Русский
24-hour blood pressure monitoring during treatment with free and fixed combinations of antihypertensive drugs
DOI: https://dx.doi.org/10.18565/therapy.2023.10.48-55
Gumerov F.R., Mayanskaya S.D., Malysheva E.V.
1) Kazan State Medical University of the Ministry of Healthcare of Russia; 2) Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia
The aim of the research is a comparative estimation of daily BP profile in patients with stage 2–3 AH while taking a free combination and FC of blockers of angiotensin II receptor and a calcium antagonist.
Material and methods. 60 patients with grade 2–3 of AH, randomized into two groups of 30 people each were involved in the study. The 1st group received FC of losartan with amlodipine, the 2nd group received a free combination of valsartan and amlodipine. The study was carried out over 3 months. At the first and second visits, participants underwent ABPM procedure.
Results. After 3 months from the start of the treatment, the dynamics of ABPM indexes in patients of both groups practically had no difference. A significant decrease in most of the main parameters of the daily BP profile was revealed, with the exception of the rate of morning rise in SBP and DBP, as well as the degree of nighttime decrease in SBP in group 1 and indicators of BP variability in group 2. An intergroup comparison of ABPM parameters revealed a more noticeable difference in all main indicators of SBP and DBP in patients taking FC.
Conclusion. Statistically significant decrease in the main ABPM parameters was observed both when taking the free combination of valsartan and amlodipine, and the FC of losartan with amlodipine. When comparing between groups, a statistically more significant decrease in most ABPM parameters was observed when using FC of losartan with amlodipine. This indicates a more expressed effect of FC at the daily blood pressure profile, which is apparently takes place due not only to increased patients’ adherence to such therapy and its economic feasibility, but also to the additional additive antihypertensive efficacy of AHDs FC.
Literature
1. Ионов М.В., Звартау Н.Э., Конради А.О. Совместные клинические рекомендации ESH/ESC 2018 по диагностике и ведению пациентов с артериальной гипертензией: первый взгляд. Артериальная гипертензия. 2018; 24(3): 351–358. [Ionov M.V., Zvartau N.E., Konradi A.O. First look at new 2018 joint ESH/ESC Guidelines on diagnosis and management of hypertension. Arterial’naya gipertenziya = Arterial Hypertension. 2018; 24(3): 351–358 (In Russ.)]. https://dx.doi.org/10.18705/1607-419X-2018-24-3-351-358. EDN: SWWKMT. 2. Кобалава Ж.Д., Конради А.О., Недогода С.В. с соавт. Артериальная гипертензия у взрослых. Клинические рекомендации 2020. Российский кардиологический журнал. 2020; 25(3): 149–218. [Kobalava Z.D., Konradi A.O., Nedogoda S.V. et al. Arterial hypertension in adults. Clinical guidelines 2020. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2020; 25(3): 149–218 (In Russ.)]. https://dx.doi.org/10.15829/1560-4071-2020-3-3786. EDN: TCRBRB. 3. Маянская С.Д., Малышева Е.В., Фролова Э.Б. с соавт. Эффективность валсартана в комплексном лечении пациентов с артериальной гипертонией и высоким риском осложнений. Вестник современной клинической медицины. 2010; 3(2): 86–89. [Efficacy valsartan in complex treatment of patients with arterial hypertension and high complications risk. Vestnik sovremennoy klinicheskoy meditsiny = The Bulletin of Contemporary Clinical Medicine. 2010; 3(2): 86–89 (In Russ.)]. 4. Михин В.П. Эффективность фиксированной комбинации (амлодипин/лозартан) в терапии у больного артериальной гипертонией с дислипидемией и ожирением. Медицинский совет. 2019; (21): 74–78. [Mikhin V.P. Efficacy of a fixed-dose combination (amlodipine/losartan) in the treatment of a patient with arterial hypertension, dyslipidemia and obesity. Meditsinskiy sovet = Medical Council. 2019; (21): 74–78 (In Russ.)]. https://dx.doi.org/10.21518/2079-701X-2019-21-74-78. EDN: NTMPCJ. 5. Маянская С.Д., Гумеров Ф.Р., Гребенкина И.А. Сравнительная оценка показателей суточного мониторирования в динамике лечения фиксированными комбинациями антигипертензивных препаратов. 2023; 21(2): 99–106. [Mayanskaya S.D., Gumerov F.R., Grebenkina I.A. Comparative evaluation of daily monitoring indicators in the dynamics of treatment with fixed combinations of antihypertensive drugs. Prakticheskaya meditsina = Practical Medicine. 2023; 21(2): 99–106 (In Russ.)]. https://dx.doi.org/10.32000/2072-1757-2023-2-99-106. EDN: UORUBS. 6. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288(23): 2981–97. https://dx.doi.org/10.1001/jama.288.23.2981. 7. Philipp T., Anlauf M., Distler A. et al. Randomised, double blind, multicentre comparison of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in antihypertensive treatment: results of the HANE study. HANE Trial Research Group. BMJ. 1997; 315(7101): 154–59. https://dx.doi.org/10.1136/bmj.315.7101.154. 8. Hansson L., Zanchetti A., Carruthers S.G. et al. Effects of intensive bloodpressure lowering and low-dose aspirin in patients with hypertension: Principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998; 351(9118): 1755–62. https://dx.doi.org/10.1016/s0140-6736(98)04311-6. 9. Ruzicka M., Leenen F.H. Monotherapy versus combination therapy as first line treatment of uncomplicated arterial hypertension. Drugs. 2001; 61(7): 943–54. https://dx.doi.org/10.2165/00003495-200161070-00004. 10. Морозова Т.Е., Самохина Е.О. Фиксированные комбинации в лечении артериальной гипертензии – реальный путь к повышению приверженности. Российский кардиологический журнал. 2020; 25(11): 177–184. [Morozova T.E., Samokhina E.O. Fixed-dose combinations in the treatment of hypertension to increase adherence. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2020; 25(11): 177–184 (In Russ.)]. https://dx.doi.org/10.15829/1560-4071-2020-4184. EDN: UJVFJU. 11. Jamerson K.A., Bakris G.L., Weber M.A. 24-hour ambulatory blood pressure in the ACCOMPLISH trial. N Engl J Med. 2010; 363(1): 98. https://dx.doi.org/10.1056/NEJMc1001410. 12. Остроумова О.Д., Максимов М.Л. Комбинированная антигипертензивная терапия: первая тройная фиксированная комбинация антигипертензивных препаратов. Consilium medicum. 2011; 13(10): 6–10. [Ostroumova O.D., Maksimov M.L. Combination antihypertensive therapy: The first triple fixed combination of antihypertensive drugs. Consilium medicum. 2011; 13(10): 6–10 (In Russ.)]. EDN: RAFOCL. 13. Byrd J.B., Zeng C., Tavel H.M. Combination therapy as initial treatment for newly diagnosed hypertension. Am Heart J. 2011; 162(2): 340–46. https://dx.doi.org/10.1016/j.ahj.2011.05.010.
About the Autors
Farid R. Gumerov, postgraduate student of the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
E-mail: biz1994@yandex.ru
ORCID: https://orcid.org/0000-0002-2329-1416
Svetlana D. Mayanskaya, MD, professor of the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
E-mail: Smayanskaya@mail.ru
ORCID: https://orcid.org/0000-0001-6701-5395
Ekaterina V. Malysheva, assistant at the Department of cardiology, X-ray endovascular and cardiovascular surgery, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 11 Mushtari St.
E-mail: ekatkardio@mail.ru
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