The role of endothelial protection in the treatment of patients with arterial hypertension: the effectiveness of quercetin

Abstract

The article presents the results of a clinical study of the effectiveness of the cytoprotective drug quercetin as a part of combined antihypertensive therapy on indices of endothelial function and daily blood pressure profile. The aim of the study. To conduct a comparative assessment of the dynamics of indices in 24-hour blood pressure monitoring (BPM) and cytokine levels in patients with hypertension, depending on using quercetin in treatment.Materials and methods. 120 patients with stage II hypertension of 2–3 degrees (66 female and 54 male) were examined. Patients were divided into 2 groups: Group I (study) – 58 patients who took quercetin (Corvitin®) in addition to basic therapy, mean age 57.87±13.6 years; II group (comparison) – 62 patients who underwent only basic antihypertensive therapy (Ramipril/Amlodipine), mean age 59.09±12.47 years. The results. During the administration of quercetin along with the standard basic therapy with the combination of Ramipril/Amlodipine in patients with stage II hypertension of 2-3 degrees of severity, more pronounced significant positive changes in the major indices of 24-hour BPM were observed, an increase in the ratio of people with a “dipper” profile due to a decrease in the number of patients with an insufficient reduction in nocturnal BP, an excessive drop in nocturnal BP or its persistent increase. The additional administration of quercetin contributes to the more effective correction of endothelial dysfunction indices: it significantly reduces the levels of soluble vascular cell adhesion molecules (s-VCAM), and soluble intercellular adhesion molecules 1 (s-ICAM-1), ET-1, IL-1, IL-6, TNF-a. During the administration of basic therapy, changes in IL-1 and ET-1 levels were less pronounced and insignificant. Correlation analysis shows the close relationship between a decrease in the main indices of 24-hour BPM and a decrease in the concentration of the cytokines, which characterize the state of endothelial dysfunction and systemic inflammation.Conclusion. The use of quercetin reliably reduces the levels of cytokines, which ensures a reduction in the manifestations of ED and contributes to better control of all blood pressure indices and normalization of the daily profile of blood pressure.