Fixed-dose perindopril and indapamide combination: in hospital effectiveness in arterial hypertension patients with obstructive sleep apnoea syndrome

Aim. То investigate effectiveness, safety, and tolerability of fixed-dose combined treatment with perindopril and indapamide (Noliprel® forte) in hospitalized patients with arterial hypertension (AH) and obstructive sleep apnoea syndrome (OSAS). Material and methods. The study included 20 patients with mild to moderate AH and OSAS. All participants were hospitalized before starting Noliprel® forte therapy. For 10 days, blood pressure (BP) was measured daily, by Korotkoff method. 24-hour blood pressure monitoring (BMP) was performed at baseline, at Weeks 2 and 4 of Noliprel® forte treatment, blood biochemical assay - at baseline and at Week 2. Results. According to daily BP measurement data, maximal BP reduction was observed by Day 4 of the treatment, and antihypertensive effect lasted till the end of Week 2. Significant reduction in main BP circadian profile (CP) parameters was observed by the end of Week 2. BP CP dynamics from baseline to Visit 3 was similar to that by visit 2, according to absolute figures and 24-hour BPM data. No significant BP CP dynamics between Visits 2 and 3 was registered in all patients. Therapy compliance was as high as 100% after 4 weeks of the treatment. Conclusion. NoUprel® forte therapy is effective and safe in hospitalized AH patients with an additional risk factor, OSAS.

1. Quan S.F., Gersh B.J. Cardiovascular consequences of sleep-disordered breathing: past, present and future. Report of a Workshop from the National Center on Sleep Disorders Research and the National Heart, Lung, and Blood Institute. Circulation 2004; 109: 951-7.13. American Academy of Sleep Medicine Task Force. Sleep-related breathing disordersin adalts.

2. Lugaresi E., Cirignotta F., Coccagna G., Piana C. Some epidemiological data on snoring and cardiocirculatory disturbances. Sleep 1980; 3(3-4): 221-4.

3. Young T., Palta M., Dempsey J., etal. The occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230-5.

4. Lavie P., Ben-Yosef R., Rubin A.E. Prevalence of sleep apnea among patients with essential hypertension. Am Heart J 1984; 108: 373-6.

5. Nieto F.J., Young Т.В., Lind B.K., et al. Association of sleep-disordered breathing, sleep apnea and hypertension in a large community-based study. JAMA 2000; 283(14): 1829-36.

6. Peppard P.E., Young T., Palta M., Scatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000; 342(18): 1378-84.

7. Aardweg van den J.G., Karemaker J.M. Repetitive apneas induce periodic hypertension in normal subjects through hypoxia. J Appl Physiol 1992; 72(3): 821-7.

8. Hedner J., Ejnell H., Sellgren J., et al. Is high and fluctuating muscle-nerve sympathetic activity in the sleep apnea syndrome of pathogenetic importance for the development of hypertension? J Hypertens 1988; 6(4) Suppl.: 5520-37.

9. Fletcher E.C., Bao G., Li R. Renin activity and blood pressure in response to chronic episodic hypoxia. Hypertension 1999; 34(2): 309-14.

10. Carlson J.T., Hedner J., Elam M., et al. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest 1993; 103(6): 1763-8.

11. Sullivan C.E., Issa F.G., Berton-Johnes M., Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure therapy. Lancet 1981; I: 862-5.

12. Рогоза A.H., Никольский В.П., Ощепкова Е.В. и др. Суточное мониторирование артериального давления. (Методические вопросы). Под ред. Г.Е. Арабидзе и О.Ю. Атькова. Москва 1997.