Prevelans of helicobacter pylori in patients with resistent primaryhypertension and the relation between eradication of h. pyloriand blood pressure changes

Background and Aim: It is known that Helicobacter pylori (H. pylori) can cause numerous extraintestinal pathologies. Number of studies showing that this bacteria can cause many pathological conditions like atherosclerosis and thrombocytopenia are increasing with each passing day. In some studies its shown that H. pylori infection causes gastritis and hypochlorhydria and as a result reduces the absoption of drugs. There are studies demonstrating the positive effects of H. pylori eradication on primary hypertension. In this study, we will investigate H. pylori prevelance and the impact of H. pylori eradication on blood pressure in resistant hypertensive patients with systolic blood pressure>140mm-Hg and diastolic blood pressure>90mm-Hg despite three antihypertensive medication including one diuretic. Material and Method: In our study, patients above 18 and under 65 years old with diagnosis of essential hypertension whose blood pressure could not be reduced below 140/90mm-Hg despite using at least three anti-hypertensive drugs, including one diuretic were included. Patients with H. pylori antigen positive in their stool samples and who had indications for eradication therapy of H. pylori were collected from cardiology and internal medicine clinics. The blood pressure of patients who fulfill the inclusion criteria was measured by 24-hour Holter and patients with blood pressure above 140/90mm-Hg were selected. Patients were checked for H. pylori antigen in their stool sample. A 14-day Standard eradication therapy were given to the patients with H. pylori antigen positive in their stool sample. Four weeks after the eradication therapy, patients with negative H. pylori antigen were considered successfully treated. These patients' blood pressures was measured again by 24-hour Holter and the average blood pressures were compared with values before treatment. Results: In this study the incidence of H. pylori in patients with resistant hypertension and without secondary hypertension was found to be 24.5%. When H. pylroi-positive patients were treated, significantly decreases were observed in both systolic (26.7mm-Hg) and diastolic (9mm-Hg) blood pressures (P=0.002, P=0.011 respectively). On the other hand, there has been no significant change in both systolic (-0.5 mm-Hg) and diastolic (0.3 mm-Hg) blood pressures of H. pylori-negative patients despite recommendations to improve the treatment compliance (P=0.52, P=0.73 respectively). These results suggest that H. pylori should be sought in patients with resistant hypertension. And it shows that if H. pylori detected to be positive, eradication therapy can be helpful in maintaining the blood pressure control.