recorded. In 37 cases patients with BA were diagnosed to have EH, including EH stage I in 19 cases (Group III), EH stage II – in 18 cases (Group IV). The most part of patients from Group III and IV had EH grade 1. In control group we included 10 healthy persons (3 males and 7 females, average age 57.1 ± 1.7 years old). Prior to starting these examinations all patients signed Informed Consent.
In our study we included outpatients who had no overt clinical signs of present or previous complications after cardiovascular diseases (coronary heart disease, stroke) or renal diseases; non-smokers, with normal fasting plasma glucose level. During the first visit nine patients with BA and concomitant EH were found to take their hypotensive medicines regularly, including angiotensin converting enzyme inhibitor (enalapril) – 3 cases, diuretic drug (indapamide) – 2 cases, angiotensin II receptor antagonist (losartan) – 1 case, calcium channel antagonist (nifedipine) – 1 case, a selective β1 receptor blocker (metoprolol tartrate) – 1 case, and combined drug (enalapril / hydrochlorothiazide) – 1 case. 2-5 days prior to the study hypotensive therapy was cancelled. In case patients should have to continue taking medicines they were not included.
All patients were examined before and after medical treatment of BA exacerbation (time period between the first and next examination was 1.5-2 months). Fasting blood sampling was performed before noon (845-900 am). Six hours before blood sampling patients were not inhaling short-acting β2-agonists, and within 24 hours – prolonged β2-agonists. ET-1 levels in patients’ plasma were estimated by using Enzyme Immunoassay test-kit for the quantitative determination of endothelin (Biomedica Gruppe, Austria). Optical density of samples was measured by using photometer “ELM-3000” (DRG, USA), at 450 nm wavelength and comparison wavelength 620 nm. Respiratory function tests were performed by using Erich Jager apparatus (Germany). Hemodynamic parameters were measured by using premier cardiovascular ultrasound system GE VIVID7 Dimension (General Electric, USA).
Therapeutic regimen for BA patients included inhaled glucocorticosteroids and β2-agonists (short-acting and prolonged); no systemic glucocorticosteroids were applied. In case hypotensive therapy was necessary patients were given lisinopril (10