.org/10.1093/ehjcvp/pvx019.
Gottesman RF, Albert MS, Alonso A, et al. Associations Between Midlife Vascular Risk Factors and 25-Year Incident Dementia in the Atherosclerosis Risk in Communities (ARIC) Cohort. JAMA Neurol. 2017 Oct 1;74(10):1246-1254. https://doi.org/10.1001/jamaneurol.2017.1658.
Rovio SP, Pahkala K, Nevalainen J, et al. Cardiovascular Risk Factors From Childhood and Midlife Cognitive Performance: The Young Finns Study. J Am Coll Cardiol. 2017 May 9;69(18):2279-2289. https://doi.org/10.1016/j.jacc.2017.02.060.
Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure lowering on outcome incidence in hypertension: 7. Effects of more vs. less intensive blood pressure lowering and different achieved blood pressure levels - updated overview and meta-analyses of randomized trials. J Hypertens. 2016 Apr;34(4):613-22. https://doi.org/10.1097/hjh.0000000000000881.
Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016 Mar 5;387(10022):957-967. https://doi.org/10.1016/s0140-6736(15)01225-8.
Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. https://doi.org/10.1093/eurheartj/ehy339.
Płudowski P, Karczmarewicz E, Bayer M, et al. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe - recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol. 2013;64(4):319-27. https://doi.org/10.5603/ep.2013.0012.
Yankouskaya LV, Snezhitskiy VA, Povoroznyuk VV, Moiseenok AG, Yahorchanka NP. The relationship of vitamin D with age, sex, diagnosis and the factors of cardiovascular risk. Med zhurn. 2017;2(60):115-120. (in Russian).
Burgaz A, Orsini N, Larsson SC, Wolk A. Blood 25-hydroxyvitamin D concentration and hypertension: a meta-analysis. J Hypertens. 2011 Apr;29(4):636-45. https://doi.org/10.1097/hjh.0b013e32834320f9.
Forman JP, Scott JB, Ng K, et al. Effect of vitamin D supplementation on blood pressure in blacks. Hypertension. 2013 Apr;61(4):779-85. https://doi.org/10.1161/hypertensionaha.111.00659.
Witham MD, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: a systematic review and meta-analysis. J Hypertens. 2009 Oct;27(10):1948-54. https://doi.org/10.1097/hjh.0b013e32832f075b.
Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008 Mar;25(3):320-5. https://doi.org/10.1111/j.1464-5491.2007.02360.x.
Erdine S, Ari O, Zanchetti A, et al. ESH-ESC guidelines for the management of hypertension. Herz. 2006 Jun;31(4):331-8. https://doi.org/10.1007/s00059-006-2829-3.
Kozhanova IN, Romanova IS, Hapaljuk AV, Stepanova MD. Fundamentals of pharmacoepidemiological and pharmacoeconomic analysis of the use of drugs in chronic diseases. Belarusian Medical Academy of Postgraduate Education. 2006. 39 р. (in Russian).