The optimal combination of Lysinopril and Amlodipine for the treatment of patients with hypertension

Arterial hypertension (AH) remains one of the most common diseases in the world. Reducing cardiovascular risk of mortality from cardiovascular complications is a priority in the treatment of hypertension. Targets of hypertension therapy is to achieve SBP/DBP <140/80 mm Hg. article, regardless of cardiovascular risk and comorbidity. The choice of antihypertensive therapy depends on blood pressure levels, the presence or absence of concomitant diseases, lesion of target organs. Effective and long-lasting control of AH proved by the use of combinations of antihypertensive drugs, including antagonists and ACE inhibitors. The purpose of the study. Evaluation of clinical efficacy and safety of fixed combination antihypertensive therapy using lisinopril combined with amlodipine in patients with hypertension. Material and methods. The study included 30 respondents from essential hypertension II-III degree (ESH/ESC, 2018) aged 35 to 75 years. Patients were treated with the schema a (lisinopril 10 mg, amlodipine 5 mg) and scheme b (lisinopril 20 mg, amlodipine 10 mg) fixed combination therapy with the drug VivaCor® once in the morning. The period of observation was 3 months. At the time of inclusion and at the end of the study all respondents was performed echocardiography, daily monitoring of blood pressure, evaluation of laboratory and instrumental methods of research. Results and discussion. The combination of lisinopril with amlodipine has a fairly high antihypertensive activity, provides a significant cardioprotective effect and is an integral part of antihypertensive therapy in the long-term strategy of administering patients with high hypertensive / very high total cardiovascular risk. Conclusions: 1. The use of a fixed combination of lisinopril and amlodipine in patients with hypertension instead of free or other two-component combinations leads to its target level within 3 months of therapy. 2. Taking a fixed combination of lisinopril and amlodipine is effective and safe. 3. Therapy using the combined drug VivaCor® in patients with high / very high risk of hypertension prevents further pathological remodeling of the heart. 4. The combination of amlodipine and lisinopril is metabolically neutral and well tolerated by patients. Keywords: arterial hypertension, lisinopril, amlodipine, VivaCor.

Download Full-text

Arterial hypertension in ophthalmic surgical patients

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-1-186-191 ◽

2021 ◽

pp. 186-191

Author(s):

L.V. Pavlyushchenko ◽

◽

E.E. Filimonova ◽

M.A. Esina ◽

◽

...

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Clinical Symptoms ◽

Antihypertensive Drugs ◽

High Stress ◽

Cardiovascular Complications ◽

Surgical Patients ◽

Uncontrolled Hypertension ◽

Standard Dosage

Purpose. Analysis of the frequency and structure of arterial hypertension (AH) among ophthalmic surgical patients, assessment of the adequacy of prescribed antihypertensive therapy. Material and methods. Clinical material is presented by 157 patients with hypertension. Its structure was assessed. Its structure was assessed according to the stage, the degree of increase in the level of blood pressure (BP) and the category of cardiovascular risk. We analyzed the proportion of cases of uncontrolled hypertension, including those with a sudden pronounced individually significant increase in blood pressure without affecting target organs. Results. The prevalence of patients was stage III hypertension (62.4%), grade 3 hypertension (53.5%), with a very high and high risk of cardiovascular complications (73.2 and 20.4%, respectively). 93.6% of patients received antihypertensive therapy, but only 57.1% of them, mostly women (69.1%), regularly took medications and monitored their blood pressure. With a sudden pronounced individually significant increase in blood pressure, we used oral antihypertensive drugs – captopril and nifedipine, which made it possible to achieve a decrease in blood pressure and relief of clinical symptoms in all cases. Conclusion. 33.1% of patients had no hypertension control at the time of hospitalization. The proportion of patients with a sudden pronounced individually significant increase in blood pressure was 12.7%. Typical reasons for loss of control over hypertension were interruptions in taking antihypertensive drugs and high stress levels before surgery. The use of standard dosage captopril and nifedipine was effective in all cases. Key words: arterial hypertension, sudden pronounced individually significant increase in blood pressure, antihypertensive therapy.

Download Full-text

Perspektivy klinicheskogo primeneniyanovoy fiksirovannoy kombinatsii -preparata Ko-Eksforzh v lecheniiarterial'noy gipertonii

Cardiosomatics ◽

10.26442/cs44978 ◽

2011 ◽

Vol 2 (1) ◽

pp. 64-71

Author(s):

Marina Gennad'evna Bubnova

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Fixed Combination ◽

Antihypertensive Drugs ◽

Treatment Compliance ◽

Efficacy And Safety ◽

High Efficacy

Summary. This review is concerned with improving of blood pressure (BP) control in patients with arterial hypertension (AH). The reasons for the low treatment compliance and combined antihypertensive therapy benefits are analyzed. Data for futility of an extended use of antihypertensive drugs (AHD) fixed combinations are given. Studies demonstrating high efficacy and safety of a new triple fixed combination of amlodipine, valsartan and hydrochlorothiazide (HCT) are presented as well. Patients with hypertension, which should more actively use this combination of drugs, are signified.

Download Full-text

Doctors’ Adherence to the Guidelines on the Diagnostics and Treatment of Arterial Hypertension

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-4-502-509 ◽

2019 ◽

Vol 15 (4) ◽

pp. 502-509

Author(s):

N. B. Perepech ◽

V. D. Shurygina ◽

A. V. Tregubov

Keyword(s):

Blood Pressure ◽

Risk Stratification ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Clinical Guidelines ◽

Antihypertensive Drugs ◽

Blood Pressure Level ◽

Cardiovascular Complications ◽

Target Blood Pressure ◽

Fixed Dose

Aim. Examination of knowledge of the basic provisions of clinical guidelines for the management of patients with arterial hypertension and finding out the readiness of doctors for the practical application of updated recommendationsMaterial and methods. Anonymous questionnaires of 306 doctors served as material for the study. The questionnaire consisted of two parts. The introductory part included questions that allow to find out the specialty, work experience, gender, age, and whether the respondent has cardiovascular risk factors. The main part of the questionnaire included 16 questions regarding provisions of the guidelines on the diagnosis and treatment of arterial hypertension in force at the time of the survey (2017/2018 academic year). Statistical processing of the results was carried out using the Microsoft Excel 2010 software package. Differences were regarded as significant at p<0.05.Results. The findings suggest that both therapists and cardiologists do not give due importance to the risk stratification of cardiovascular complications in patients with arterial hypertension and are not sufficiently aware of the possibilities and limitations of the use of combinations of antihypertensive drugs. Therapists worse than cardiologists know the main points of the clinical guidelines for the management of patients with arterial hypertension (target blood pressure levels during treatment [64.6% vs 87.7%, p<0.001], indications for combination antihypertensive therapy starting, the possibility of fixed dose combinations using [52.3% vs 83.9%, p<0.001]). A significant part of physicians (both cardiologists and therapists) adequately assess the antihypertensive treatment effectiveness, not enough frequent achievement of the target blood pressure level in their patients and is willing to provide more strict control of blood pressure.Conclusion. The results of the survey indicate the need of the active education of doctors in the management of patients with arterial hypertension. The most attention should be paid to the training of therapists and general practitioners on the cardiovascular complications risk stratification, the using of the antihypertensive drugs combinations use and methods to increase patient adherence to antihypertensive therapy.

Download Full-text

The comparative effects of different fixed combinations of antihypertensive drugs in patients with arterial hypertension and hypothyroidism

Ukrainian Journal of Cardiology ◽

10.31928/1608-635x-2020.4.3544 ◽

2020 ◽

Vol 27 (4) ◽

pp. 35-44

Author(s):

V. I. Tseluyko ◽

D. A. Korchagina

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Fixed Combination ◽

Antihypertensive Drugs ◽

Blood Pressure Monitoring ◽

Myocardial Mass ◽

Pressure Monitoring ◽

Heart Remodeling ◽

Group 2

The aim – to assess the effects of different fixed double combinations of antihypertensive drugs and analyze their impact on heart remodeling in patients with arterial hypertension and hypothyroidism. Materials and methods. The study included 50 patients with hypertension and hypertension, which were divided into 2 groups by the method of blind envelopes of 25 people each. Patients in group 1 were assigned a fixed combination of perindopril with indapamide, patients in group 2 were assigned a fixed combination of perindopril with amlodipine. The groups were statistically compared by age, duration of hormonal substitution therapy, duration of hypertension, level of office SBP, DBP at inclusion in the study. In terms of body mass index, the study groups were comparable, but the number of obese patients was higher in group 2 (p=0.05). Observation of patients lasted 12 months.Results and discussion. The studied fixed combinations of antihypertensive drugs, namely perindopril with indapamide and perindopril with amlodipine provide a reduction in blood pressure in patients with hypertension with concomitant hypothyroidism according to the results of ambulatory blood pressure monitoring. Control of blood pressure in patients with arterial hypertension and concomitant hypothyroidism during a year of antihypertensive therapy provides a reduction in the severity of heart remodeling, the nature and extent of which depends on both the presence of obesity and the choice of a fixed combination of antihypertensive drugs.Conclusions. The results showed that in patients with AН and hypothyroidism achievement of euthyroid state contributes to BP reduction, but requires further administration of antihypertensive therapy. We studied fixed combinations of antihypertensive drugs, namely perindopril with indapamide and perindopril with amlodipine in patients with AG and associated hypothyroidism provide reliable blood pressure reduction according to the results of outpatient blood pressure monitoring (р<0.05). The fixed combination of perindopril with amlodipine compared with the fixed combination of perindopril with indapamide provides a significantly more significant effect on the regression of left ventricular myocardial hypertrophy, namely, a decrease in myocardial mass index by a degree of 2.7 in patients with obesity (р<0,01) myocardial mass index by body surface area in patients without obesity (p=0.06).

Download Full-text

Multi-aspect approach to the optimization of pharmacotherapy of patients with arterial hypertension of high and very high risk

Research Results in Pharmacology ◽

10.3897/rrpharmacology.4.31952 ◽

2018 ◽

Vol 4 (4) ◽

pp. 53-64

Author(s):

Svetlana Gridina

Keyword(s):

High Risk ◽

Arterial Hypertension ◽

Fixed Combination ◽

Antihypertensive Drugs ◽

Treatment Options ◽

Hypotensive Effect ◽

Cardiovascular Complications ◽

Left Ventricular ◽

Hypotensive Action ◽

Very High

Introduction: Personalization of pharmacotherapy of cardiovascular diseases is one of the urgent problems of cardiology. Material and methods: The study includes 120 patients with grades 2-3 arterial hypertension with the criteria of high and very high risk of developing cardiovascular complications. The patients were randomized into three groups with differentstarting regimens of pharmacotherapy – fixed and free combinations of ACE inhibitors and dihydropyridine CCB. Evaluation of the efficacy, safety and individualization of a therapy was carried out by using pharmacokinetic, pharmacoeconomic, sonographic, and laboratory methods. Results and discussion: Antihypertensive treatment with the inclusion of Amlodipine and Lisinopril or Ramipril in patients with arterial hypertension, having a slow and very slow oxidative metabolism phenotype, is characterized by the development of a more pronounced hypotensive effect in this group of patients (p<0.05-0.001) (Δ% SBP from 12.7 to 24.6 and from 19.6 to 27.9, respectively; Δ% DBP from 10.6 to 19.1 and from 15.9 to 23.6, respectively) in comparison to the group of patients with a fast phenotype (Δ% SBP from 6.42 to 9.34; Δ% DBP from 1.04 to 5.66), which allows administering a personalized pharmacotherapy. For patients with arterial hypertension of high and very high risk, the use of a fixed combination of Amlodipine and Lisinopril as a basic variant of the two-four-component therapy compared with treatment options based on free combinations of the studied drugs provided a significantly more pronounced decrease in systolic blood pressure (24.9%, 17.8 %, 19.0%, respectively, p<0.01), a greater degree of regression of left ventricular myocardial hypertrophy (8.70%, 5.67%, 5.84%, respectively, p<0.05), significant (p<0.05-0.001) improvement in a number of parameters of the patients’ quality of life, and was characterized by the greatest economic efficiency according to various criteria of hypotensive action. Conclusion: The results obtained in the study demonstrate the advantages of a fixed combination over free combinations of antihypertensive drugs and demonstrate the possibility of a pharmacokinetic approach to individualization of pharmacotherapy.

Download Full-text

Antihypertensive Efficacy of Fixed Combination of Amlodipine and Ramipril in Patients with Arterial Hypertension and Very High Cardiovascular Risk

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2018-14-6-840-845 ◽

2019 ◽

Vol 14 (6) ◽

pp. 840-845

Author(s):

O. Yu. Korennova ◽

S. P. Podolnaya ◽

E. P. Prihodko ◽

E. A. Turusheva ◽

S. N. Starinskaya ◽

...

Keyword(s):

Cardiovascular Risk ◽

Coronary Artery ◽

Fixed Combination ◽

Antihypertensive Drugs ◽

Antihypertensive Efficacy ◽

High Cardiovascular Risk ◽

Hypertensive Patients ◽

Coronary Artery Stenting ◽

History Of ◽

Very High

Aim. To evaluate the antihypertensive efficacy and tolerability of a fixed combination of amlodipine and ramipril in hypertensive patients with very high cardiovascular risk. Material and methods. A retrospective cohort study of real clinical practice of prescribing antihypertensive drugs according to 255 medical records of outpatient hypertensive patients with a history of acute coronary syndrome (ACS) and coronary artery stenting was performed in the first part. An open observational study was performed in the second part. 69 people older than 18 years with a history of ACS and coronary artery stenting, without reaching the target blood pressure (BP) level while using free combinations of antihypertensive drugs and with indications for a fixed combination of ramipril and amlodipine were included into the study. Analysis of self-monitoring of BP, office BP, daily BP monitoring (ABPM) and patients’ adherence to treatment (Morisky-Green test) initially, after 4 and after 12 weeks of taking the fixed combination of ramipril and amlodipine was performed to assess the clinical efficacy of the studied drug. Results. It was found that 42.0% of patients did not follow the recommendations for regular intake of antihypertensive drugs. So, hypertension of all patients regarded as false-refractory, which was the basis for the prescription of the fixed combination of ramipril and amlodipine in accordance with clinical guidelines for the diagnosis and treatment of hypertension. After 4 weeks of therapy, there was significant decrease in office BP with the achievement and preservation of the target level by the 12th week, normalization to the 12th week of day and night BP variability in 54.9% of patients. 78.0% of patients followed medical recommendations for regular administration of antihypertensive drugs, none of the patients had adverse events. Conclusion. The use of fixed combinations of drugs, in particular, amlodipine and ramipril as a part of multicomponent therapy in hypertensive patients with very high cardiovascular risk, led to the achievement of target BP by the 4th week of therapy and stable preservation of antihypertensive effect in 12 weeks of treatment as well as gradual normalization of day and night BP variability in more than half of patients. Fixed combination of ramipril and amlodipine allowed to improve adherence of patients to cardiovascular diseases.

Download Full-text

The effectiveness of combination antihypertensive therapy in patients with arterial hypertension and additional risk factors: obesity and obstructive sleep apnea syndrome

Terapevticheskii arkhiv ◽

10.26442/00403660.2018.12.000005 ◽

2018 ◽

Vol 90 (12) ◽

pp. 28-33 ◽

Cited By ~ 1

Author(s):

E M Elfimova ◽

A Yu Litvin ◽

I E Chazova

Keyword(s):

Blood Pressure ◽

Sleep Apnea ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Fixed Combination ◽

Blood Pressure Monitoring ◽

Target Blood Pressure ◽

Effective Control ◽

Pressure Monitoring ◽

Male Patients

Aim. To study the effectiveness of a fixed combination of perindopril and amlodipine, with the subsequent addition of indapamide-retard in male patients with arterial hypertension (AH), obesity and severe sleep apnea (OSAS). Materials and methods. The study included 43 male patients in whom antihypertensive therapy titration was performed to achieve target blood pressure values with a fixed combination of calcium antagonist amlodipine (10 mg) and an angiotensin-converting inhibitor perindopril (5-10 mg) and indapamide-retard. At baseline and after 4-6 weeks, the effectiveness of antihypertensive therapy was monitored according to clinical measurements and ambulatory blood pressure monitoring (ABPM). An assessment of the carotid-femoral pulse wave velocity (cfPWV), aortic PWV (aoPWV), and ankle-brachial PWV (abPWV) was performed. Results and discussion. Target blood pressure values (according to clinical blood pressure, 24-hour blood pressure monitoring) during therapy with amlodipine 10 mg and perindopril 10 mg reached 65% of patients and another 30% reached target blood pressure when adding indapamide-retard 1.5 mg, that is - 95% of all patients included in the study. Upon reaching the target blood pressure values, a significant decrease in cfPWV, aoPWV and abPWV was observed. Conclusion. The fixed combination of perindopril arginine and amplodipine, with the addition of indapamide retard in male patients with hypertension 1st degree in the presence of obesity and severe OSAS allows to reach effective control of blood pressure and improve the elastic properties of large arteries, which can lead to a favorable organoprotective effect in this category of patients.

Download Full-text

Clinical haracteristik and psychological profile of patients with arterial hypertension with high cardiovascular risk against the background of antihypertensive therapy with inhibitors of angiotensin converting enzyme (ACE)

Cardiosomatics ◽

10.26442/cs45047 ◽

2013 ◽

Vol 4 (4) ◽

pp. 36-39

Author(s):

D. S Kaskayeva ◽

M. M Petrova ◽

V. V Kostina ◽

A. A Evsyukov ◽

E. A Tepper

Keyword(s):

Cardiovascular Risk ◽

Angiotensin Converting Enzyme ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Cardiovascular Complications ◽

Psychological Profile ◽

Converting Enzyme ◽

High Cardiovascular Risk ◽

Dynamic Observation ◽

Comparative Aspect

The article in comparative aspect presents results of rating of psychological profile of 142 patients (all are men, average age 46,5±0,35 years) with arterial hypertension of stage I–III with high risk of cardiovascular complications having been studied after 6 months of dynamic observation against the background of conducted antihypertensive therapy with inhibitors of angiotensin converting enzyme (ACE).

Download Full-text

Assessing the impact of antihypertensive therapy on ambulatory blood pressure monitoring in patients with isolated systolic hypertension

Cardiosomatics ◽

10.26442/cs45038 ◽

2014 ◽

Vol 5 (1) ◽

pp. 5-9

Author(s):

V. A Aydarova ◽

Z. T Astahova ◽

F. U Kanukova ◽

M. M Besaeva

Keyword(s):

Blood Pressure ◽

Antihypertensive Therapy ◽

Systolic Hypertension ◽

Fixed Combination ◽

Antihypertensive Drugs ◽

Blood Pressure Monitoring ◽

Isolated Systolic Hypertension ◽

Pressure Monitoring ◽

Group 2 ◽

The Impact

The study examined the effectiveness of drug correction of high numbers of blood pressure (BP) by means of modern groups of antihypertensive drugs, the effect of a fixed combination of perindopril and indapamide on circadian blood pressure monitoring, and a commitment to patients of antihypertensive therapy, based on the opened simple randomization three groupswere formed: 1st comprised of 21 patients with isolated systolic hypertension (ISAH) and 22 patients with systolic-diastolic hypertension (SDAH) - they all received monotherapy with calcium antagonists (amlodipine 10 mg/day); Group 2 - of 16 ISAH patients and 24 SDAH patients - who received monotherapy with perindopril (2 mg/day) and the third group - of 17 patients with ISAH and 14 patients with SDAH - who received combination therapy with the drug noliprel (Servier) with a fixed combination of perindopril (2 mg) and indapamide of 0,625 mg. Treatment efficacy was assessed primarily to reduce the absolute numbers of blood pressure, and taken into account as a reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP), uncontrolled drop of which, according to the literature, in elderly patients can have fatal consequences

Download Full-text

CARDIO-ANKLE VASCULAR INDEX (CAVI) AND ARTERIAL STIFFNESS ASSESSMENT AT MEDICAL PREVENTION DEPARTMENTS AND UNITS

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2014-1-40-43 ◽

2014 ◽

Vol 13 (1) ◽

pp. 40-43

Author(s):

R. M. Linchak ◽

R. M. Komkov ◽

O. G. Prishchepa ◽

O. B. Shvabskaya

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Arterial Hypertension ◽

Prognostic Models ◽

Medical Prevention ◽

Clinical Potential ◽

Preventive Examination ◽

Very High ◽

Score Index

Aim. To study the clinical potential and feasibility of the assessment of cardio-ankle vascular index (CAVI) at medical prevention departments and units.Material and methods. The study included 66 patients (13 men and 53 women; mean age 52,26±11,2 years) with very low to very high total cardiovascular risk (CVR) levels and SCORE index 0–25% (mean SCORE index 3,18±4,34%), who underwent volume sphygmography and automatic CAVI measurement.Results. There was a moderately strong, statistically significant correlation between CAVI and age; CAVI and systolic blood pressure (SBP); and CAVI and SCORE. While higher CAVI values were observed among non-smokers and patients with arterial hypertension, these differences were not statistically significant.Conclusion. As a method for arterial stiffness assessment, CAVI measurement is easy to perform, does not require any special preparation, and can be used at medical prevention departments and units as a part of a more detailed preventive examination. A moderately strong, statistically significant correlation was observed between CAVI and SCORE, as well as between CAVI and such SCORE components as age and SBP. However, further research is needed in order to clarify the possibility of CAVI inclusion in prognostic models.

Download Full-text