Pleiotropic effects of antihypertensive therapy variants
Abstract
Aim. То compare the effects of different two-component antihypertensive therapy (AHT) variants on endothelial dysfunction (ED) and albuminuria (AU) in patients with arterial hypertension (AH).
Material and methods. The study included 140 AH patients (mean age 57,0±8,9 years): 28,6 % men and 71,4 % women. Inclusion criterion was ineffective AHT in anamnesis. Endothelial function (EF) was assessed by ultrasound, AU — by turbidimetry, and glomerular filtration rate (GFR) — by MDRD formula. All participants were randomised into 4 groups, containing 35 persons each. The treatment phase lasted for 12 weeks.
Results. Most AH patients demonstrated ED symptoms, including paradox vasoconstriction. The most severe ED variants were observed in patients with diabetes mellitus. A significant reduction in blood pressure level was achieved in all groups, while АНТ benefits for EF were observed only in Groups A, В and C. Comparing to Group D, perindopril combination more effectively reduced AU. A small, but significant increase in GFR was achieved in patients receiving lisinopril and amlodipine. The combination of bisoprolol and amlodipine did not show any significant effects on ED and AU.
Conclusion. Twelve-week combined АНТ (perindopril + indapamide retard, amlodipine + indapamide retard, lisinopril + amlodipine) was associated with significantly improved EF. The most effective combinations included ACE inhibitors. The combination of bisoprolol and amlodipine was not effective in patients with reduced GFR and microalbuminuria, as it did not improve EF.
About the Authors
S. V. Malchikova
Kirov State Medical Academy
Russian Federation
Russian Federation
E. I. Tarlovskaya
Kirov State Medical Academy
Russian Federation
Russian Federation
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Review
For citations:
Malchikova S.V., Tarlovskaya E.I. Pleiotropic effects of antihypertensive therapy variants. Cardiovascular Therapy and Prevention. 2009;8(2):33-38. (In Russ.)
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