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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 March;179(3):129-35

DOI: 10.23736/S0393-3660.19.04047-6

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Should we be concerned about pain in hypertension treatment in young patients?

Ersin YILDIRIM 1, Ozlem SECEN 2, Muhammed KESKIN 3

1 Department of Cardiology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey; 2 Department of Cardiology, Training and Research Hospital, University of Health Sciences, Elazig, Turkey; 3 Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey



BACKGROUND: The aim of this study was to investigate whether increased level of substance P and bradykinin caused by hypertension therapy lead to an important pain problem or not.
METHODS: The study included a total of 177 patients; among those, 111 were female (mean age: 60.75 years) and 66 were male (mean age: 60.39 years). Two groups were formed, which included patients receiving angiotensin converting enzyme inhibitor (ACEI) (87 patient) and those receiving angiotensin receptor blocker (ARB) (90 patients). Then these patients were divided into two subgroups according to their age [≥65 years (N.=68) and <65 years (N.=109)]. The pain perceptions of the patients were compared using the Visual Analogue Scale (VAS).
RESULTS: Patients over 65 years of age, no significant difference was observed between the VAS scores of ACEI and ARB groups (4.69±2.57 vs. 4.42±2.15, P=0.638). In young patients, there was a significant difference between the VAS scores of ACEI and ARB groups (4.09±2.12 vs. 3.04±2.24, P=0.013). The left ventircular ejection fraction was significantly lower in the elderly group (55.82±6.25vs. 52.92±8.83, P=0.013). The education level was statistically significant lower in the elderly group (2.25±.1.15 vs. 1.78±0.99, P=0.007). The incidence of any orthopedic or rheumatic disease that may cause pain was higher in the elderly group (38(%35.20) vs. 37(%54.41), P=0.010).
CONCLUSIONS: Increased level of substance P and bradykinin related to ACEI intake was observed to be statistically important problem with regard to its effect on the appearance of pain in hypertensive young patients.


KEY WORDS: Hypertension; Bradykinin; Pain; Angiotensin-converting enzyme inhibitors

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