Changes of plasma hemostasis indicators in elderly and middle-aged hypertensive patients under combined antihypertensive treatment

Background. The worsening of the demographic situation in most countries of the world is due to the steady increase in the population of arterial hypertension and the aging of the population. According to a UN statistical forecast, by 2025, the number of people over 60 years of age will exceed 1 billion people, that is, 15% of the total population of the planet. The demographic situation in most countries of the world is characterized by a steady increase in the proportion of the elderly population that creates the need for active adaptation of all areas of life to the characteristics and needs of elderly people. In evidence-based medicine, the process of population aging stimulates the development and conduct of clinical trials and creation of guidelines for the management of various diseases in patients of older age categories. Scientific and practical data that allow us to understand the problems that accompany old age accumulate relatively slowly. Purpose: to conduct a comparative assessment of the dynamics of plasma hemostasis parameters in elderly and middle-aged hypertensive patients under combined antihypertensive treatment with enalapril and amlodipine. Materials and methods. The work is based on the special examination of 93 elderly (60-74 years) (group I) and 127 middle-aged hypertensive patients (45-59 years) (group II) who were on inpatient two-week treatment. And they were divided into 2 groups of 24-hour’ day's profile of blood pressure: dippers and non-dippers. Fibrinogen (g/l) was determined on Amelung KC 1A hemocoagulometer in order to assess the state of plasma hemostasis. Fibrinolytic activity of plasma (min) was according to the Kowalskii method. Antithrombin III (%) with the help of Humalyzer Junior filter photometer. Results. Thus, antithrombin III activity in the elderly group increased by 14.2% (p<0.01) while in middle-aged people by 9.1% (from 80.1±8.0% to 87.4±11.4%). When assessing the indicators of plasma hemostasis in elderly and middle-aged hypertensive patients of dipper and non-dipper groups under combined antihypertensive therapy, antithrombin III turned out to be informative that, accordingly, increased from 80.7±7.3% to 90.5±7.5% in patients of dipper group of middle age; from 78.1±12.2% to 89.2±5.8% in elderly patients. Regarding patients in the non-dipper group, antithrombin III increased in elderly patients from 71.1±17.5% to 80.7±9.7% (p<0.05). Conclusions. Thus, positive changes occur in various parts of the blood coagulation system to a greater extent in terms of activation of the anticoagulant part of the hemostasis system under combined antihypertensive treatment with enalapril and amlodipine.