Effect of vitamin-mineral complexes on quality of life of patients with arterial hypertension
More details
Hide details
Clinical Pharmacology and Propaedeutic of Internal Diseases, First Moscow State Medical University named after I. M. Sechenov, Moscow, Russia
Medical and Social Assessment, Urgent and Ambulatory Care, First Moscow State Medical University named after I. M. Sechenov, Moscow, Russia
Online publish date: 2018-03-16
Publish date: 2018-03-16
Submission date: 2018-02-02
Acceptance date: 2018-02-03
Electron J Gen Med 2018;15(4):em41
A considerable proportion of the population due to both economic reasons and traditions appear to be experiencing chronic deficit in micronutrients, which may be deteriorated on the background of drug therapy being performed. The purpose of our study was to optimize pharmacotherapy of patients with first-ever prescribed diuretic-containing combined therapy for arterial hypertension (AH) by means of adding a vitamin-mineral complex.

To determine B-group vitamins (thiamine, riboflavin, pyridoxine) in blood plasma by means of high-performance liquid chromatography (HPLC) and, on achieving the target values of arterial pressure (AP), to analyse the patients’ quality of life by means of such neuropsychological tests as the General Health Questionnaire – 36 (GHQ-36) and WAM (wellbeing, activity, mood) questionnaire.

The group of patients receiving antihypertensive therapy alone demonstrated a decrease in blood plasma thiamine, riboflavin and pyridoxine from 34.5±4.2 to 25.4±3.2 ng/ml (p<0.05), from 11.3±1.5 to 7.8±1.1 ng/ml (p<0.05) and from 13.4±1.5 to 9.1±1.3 ng ng/ml, respectively. In patients receiving the vitamin-mineral complex additionally to drug therapy of AH, no significant alterations in the content of micronutrients in blood plasma were revealed. We noted more pronounced dynamics in the scores by the GHQ-36 and a more pronounced increase in the patients’ activity by the WAM test, amounting to 28,9 Δ % and 15.51 Δ %, respectively (p<0.05).

Supplementing antihypertensive pharmacotherapy with a vitamin-mineral complex makes it possible not only to maintain the level of micronutrients at the level of the physiological requirements but to improve the patients’ quality of life as assessed by neuropsychological scales.

1. Pogozheva AG, Baturin AK, Aleshina IV, Toboleva MA, Denisova NN, Levin LG, Aristarkhova TB, Zhukova LA. Study of association of nutritional status impairments with arterial pressure level. Almanac of Clinical Medicine. 2015;1:67-75 [in Russian].
2. McCormick DB. Vitamin B6. In: Bowman BA, Russell RM, editors. Present Knowledge in Nutrition. Vol. I. Washington, D.C.: International Life Sciences Institute; 2006:269-77.
3. Maksimenko LV, Kalinicheva MS. Quality of life and nutrition-related individual behaviour. Problems of Nutrition. 2016;85(52):110 [in Russian].
4. Mackey AD, Davis SR, Gregory JF, 3rd. Vitamin B6. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern Nutrition in Health and Disease. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2006:452-61.
5. Zemtsova II. Modern concepts of nutrition of athletes. Sports Medicine. 2012;2:77-84 [in Russian].
6. Smashevsky ND, Ionova LP. Antivitamins in food, biological effect, occurrence and use. Astrakhan Review of Ecological Education. 2016;2(36):54-66 [in Russian].
7. Zelder F, Sonnay M, Prieto L. Antivitamins for Medicinal Applications. Chembiochem. 2015 Jun 15;16(9):1264-78. https://doi.org/10.1002/cbic.2....
8. Rodriguez NR, Di Marco NM, Langley S. American College of Sports Medicine position stand. Nutrition and athletic performance. American Dietetic Association; Dietitians of Canada; American College of Sports Medicine. Med. Sci. Sports Exerc. 2009;41(3):709-31.
9. Knez WL, Peake JM. The prevalence of vitamin supplementation in ultraendurance triathletes. Int J Sport Nutr Exerc Metab. 2010;20(6): 507-14. https://doi.org/10.1123/ijsnem....
10. Bailey AL, Finglas PM. A normal phase high-performance liquid chromatographic method for the determination of thiamin in blood and tissue samples. J. Micronutr. Anal. 1990;7(2):147.
11. Amirdzhanova VN, Goryachev DV, Korshunov NI, Rebrov AP, Sorotskaya VN. Populational indices of quality of life according to the SF-36 questionnaire (results of a multicenter quality-of-life study). Scientific and Practical Rheumatology. 2008;1:36-48 [in Russian]. https://doi.org/10.14412/1995-....
12. Zakharov VV. Neuropsychological tests. Necessity and possibility of administration. «CONSILIUM MEDICUM». 2011;13(2):82-90 [in Russian].
13. Beketova NA, Pogozheva AV, Kodentsova VV, Vrzhesinskaya OA, Kosheleva OV, Pereverzeva OG, Aristarkhova TV, Levin LG, Denisova NN, Baturin AK. Vitamin status of residents of the Moscow region. Problems of Nutrition. 2016;85(4):61-7 [in Russian].
14. Kodentsova VM, Vrzhesinskaya OA, Spirichev VB. Alteration in the vitamin status of adult population of the Russian Federation over 1987-2009 (to the 40th anniversary of the Laboratory of Vitamins and Minerals, Institute of Nutrition under the Russian Academy of Medical Sciences. Problems of Nutrition. 2010;79(3):68-72 [in Russian].
15. Suter PM, Haller J, Hany A, Vetter W. Diuretic use: a risk for subclinical thiamine deficiency in elderly patients. J Nutr Health Aging. 2000;4(2):69-71.
16. Ubbink JB, van der Merwe A, Delport R, et al. The effect of a subnormal vitamin B-6 status on homocysteine metabolism. J. Clin. Invest.1996;98(1):177-84. https://doi.org/10.1172/JCI118....
17. Allen LH. Causes of vitamin B12 and folate deficiency. Food and Nutrition Bulletin. 2008;29(2 Suppl.):20–34. https://doi.org/10.1177/156482....
18. Carmel R. Cobalamin (Vitamin B-12). In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern Nutrition in Health and Disease. Philadelphia: Lippincott Williams & Wilkins;2006:482-97.
19. Dakshinamurti S, Dakshinamurti K. Vitamin B6. In: Zempleni J, Rucker RB, McCormick DB, Suttie JW, editors. Handbook of Vitamins. 4th ed. New York: CRC Press (Taylor & Fracis Group); 2007:315-59. https://doi.org/10.1201/978142....
20. Wilcox CS. Do diuretics cause thiamine deficiency? J Lab Clin Med. 1999;134(3):192-3. https://doi.org/10.1016/S0022-....
21. Shikh E. Thiamine excretion depends upon diuresis in patients with congestive heart failure. Abstracts of the joint meeting of the 5th Congress of the European Association for Clinical Pharmacology and Therapeutics. In Ass. British J. of Clin. Pharm. Odense, Denmark, 2001;345.
22. Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J. Lab. Clin. Med. 1999;134(3):232-7. https://doi.org/10.1016/S0022-....
23. Sica DA. Loop diuretic therapy, thiamine balance, and heart failure. Congestive heart failure. 2007;13(4):244-7. https://doi.org/10.1111/j.1527....
24. Penberthy WT, Kirkland JB. Niacin. In: Erdman JW, MacDonald I, Zeisel SH, editors. Present Knowledge in Nutrition. 10th ed. Ames: International Life Sciences Institute; 2012:293-306. https://doi.org/10.1002/978111....
25. Shah SN. Adjuvant role of vitamin B analogue (sulbutiamine) with anti-infective treatment in infection associated asthenia. J Assoc. Physicians India. 2003 Sep;51:891-5.
26. Manore MM. Effect of physical activity on thiamine, riboflavin, and vitamin B6 requirements. Am. J. Clin. Nutr. 2000;72(2): 598-606.