Arterial hypertension in patients with type 1 diabetes mellitus and orthostatic disorders and its correction: Clinical features and possibilities of correction

Objective. To characterize diabetic nephropathy and cognitive function in patients with arterial hypertension (AH) and diabetes mellitus (DM) type 1, complicated by orthostatic hypotension (OH), and to assess the benefits of venoprotector therapy for the correction of dyscirculatory encephalopathy (DE) and diabetic nephropathy (DN). Design and methods. Sixty patients with AH, DM type 1 and OH were included in the study. Schellongs' orthostatic probe, microalbuminuria (MAU) screening with «Micral-Test-11», Mini Mental State examination (MMSE) test, 10 words memo probe, Spielberg test, Beck questionnaire were used. Antihypertensive therapy included «Enalapril» («Hemofarm», Serbia), venoprotective therapy - with «Detralex» («Servier», France). Results. Adequate antihypertensive therapy in patients with DM type 1 in combination with AH and OH leads to aggravation of postural hypertension symptoms. Blood pressure decrease in orthostatic probe and cognitive disorders are associated (r = 0,56, p = 0,009). Use of active orthostatic probe (AOP) leads to the increase of MAU. Venotonic therapy attenuates the symptoms of postural hypotension, leads to the decrease of MAU in AOP and improves cognitive function.

diabetes mellitus, arterial hypertension, orthostatic hypotension, microalbuminuria, cognitive disorders

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