Effectiveness of Sulfide Balneopeloidtherapy in Patients with Hypertension in Comorbid Combinations: Randomized Prospective Study

INTRODUCTION. In the treatment of cardiovascular diseases, the use of hydrogen sulfide, which is a universal gas transmitter and performs many physiological functions in the body, is of interest. AIM. To evaluate the effectiveness of sulfide balneopeloid therapy (SBPT), carried out at the Klyuchi resort (Perm region), in patients with arterial hypertension (AH), as well as their combinations with coronary heart disease (CHD), prediabetes and cerebrovascular disease (CVD) with chronic ischemia brain (CHM). MATERIALS AND METHODS. A comparative randomized prospective study was conducted at the Klyuchi resort (Perm region), which studied the effectiveness of SBPT in patients with hypertension in various comorbid combinations. General inclusion criteria were the presence of hypertension and age from 40 to 70 years. RESULTS. The results of a study of the effectiveness of different durations of SBPT in patients with hypertension showed that when a course of SBPT was carried out for 14 days, the hypotensive effect was less significant, while mid-term observation revealed that the hypotensive effect after a 21-day course of SBPT persisted for up to 6 months, and after 14-day course — 3 months. In patients with hypertension and prediabetes, complex therapy, including 14 days of SBPT, helps reduce the severity of clinical manifestations and improve quality of life; causes redistribution of fat deposits, improvement of blood pressure profile, aortic compliance, endothelial and neurogenic circuit of skin microcurrent regulation; reduces the serum concentration of vascular endothelial growth factor (VEGF), leptin, and also increases the serum concentration of transforming growth factor beta 1 (TGF-β1). When treating patients with hypertension and coronary artery disease using SBPT, an increase in the activity of the parasympathetic part of the nervous system, a lipid-correcting effect, improvement of endothelium-dependent vasodilation and exercise tolerance. The results of a study of patients with hypertension with CVD and MS showed that patients who received a course of SBRT had a significant improvement in cognitive functions. DISCUSSION. The effects that develop during SBPT are associated with the polymodal effect of the H2S molecule on the main metabolic signaling pathways and regulatory mechanisms of the body’s hormonal-humoral systems, which leads to optimal regulation of micro- and macrohemodynamics, favorable changes in lipid metabolism, trophological status and trophic factors. CONCLUSION. SBPT, carried out at the Klyuchi resort (Perm Region), is effective in patients with hypertension, including various comorbid combinations — hypertension and prediabetes, hypertension and ischemic heart disease, CCI.