HEART RHYTHM DISORDERS IN HYPERTENSIVE PATIENTS WITH BRONCHIAL ASTHMA: THE EFFECT OF IVABRADINE VERSUS DILTIAZEM

Objective.  Bronchial asthma (BA) is a serious problem. The rate of arterial hypertension (HTN) in BA patients is about 30 %. The objective of our study was the assessment of efficacy of diltiazem-retard and ivabradine on myocardial structural and functional changes and HR in hypertensive patients with BA.

Design and methods. Outpatients (n = 91) with BA with HTN 1, 2 degree with high or very high cardiovascular risk by SCORE. All participants used inhaled corticosteroids and β2-agonists. All patients underwent Holter electrocardiogram monitoring (HM-ECG, GE SEER MC Marquette Medical System, USA). Based on HMECG data myocardial ischemia was found in 18 patients. Altogether 67 patients were included in the further analysis. They were divided into 2 groups: 1st group (n = 35, age 58,5 ± 8,34 years) received diltiazem-retard, 2nd  group (n = 32, age 55,2 ± 9,21 years) took ivabradine. Duration of follow-up was 12 weeks.

Results. In hypertensive patients with BA, both ivabradine and diltiazem decrease the frequency of ventricular premature beats and HR (р < 0,05), and supraventricular premature beats. Compared to ivabradine, diltiazem showed comparable efficiency regarding the decrease in HR, ventricular and supraventricular premature beats (р > 0,05). After 12-week therapy ivabradine led to a more significant decrease in ventricular premature beats compared to diltiazem in hypertensive patients with BA.

Conclusions. Ivabradine and diltiazem demonstrate comparable efficiency regarding decrease of HR and ventricular premature beats in hypertensive patients with BA.

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