STUDY OF PATIENTS ADHERENCE TO TREATMENT IN METABOLIC SYNDROME, WITH THE NOVEL COMBINATION ANTIHYPERTENSION COMPOUND OF RAMIPRIL AND AMLODIPINE BY THE DATA OF OBSERVATIONAL STUDY GRANAT-1

Aim.  To  study  some   aspects  of  antihypertension   therapy  (AHT) adherence in patients  with arterial hypertension  (AH) and  metabolic syndrome  (MS) by an  example  of fixed combination  of ramipril and amlodipine,  under  the  framework  of GRANAT-1  trial (Observational Program   for  Patients   with  Arterial  Hypertension   and   Metabolic Syndrome).

Material  and  methods. Totally,  101  patient  included,  having  had confirmed AH and MS. All participants completed the study. All patients consented to participate, had been recommended the combination drug AHT — fixed  combination of ramipril and amlodipine (Egipres) in various dosages selected  by clinician in routine assessment. Every patient was invited to clinic for 4 visits during 5 months with interval 1-2-2 months (visits 1-4).  For  assessment of  the  general  adherence  to  clinician recommendations (CR) during the first and final visits, all patients filled the Moriskos-Green test (MG) including 4 questions. In all visits, patients were assessed BP level, heart  rate,  and  during visits 2-4  there  was adverse events evaluation (AE). Also, the real adherence was evaluated by  the  intake  of Egipres,  and  activeness   of clinicians towards  the achievement of target BP levels in participants.

Results. The recommended AHT started taking 95 patients, by the end Egipres was being taken by 92 participants, 9 of them took other AHT. 90 patients achieved target BP (81 taking Egipres). Effect of the prescribed at visit 1 AHT in most patients appeared by 1 month (visit 2): in every third patient the target BP was reached,  and mean systolic BP decreased by 17,2 mmHg and diastolic BP by 7,7 mmHg (visit 2), and 31,0 mmHg and 16,1  mmHg,  resp.  — by visit 4.  Totally, 3  AE  registered,   probably amlodipine-related.  A significant improvement of total adherence was found: if at the beginning of study, by MG test only 22 (21,8%) adhered, by the end — 70 (69%) of patients.  In three  cases  there  was lack of clinician activity to help achieve target BP.

Conclusion. Single-time usage  of the fixed combination of amlodipine and ramipril, its high efficacy and safety with regular visiting of physician help to increase general adherence of patients to treatment.

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