Effectiveness of ramipril and amlodipine combination in patients with arterial hypertension, Type 2 diabetes mellitus, and anxiety and depressive disorders

Aim. To study the effects of the ramipril and amlodipine combination on blood pressure (BP) levels and anxiety and depression indices in patients with arterial hypertension (AH) and Type 2 diabetes mellitus (DM-2).

Material and methods. In total, 25 patients with AH and DM-2 were examined. All participants underwent 24-hour BP monitoring, psychological status assessment, and glycated haemoglobin level measurement at baseline and 6 months after the start of the combined therapy (ramipril 5-10 mg/d; amlodipine 2,5-10 mg/d).

Results. In 81,2% of the patients, depressive disorders were observed, with mild and severe depression in 45,7% and 3,2%, respectively. The levels of personal (52,3±3,4) and reactive anxiety (57,2±3,9) were elevated. By the baseline MMPI results, the participants were divided into two groups: Group I – with hyposthenic register, Group II – with sthenic register. Antihypertensive therapy (AHT) was associated with reduction in all scales of the neurotic triad in Group I, and with more homogeneous estimates across scales in Group II. Mean systolic and diastolic BP levels were significantly reduced by 18% and 13%, respectively, without any significant dynamics of heart rate (71,5±0,9 bpm at baseline, 72,3±0,8 bpm after 6 months). According to office BP measurements, BP normalisation (≤130/80 mm Hg) was observed in 81% (n=20).

Conclusion. In patients with AH and DM-2, anxiety and depressive disorders are widely prevalent, which should be considered when administering AHT. The combination of ramipril and amlodipine was effective in >80%, improving not only metabolic profile, but also clinico-psychological status of the patients.

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