Abstract:
Problem statement: Hypertension and diabetes frequently occur together, as they share similar risk factors and are components of the metabolic syndrome. The comorbidity of these conditions is among the most common diseases and risk factors for cardiovascular diseases, the prevalence of which increases with age.
Objective: The study aimed to improve the health of middle-aged patients with hypertension associated with diabetes mellitus through a customized rehabilitation program.
Material and Methods: The study involved 50 men aged 51.4 ± 4.7 years, diagnosed with arterial hypertension alongside type 2 diabetes mellitus. The participants were divided into two randomized groups (the main group and the comparison group). All subjects provided informed consent before participation. A personalized rehabilitation program was developed for the main group (MG, n = 30), while the comparison group (CG, n = 20) followed standard recommendations for recovery. Blood parameters related to carbohydrate metabolism (glucose, mmol/L; glycated hemoglobin (HbA1c, %); insulin, µU/mL; HOMA index, units) were assessed in all patients. Additionally, lipid profile parameters were measured (cholesterol, mmol/L; triglyceride levels, mmol/L; high-density lipoproteins (HDL), mmol/L; low-density lipoproteins (LDL), mmol/L; very low-density lipoproteins (VLDL), mmol/L; atherogenic index (AI)). Changes in blood pressure (mm Hg) and the risk of premature death from cardiovascular events, as assessed by the SCORE index (%), were also evaluated.
Results: Implementation of the tailored rehabilitation program, which included health walking, swimming, and diaphragmatic breathing, resulted in a greater reduction in symptoms of hypertension and diabetes in the MG compared to the CG. In the MG, systolic blood pressure decreased by 10.5% (p < 0.05). Improvements in carbohydrate metabolism parameters were observed, including a 46.1% decrease in glucose levels, a 31.5% reduction in insulin levels, and a 64.1% decline in the HOMA index (p < 0.01). HDL levels increased by 48.0% (p < 0.05), while the lipid profile improved, with cholesterol decreasing by 30.3%, LDL by 35.1%, triglycerides by 33.8%, and the atherogenic index decreasing by 41.7% (p < 0.01). The SCORE index showed a 47.4% reduction in the risk of premature cardiovascular mortality in the MG (p < 0.01). In the CG, patients who followed general lifestyle recommendations showed only a modest decrease in glucose (18.3%), HOMA index (28.6%), and the atherogenic index (29.8%) (p < 0.05).
Conclusions: The results obtained demonstrate that the customized rehabilitation program, incorporating health walking, swimming, and diaphragmatic breathing, had a positive impact on the progression of the disease and significantly improved health. The study supports the implementation of such programs in clinical practice to enhance cardiovascular health and metabolic function in patients with hypertension and type 2 diabetes.
