Volume 02 Issue 10-2022
16
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
02
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SSUE
10
P
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:
16-20
SJIF
I
MPACT
FACTOR
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(2022:
5.
893
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OCLC
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1121105677
METADATA
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5.654
Publisher:
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ABSTRACT
Hypertension (AH) was designated by Russian scientists as the greatest non-infectious pandemic in the history of
mankind [7-14]. This definition, given at the end of the 20th century, retains its significance at the beginning of the 21st
century, when an increase in the upward trend in the incidence of GB was noted. Currently, in the fight against
hypertension, it is important not only to reduce blood pressure, but also to prevent and treat organ complications
[3,5].
KEYWORDS
Hypertensive encephalopathy, blood pressure, pathology, otoneurological status, rheoencephalography (REG),
echoencephaloscopy (EchoES), electroencephalography (EEG), audiometry (AM) and electronystagmography (ENG).
Research Article
DYNAMICS OF HEARING DISORDERS IN PATIENTS WITH ARTERIAL
HYPERTENSION UNDER THE INFLUENCE OF HYPOTENSIVE THERAPY
Submission Date:
October 01, 2022,
Accepted Date:
October 07, 2022,
Published Date:
October 20, 2022
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume02Issue10-04
U.S. Khasanov
Doctor Of Medical Sciences, Professor, Head Of The Department Of Otorhinolaryngology And Dentistry,
Tashkent Medical Academy, Uzbekistan
N.A. Akhundjanov
Doctor Of Medical Sciences, Tashkent Medical Academy, Uzbekistan
J.A. Djuraev
Doctor Of Medical Sciences, Associate Professor Of The Department Of Otorhinolaryngology And Dentistry,
Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 02 Issue 10-2022
17
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
02
I
SSUE
10
P
AGES
:
16-20
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
OCLC
–
1121105677
METADATA
IF
–
5.654
Publisher:
Oscar Publishing Services
Servi
INTRODUCTION
As
is
known,
among
organ
complications,
cerebrovascular ones are life-threatening. In particular,
damage to the auditory analyzer significantly reduces
the quality of life of patients with GB. Therefore, it is
very important to study the state of auditory function
in patients with hypertension, to determine the
relationship of this pathology in general with
dyscirculatory disorders of the brain. This issue has not
been covered enough in the literature, only a few
reports [1-6] discuss certain aspects of this problem.
Considering the foregoing, the aim of this work was to
study the state of auditory function in patients with
hypertension
with
pre-stroke
cerebrovascular
disorders (DCVR) and their dynamics during treatment
with modern antihypertensive drugs.
MATERIAL AND RESEARCH METHODS
We examined 79 patients with GB, who had a duration
of the disease from 1 to 15 years. Among the sick men
were 92, women - 18, their age ranged from 31 to 73
years. According to the structure of the identified
LCVR, the patients were distributed as follows: with
initial manifestations of inferiority of the brain blood
supply (NPNKM) 20 patients, with hypertensive
encephalopathy (HE)-Ist. - 20 people, with GE-II Art. - 20
and HE with episodes of transient cerebrovascular
accident (TIMC) - 19 patients.
The examination included: examination of the somatic
(cardiological), neurological and otoneurological
status,
rheoencephalography
(REG),
echoencephaloscopy
(EchoES),
electroencephalography (EEG), audiometry (AM) and
electronystagmography (ENG) according to generally
accepted standard methods. The specified set of
examinations was carried out by the patient twice,
before and 1 month after treatment. In 40 patients,
antihypertensive therapy was carried out with the ACE
inhibitor Vasotec (enalopril) at a dose of 5-10 mg/day.
39 patients received antihypertensive therapy with
calcium antagonists (corinfar up to 30 mg/day or
norvascom 5-10 mg/day). No statistically significant
differences were found in terms of the effect on the
indicators of auditory function, and therefore the
results are summarized.
RESULTS AND DISCUSSION
Analysis of patients' complaints showed that out of 79
patients who complained of tinnitus, 28 had
completely regressed, and 51 had partially. When
comparing the dynamics of noise with the dynamics of
blood pressure, we observed the following picture. Of
the 64 patients with CVD with a decrease in blood
pressure as a result of treatment, murmurs
disappeared or decreased in 42, respectively (65.6%).
And among those with unchanged blood pressure,
murmurs remained unchanged in 63.3% of cases. The
dynamics of tinnitus in the context of the LCVR
structure looked as follows: in patients with NPNKM,
the noise decreased or disappeared in 17 out of 20
(85%), in patients with HE-I stage. - in 13 out of 20 (65%),
GE-IIst. - in 10 out of 20 (50%), and in patients with HE
with MIMC, the murmurs disappeared or decreased
only in 5 out of 19 (26.3%). According to the study of
hearing acuity by speech, after treatment, a significant
improvement in hearing occurs in the initial stages of
the disease, while in later stages, improvement occurs
in a smaller percentage of cases. It should also be
noted that the perception of colloquial speech
improves to a greater extent than whispered.
The results of tuning fork C128 studies of sound
perception through the air in patients who received
Volume 02 Issue 10-2022
18
International Journal of Medical Sciences And Clinical Research
(ISSN
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VOLUME
02
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SJIF
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5.
893
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OCLC
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Publisher:
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calcium antagonists showed that positive dynamics
occurs in 48.7%, and in patients who received ACE
inhibitors in 50%. As can be seen, the differences are
not statistically significant. At the same time, the
difference in bone conduction is more distinct,
amounting to a positive trend in the group with AK
41.01% and in the ACE inhibitor group 45.0%.
Audiometric studies of auditory function have
expanded the understanding of the state of hearing in
patients with hypertension with CVD, both in terms of
initial and dynamic data. In particular, audiometric
indicators of hearing loss according to the initial data
were detected in 65 (81.2%) patients out of 79. After a
month
of
antihypertensive
therapy,
positive
audiometric dynamics was detected in 36 (55.3%) of 65
patients. The structure and dynamics of audiometric
changes were as follows: a) in the majority of patients
with an isolated lesion in the perception of high-
pitched sounds during treatment, some improvement
in the perception of these sounds was observed within
10-15 dB, less often 20 dB. b) in some patients with a
general increase in the thresholds of auditory
sensitivity, a decrease in hearing thresholds was
observed over the entire frequency range within 10-15
dB, less often -20 dB. c) in several patients with GE-II
and HE with PNMK, a mixed change in hearing was
observed, which consisted mainly in improving the
perception of low sounds and worsening the
perception of high sounds within 10-15 dB, less often 20
dB.
Interesting data were obtained in the analysis of the
dynamics of blood pressure and audiological changes.
Of the 79 patients, BP was reduced to target values in
64 (81%) cases. At the same time, audiometric
parameters normalized in (18.4%) patients, improved in
(15.3%) patients and remained unchanged in (3.1%)
patients (P<0.05). There were no cases of hearing loss.
BP did not reach the target values in 15 (19%) patients.
There were no cases of hearing normalization in this
subgroup. Improvement occurred in (3.1%) patients.
Hearing remained unchanged in (9.2%) and worsened
in (3.1%) patients.
From the comparative data, it can be seen that the
percentage of positive changes with a decrease in
blood pressure to target values is much higher (%) than
with ineffective antihypertensive therapy (%). It was
found that the latter patients were mostly diagnosed
with GE-II st. and HE with PNMK, that is, these are the
cases when the state of cerebral hemodynamics and
dyscirculatory disorders are not sufficiently correlated
with antihypertensive drugs. This thesis was also
confirmed by the results of neurophysiological (REG,
EchoES, EEG) studies.
It should also be noted that when comparing the
degree of improvement in hearing acuity by speech
with a change in hearing sensitivity thresholds as a
result of treatment, it was noted that in some patients,
in the absence of any shifts in hearing thresholds, there
was a significant improvement in hearing acuity for
whispered speech. Such data may indicate that hearing
loss in hypertensive patients is caused not only by
damage to the receptor of the auditory analyzer, but
also to its cortical centers.
CONCLUSION
Thus, it can be concluded that the study of the state of
the auditory analyzer in patients with AH makes it
possible to determine not only the early signs of
damage to the brain, the target organ of AH, but also
to assess the severity of dyscirculatory disorders.
Our studies confirm the literature data (1,3,5,8) on the
high hypotensive efficacy of ACE inhibitors (Vazotek)
and calcium antagonists (Corinfar, Norvasc) in patients
Volume 02 Issue 10-2022
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VOLUME
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with GB, show their ability to improve auditory
disorders in NPCM and GB-I stage. To achieve the
desired results in patients with EH with ET-II and HE
with
PNMK,
it
is
necessary
to
combine
antihypertensive therapy with neurometabolic and
antioxidant drugs. Other researchers speak about such
tactics
in
the
treatment
of
dyscirculatory
encephalopathy of various origins (2,4,5).
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(ISSN
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VOLUME
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