EXPERIENCE AND PROSPECTS FOR ТНЕ USE OF COLLECALCIPHEROL IN ТНЕ COMPLEX TREATMENT OF ESSENTIAL ARTERIAL HYPERTENSION IN CHILDREN
The prevalence of arterial hypertension in children ranges from 1 to 25 %, depending on age and the selected criteria. Vitamin D can affect blood pressure (BP) through several mechanisms. The most important function of vitamin D is its role in the regulation of the renin-angiotensin-aldosterone system. The only metabolite of vitamin D that is used to determine its content in the human body is 25 (OH) D (calcidiol). The data on the effect of vitamin D on blood pressure in adolescents are contradictory, indicating a lack of knowledge of this issue. Objective: to evaluate the effectiveness of the use of an aqueous solution of vitamin D3 in the complex treatment of children with essential hypertension. Materials and methods. We examined 30 children (24 boys and 6 girls) aged 13 to 17 years with essential hypertension who had a deficiency of 25 (OH) D in blood serum, the treatment complex of which was supplemented with an aqueous solution of vitamin D3 at 1500 IU/day for 3 months. The control group consisted of 30 children (20 boys and 10 girls) with essential hypertension who received standard therapy. Results. In the main group, after 3 months of taking colecalciferol, a statistically significant normalization of vitamin D levels was documented in 15 (50.0 %) patients, an average of 33.26±1.2 ng/ml. Vitamin D deficiency persisted in 8 (26.6 %) children, vitamin D deficiency persisted in 7 (23.3 %) patients, which served as a basis for increasing the dose of colecalciferol to 2000 IU and continuing to take the drug for another 1 month with a reevaluation serum 25 (OH) D content. A study of the dynamics of blood pressure with the addition of complex treatment with colecalciferol showed that in 24 (80.0 %) children the level of blood pressure decreased, which was statistically significantly more often in comparison with the control group (53.3 %, p<0.05): systolic blood pressure decreased from 142.6±2.4 mm Hg up to 125±0.6 mm Hg (p<0.05), diastolic blood pressure – with 80.2±1.3 mm Hg up to 78.5±1.5 mm Hg. Normalization of blood pressure in the main group was detected after 31±4 days, while in the control group after 60±7 days (p<0.05). There were no adverse reactions during treatment. Conclusions: The positive effect of the drug is proved, which consists in restoring the normal content of 25 (OH) D in blood plasma and reducing systolic blood pressure.