scholarly journals Influence fixed combination therapy on arterial stiffness and erectile function in patients with arterial hypertension

2021 ◽  
Vol 28 (3) ◽  
pp. 20-29
Author(s):  
Yu. M. Sirenko ◽  
O. L. Rekovets ◽  
G. D. Radchenko ◽  
O. O. Torbas ◽  
S. M. Kushnir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Erectile Function ◽  
Fixed Combination ◽  
Dual Therapy ◽  
Office Blood Pressure ◽  
Combination Group ◽  
Triple Combination ◽  
Significant Difference

The aim – to evaluate the therapeutic efficacy and dynamics of arterial stiffness using сardio-ankle vascular index (CAVI), as well as the dynamics of erectile function in men of the generic fixed triple combination of valsartan/amlodipine/hydrochlorothiazide and a double fixed combination of valsartan/amlodipine in the treatment of patients with arterial hypertension II–III degree. Materials and methods. The study included patients with moderate and severe arterial hypertension without diabetes. Patients were divided into 2 groups by the method of envelopes of 25 each. The first group (n=25) was assigned a fixed triple combination of tablets valsartan/amlodipine/hydrochlorothiazide. The drug was administered 1 tablet (160 mg of valsartan/5 mg of amlodipine/12.5 mg of hydrochlorothiazide) once a day in the morning for 1 month. Patients in the second group (n=25) received a similar scheme of a double fixed combination of the drug valsartan/amlodipine. The drug was administered 1 tablet (160 mg of valsartan/5 mg of amlodipine) once a day in the morning for 1 month. If necessary, the target level of office blood pressure was less than 140/90 mm Hg, the dose was titrated to a daily dose of 320/10/12.5 mg (valsartan/amlodipine/hydrochlorothiazide) on a fixed triple combination and up to 320/10 mg (valsartan/amlodipine) on a fixed double combination. After 3 months of treatment there was control of therapy.Results and discussion. The study included 50 patients with moderate and severe hypertension. The average age of patients was 54.9±1.8 (25–75) years. The average BMI is 31.2±0.7 kg/m2. The average of the office of SBP and DBP at the beginning of the study were 161.7±1.8 mm Hg and 98.5±1.4 mm Hg in accordance. The office heart rate is 70.7±1.4 bpm. The decrease in the office blood pressure (SBP/DBP) was 35/19 mm Hg (р<0,05) on the double combination and 42/26 mm Hg (р<0,05) on the triple combination. Achieving target BP measurement in the office was 90.9 % – in the double combination and 95.7 % – in triple combination. In the dual combination group, withdrawal was observed in 3 (6 %) patients, in the triple combination group, withdrawal was observed in 4 (8 %) patients. There was a tendency to decrease the stiffness of the arterial wall in terms of cardio-vascular index CAVI, but there was no significant difference. CAVI right on dual therapy up to 8.68±0.57 units and after treatment 8.30±0.55 units. CAVI on the left on double therapy to 8.49±1.49 units and after treatment 8.17±1.49 units. CAVI right on triple therapy up to 8.86±0.39 units and after treatment 8.50±0.40 units from CAVI on the left in a triple combination up to 8.09±0.53 units and after treatment 8.27±0.36 units (p>0.05 for all values). No significant change in erectile function in men was detected during treatment.Conclusion. The dual (valsartan/amlodipine) and triple (valsartan/amlodipine/hydrochlorothiazide) fixed combination showed high antihypertensive efficacy, did not adversely affect metabolic disorders and erectile function in men, and inhibited the progression of stiffness.

scholarly journals The place of fixed antihypertensive drugs in modern therapy of arterial hypertension

2021 ◽  
Vol 17 (4) ◽  
pp. 44-48
Author(s):  
Tatiana V. Pinchuk ◽  
Natalia V. Orlova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Calcium Channel ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Dual Therapy ◽  
Evidence Base ◽  
Target Blood Pressure ◽  
High Dose ◽  
Channel Blockers

The article provides information on modern approaches to the treatment of arterial hypertension. The historical information about therapy with combined antihypertensive drugs is given. Based on data from multicenter clinical trials, the article provides evidence of the benefits of dual and triple fixed drug combinations. Combinations of 1-adrenoreceptor antagonist bisoprolol and the dihydropyridine-type calcium channel blocker amlodipine are considered. The article highlights the advantages of each of the drugs, as well as their combination. It shows the benefits of a fixed combination of low and medium doses compared to high-dose monotherapy, such as efficacy in achieving target blood pressure, preventing cardiovascular events, increasing adherence to treatment, safety and development of side effects. It provides the evidence base for the effectiveness of a triple fixed combination of renin-angiotensin-aldosterone system blockers with calcium channel blockers and diuretics in achieving target blood pressure compared to a double fixed combination of members of these drug classes, which is due to additive effects. The safety and tolerability profiles were found to be more effective with triple therapy compared with dual therapy, which is also supported by studies.

scholarly journals Efficacy of fixed dose of triple combination of perindopril-indapamide-amlodipine in obese patients with moderate-to-severe arterial hypertension: an open-label 6-month study

2019 ◽  
Vol 6 (11) ◽  
pp. 3501-3512
Author(s):  
Sergiy M. Koval ◽  
Iryna O. Snihurska ◽  
Tetyana G. Starchenko ◽  
Marina Yu. Penkova ◽  
Olga V. Mysnychenko ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Abdominal Obesity ◽  
Ambulatory Blood Pressure ◽  
Fixed Combination ◽  
Antihypertensive Agents ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Combination Group ◽  
Dose Combination

Background: Arterial hypertension (AH) remains the most common cardiovascular (CV) risk factor worldwide. Methods: Seventy five moderate-to-severe hypertensive patients with abdominal obesity aged from 48 to 66 years (45/30 men and women respectively) were selected from the entire cohort (n = 375) according to the inclusion and exclusion criteria. The patients were divided into two subgroups depending on the arm of antihypertensive therapy lines. The first subgroup of patients (n = 36) received a non-fixed combination of oral antihypertensive agents: perindopril (4–8 mg daily), indapamide (1.25–2.5 mg daily) and amlodopine (5–10 mg daily). The second subgroup of patients (n=39) received fixed-dosed combination of these antihypertensive agents aforementioned in the ranged doses (4 mg/1.25mg/5 mg; 4 mg/1.25mg/10 mg; 8 mg/2.5 mg/5 mg; 8 mg/2.5mg/10 mg) in the same manner. The examinations of the clinical status, office, and ambulatory blood pressure values were carried out at baseline in 3 and 6 months after study entry. Results: The frequencies of BP target levels after treatment were higher in the fixed-dose combination group than in the non-fixed combination (at 3 months: 80% versus 58%, p<0.05 and at 6 months: 85% versus 53%, p<0.05). The adherence to triple fixed-dose combination was also higher in comparison with one to non-fixed combination (at 3 months: 82% versus 64%, p<0.05 and at 6 months: 87% versus 61%, p<0.05). It has been established that low-dose of perindopril/indapamide/amlodopine (4mg/1.25/10mg and 8mg/2.5/5mg) were used frequently in fixed-dose combination cohort of patients than in non-fixed combination (15% versus 0%, P<0.05, and 33% versus 19%, p<0.05, respectively). At the same time, maximum doses of these agents (8mg/2.5mg/10mg) were required for achieving target BP levels in a significantly lower proportion of patients receiving fixed-dose combination as compared to patients receiving non-fixed combination (52% versus 81%, p<0.05). Additionally, the triple fixed-dose combination has proved to be better in restoring ambulatory blood pressure monitoring profile than non-fixed combination. Conclusion: Achievement of target blood pressure levels in patients with uncontrolled arterial hypertension and abdominal obesity was possible at lower doses of perindopril, indapamide, and amlodipine when used as a fixed-dose combination rather than non-fixed (free) combination.  

Abstract P124: Repeat Manual Office Blood Pressure By A Physician Is Lower Than Automated Office Blood Pressure

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Bryce Rhodehouse ◽  
Courtney Shaver ◽  
Jerry Fan ◽  
Bright Izekor ◽  
Clinton Jones ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vital Signs ◽  
Outpatient Setting ◽  
Office Blood Pressure ◽  
P Value ◽  
Signed Rank ◽  
Significant Difference ◽  
Minute Interval ◽  
The Difference ◽  
Automated Office Blood Pressure

Introduction: An accurate measurement of blood pressure (BP) is critical to diagnosing and treating hypertension (HTN). Manual office BP (MOBP) often results in higher readings than automated office BP (AOBP). In previous studies, a repeat MOBP by a physician resulted in a lower BP than the initial MOBP by nursing staff. We evaluated our hypothesis that a repeat MOBP by a physician is statistically equivalent to AOBP. Methods: In an ambulatory outpatient setting, patients were roomed and at least a 5-minute interval lapsed before an AOBP was performed using a Welch Allyn Connex Vital Signs Monitor. The physician was blinded to the AOBP. The physician then entered the room and obtained a MOBP with a manual aneroid sphygmomanometer. The difference between the AOBP and the MOBP was calculated. A Wilcoxon signed rank sum test was used to determine if a significant difference between AOBP and MOBP exists. Results: A total of 186 patients (112 females, 74 male) had BP measured with a mean age of 66 years. AOBP resulted in a median systolic BP (SBP) 136 mmHg (IQR 121-150 mmHg) and median diastolic BP (DBP) of 78 mmHg (IQR 72-85 mmHg). MOBP SBP had a median of 132 mmHg (IQR 120-142 mmHg) and DBP had a median of 76 mmHg (IQR 70-81 mmHg). SBP and DBP were significantly lower in the MOBP group with a mean difference between AOBP and MOBP of 4.0 and 2.7 mmHg respectively (p-value of <0.0001). Conclusions: Repeat MOBP performed by the physician resulted in a significantly lower BP compared to AOBP. The lower BP may be due to an overall longer interval between the AOBP measurement and MOBP measurement. MOBP may be a viable option for accurate diagnosis and treatment of HTN clinics without access to a AOBP machine.

scholarly journals Perbedaan Derajat Ansietas antara Penyandang Hipertensi Belum Terkontrol dengan yang Terkontrol

e-CliniC ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Cerelia E. C. Sugeng ◽  
Emma Sy. Moeis ◽  
Glady I. Rambert
Keyword(s):  
Blood Pressure ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Blood Pressure Monitoring ◽  
Office Blood Pressure ◽  
Generalized Anxiety ◽  
Pressure Monitoring ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
The Difference

Abstract: Hypertension and anxiety are among the group of the most common chronic disease worldwide, and according to numerous studies they are oftentimes associated each other. Patients suffered from chronic illnesses, such as hypertension, may have negative emotion that increases the risk of mental disorders, most commonly anxiety disorder. This study was aimed to assess the difference of anxiety degree between uncontrolled and controlled hypertensive patients. This was an observational analytical study with a cross-sectional design. Subjects were divided into two groups: controlled and uncontrolled hypertensive patients. Measurement of blood pressure parameter was performed by using office blood pressure monitoring. Anxiety parameter was classified based on the scoring of the Generalized Anxiety Disorder Scale (GAD-7). Data were analyzed by using the Mann-Whitney test. Subjects consisted of 60 hypertensive patients (35 males and 25 females), aged 30-70 years (mean 56.48 years). There were 35 controlled hypertension patients and 22 uncontrolled hypertensive patients. The results showed that the difference in anxiety degree based on GAD-7 between controlled hypertensive and uncontrolled hypertensive groups obtained a p-value of 0.000. In conclusion, there was a significant difference in anxiety degree between uncontrolled and controlled hypertensive patients. Screening for anxiety among hypertensive patients is a simple and cost-effective tool that may improve outcomes.Keywords: anxiety, uncontrolled hypertension, controlled hypertension Abstrak: Hipertensi dan ansietas merupakan kelompok penyakit kronik yang paling umum di seluruh dunia. Berdasarkan banyak penelitian kedua penyakit ini saling berhubungan satu sama lain. Penyandang hipertensi mungkin memiliki emosi negatif yang meningkatkan risiko terjadinya gangguan mental berupa ansietas. Ansietas dan dukungan sosial rendah akan menghambat proses penyembuhan terutama dalam mengontrol tekanan darah. Penelitian ini bertujuan untuk menge-tahui apakah terdapat perbedaan derajat ansietas antara penyandang hipertensi belum terkontrol dengan hipertensi terkontrol. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok penyandang hipertensi belum terkontrol dan hipertensi terkontrol. Pengukuran parameter tekanan darah dilakukan dengan menggunakan alat Oscillometric digital dengan cara Office Blood Pressure Monitoring (OBPM). Parameter ansietas diklasifikasikan berdasarkan skala Generalized Anxiety Disorder Scale (GAD-7). Adanya perbedaan derajat ansietas antara kedua kelompok dinilai dengan uji Mann-Whitney. Subyek penelitian terdiri dari 60 penyandang hipertensi (35 laki-laki dan 25 perempuan) berusia 30-70 tahun (rerata 56,48 tahun). Terdapat 25 penyandang hipertensi yang belum terkontrol dan 35 penyandang hipertensi terkontrol. Hasil penelitian menunjukkan bahwa terdapat perbedaan derajat ansietas berdasarkan GAD-7 antara kedua kelompok (p=0,000). Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam derajat ansietas antara penyandang hipertensi yang belum terkontrol dengan yang terkontrol. Skrining ansietas pada penyandang hipertensi merupakan modalitas penting dalam penatalaksanaan penyandang hipertensi.Kata kunci: ansietas, hipertensi belum terkontrol, hipertensi terkontrol

scholarly journals Tactics of antihypertensive therapy during COVID-19 pandemic

2021 ◽  
Vol 93 (9) ◽  
pp. 1125-1131
Author(s):  
Valery I. Podzolkov ◽  
Anna Е. Bragina ◽  
Yulia N. Rodionova ◽  
Galina I. Bragina ◽  
Ekaterina E. Bykova
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
Ace Inhibitor ◽  
Fixed Combination ◽  
Significant Risk ◽  
Effective Control ◽  
Combination Drug ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin

Results of foreign and Russian studies indicate a higher mortality rate of patients with concomitant cardiovascular diseases (CVD) due to the new coronavirus infection COVID-19. It has been proven that arterial hypertension, as one of the significant risk factors for the development of concomitant cardiovascular diseases, is associated with a more severe prognosis of COVID-19. This article presents the results of modern studies and large meta-analyzes of necessity and safety of the use of blockers of the renin-angiotensin-aldosterone system in patients with arterial hypertension and COVID-19. The data of studies show that an angiotensin-converting enzyme inhibitor (ACE inhibitor) and a thiazide-like diuretic is a pathogenetically rational combination. It realizes various ways of lowering blood pressure by reducing the activity of the renin-angiotensin-aldosterone system, which is achieved by using an ACE inhibitor, and natriuresis due to diuretics. As an example, a highly effective fixed combination of drugs is considered, characterized by good tolerance, which consists of an ACE inhibitor lisinopril and a thiazide-like diuretic indapamide of prolonged action. The authors expressed the opinion that the appointment of the fixed combination drug Diroton Plus (Gedeon Richter) will contribute to effective control of blood pressure and organoprotection in conditions of increased thrombogenic and prooxidative potential, characteristic of COVID-19 both in the acute stage and within the post-COVID Syndrome.

scholarly journals Single Pill Indapamide and Perindopril Arginine Combination: Optimal Coupling of Vascular Protection and Hemodynamic Risk Factors Reduction in Patients with Essential Arterial Hypertension

Kardiologiia ◽  
2019 ◽  
Vol 59 (3) ◽  
pp. 18-26 ◽  
Author(s):  
E. V. Borisova ◽  
A. I. Kochetkov ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Arterial Compliance ◽  
Stage Ii ◽  
Stiffness Index ◽  
Single Pill ◽  
Essential Arterial Hypertension ◽  
The Impact

Objective: to investigate the impact of indapamide / perindopril single-pill combination (I / P SPC) on arterial stiffness parameters, blood pressure (BP) level and BP variability (BPV) in middle-aged patients with stage II grade 1–2 essential arterial hypertension (EAH). Materials and methods. We retrospectively formed a group of patients with stage II grade 1–2 EAH who had not previously received regular antihypertensive therapy (AHT) (n=52, mean age 52.9±6.0 years). All patients were treated with I / P SPC and all of them achieved target office BP level (less than 140 / 90 mm Hg). After 12 weeks of follow-up (from the time of reaching the target BP) assessment of AHT effectiveness (general clinical data, ambulatory blood pressure monitoring [ABPM], volume sphygmography, echocardiography), and vascular stiffness evaluation were performed.Results. At the end of follow-up office systolic BP (SBP), diastolic BP (DBP), pulse BP, day-time, night-time and 24‑hour SBP and DBP significantly (p<0.001 for all) decreased. According to the ABPM data day-time, nighttime, and 24‑hour systolic BPV significantly decreased (p=0.029, p=0.006 and p<0.001, respectively); day-time and 24‑hour diastolic BPV also significantly decreased (p=0.001 and p<0.001, respectively). Day-night standard deviation (SDdn) significantly decreased too (p=0.002 and p<0.001, respectively). Volumetric sphygmography showed significant decrease of right cardio-ankle vascular index (CAVI) (from 8.20±1.29 to 7.58±1.44, p=0.001) and of left CAVI (from 8.13±1.40 to 7.46±1.43, p<0.001), as well as reduction of the number o f patients with a right- and / or left-CAVI >9.0 (from 32.7 to 11.5 %, p=0.018). According to assessment of arterial stiffness using the Vasotens24 software package, the arterial stiffness index (ASI) significantly (p<0.001) decreased from 153.5±29.9 to 138.3±20.0 (by –9.2±13.1 %). Transthoracic echocardiography data demonstrated significant decrease (p<0.001) in effective arterial elastance (from 1.82±0.43 to 1.58±0.36 mm Hg; by –11.85±16.29 %) and significant (p<0.001) increase in the arterial compliance – from 1.27±0.34 to 1.54±0.38 mm Hg / ml (+26.95±38.06 %).Conclusion. In AHT naive patients 40–65 years old with stage II grade 1–2 EAH therapy with I / P SPC provided effective 24‑hour BP control, reduced BPV and improved arterial stiffness parameters. 

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