Efficiency of Double Combined Therapy in Hypertensive Patients with High Cardiovascular Risk
Objective: to study the antihypertensive efficacy and the possibility of organ protection of combination therapy with lercanidipine and renin-angiotensin-aldosterone system blockers, perindopril or eprosartan, in patients with essential hypertension and high and very high risk of cardiovascular complications.
Material and methods. The study included 78 patients with essential hypertension I–III degree (ESH/ESC, 2007). The average age of the patients was 46.52 ± 10.31 years, the mean disease duration — 5.96 ± 4.04 years. Patients received therapy with lercanidipine and perindopril or lercanidipine and eprosartan. Echocardiography, vascular ultrasound with determination of endothelium-dependent vasodilation of the brachial artery, common carotid intima-media thickness, biochemical analyzes with determination of creatinine, microalbuminuria level, lipid profile, glomerular filtration rate were carried out.
Results of the study. The use of combination therapy with lercanidipine and perindopril and eprosartan in patients with essential hypertension with high and very high risk of cardiovascular events enables to reach quickly the target levels of systolic and diastolic blood pressure. Combination therapy provides reliable regression of left ventricular hypertrophy, the normalization of endothelium-dependent vasodilation of the brachial artery and a decrease in common carotid intima-media thickness. There was a significant reduction in the levels of malalbuminuria, serum creatinine, increase in the estimated glomerular filtration rate, which characte-rizes a high renal protection effect of the combined therapy. Due to the treatment, there was a significant reduction in total cholesterol, triglycerides, increase in high-density lipoprotein cholesterol levels. At that, both regimens were well tolerated.
Conclusion. The combined use of lercanidipine and renin-angiotensin-aldosterone system blockers has a high antihypertensive efficacy, expressed organ protective influences, metabolic neutrality, good tolerability, which generally characterizes this combination as the most optimal and efficient in reducing the risk of cardiovascular complications in the majority of patients with hypertension.
Full Text:PDF (Русский)
Mancia G., Laurent S., Agabiti-Rosei E. et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document (ESH 2009) // J. Hypertens. — 2009. — V. 27. — Р. 2121-2158.
ESH-ESC Guidelines Committee. Guidelines for the management of arterial hypertension // J. Hypertension. — 2007. — V. 25. — Р. 1105-1187.
Laurent S., Cockcroft J., Van Bortel L. et al. On behalf of the European Network for Non-invasive Investigation of Large Arteries. Eхpert consensus document on arterial stiffness: methodological issues and clinical applications // Europ. Heart J. — 2006. — V. 27. — Р. 2588-2605.
Грачев А.В. Центральные и периферические механизмы адаптации сердечно-сосудистой системы у больных артериальной гипертонией (патогенетические и терапевтические аспекты): Дис... д-ра мед. наук. — Ташкент, 2001. — 364 с.
Kaplan N. jn uheggs Clinical Altace Real-World Efficacy (CARE). The CARE Stady: A postmarketing evaluation of ramipril in 11000 patients // Clin. Ther. — 1996. — V. 18(4). — Р. 658-670.
Jamerson K., Weber M.A., Bakris G.L. et al. For the ACCOMPLICH trial Investigators. Benazepril plus amlodipine or hydrochlortiazide for hypertension in high risk patients // N. Eng. J. Med. — 2008. — V. 359. — Р. 2417-28.
Copyright (c) 2016 HYPERTENSION
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2019