Effective polypill therapy in patients with hypertension and dyslipidemia

Abstract

Aim. To identify factors associated with achieving the target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels with polypill therapy (indapamide, perindopril, rosuvastatin) in patients with hypertension (HTN) and dyslipidemia after a coronavirus disease 2019.

Material and methods. The study included 62 patients who were divided into following groups: 1^st (n=42) — BP and LDL-C target levels were achieved after 24 weeks; 2^nd (n=20) — target levels were not achieved. Lipid profile, structural and functional characteristics of arteries were determined.

Results. Polypill therapy was characterized by achieving BP and LDL-C target levels in 38,7%, while the addition of amlodipine and ezetimibe increased the effectiveness to 67,7%. In group 1, the carotid intima-media thickness decreased by 11,8%, and in group 2 — by 7% (p<0,05). Only in the 1^st group, the proportion of individuals with normal intima-media values increased, the b stiffness index decreased (-15,2%; p<0,01), and the pulse wave velocity decreased according to applanation tonometry. The following predictors of achieving BP and LDL-C target levels with combination therapy, including polypill, were identified: age, history of hypertension, systolic blood pressure, pulse wave velocity, cardio-ankle vascular index.

Conclusion. Simultaneous achievement of BP and LDL-C target levels with polypill therapy in patients with HTN and dyslipidemia after coronavirus infection was accompanied by a pronounced vasoprotective effect. A multifactorial model was created to predict a decrease in BP and LDL-C to target levels, including age, history of HTN, systolic BP.