SELECTION OF THE OPTIMAL ANTIHYPERTENSION TREATMENT IN PATIENTS WITH CHRONIC HEART FAILURE WITH THE SIGNS OF CHRONIC KIDNEY DISEASE

Abstract

Aim. To evaluate the effectiveness of fixed combination of perindopril arginine and amlodipine besilate (Prestans®, Les Laboratoires Servier) in optimal treatment scheme selection of arterial hypertension (AH) in patients with chronic heart failure (CHF) having the signs of chronic kidney disease (CKD).Material and methods. Totally, 118 patients studied, with essential AH, with CHF. In 53 (44,9%) of those, thre were signs of CKD. The latter presented with a decreased glomerular filtration rate (GFR) and increased cystatin C in the blood plasma (1,4+0,3 mg/L). As the treatment, they were prescribed the fixed combination of perindopril arginine and amlodipine besilate—5/5, 5/10, 10/10 mg. The assessment of treatment was done in 2 months follow-up.Results. During treatment there was significant decrease of office systolic and diastolic blood pressure (BP). Target BP was reached in 82,6% cases. The mean daily values of systolic and diastolic BP load became lower. During the treatment, there was improvement of clinical condition by functional class of CHF. The score by CAS decreased from 6,2+1,1 to 4,2+1,3 (р<0,01) and exercise tolerance increased: six-minute walking test distance from 160,4+14,5 to 307,14+13,1 m (р<0,01). Also, the level of cystatin C decreased in plasma, and GFR increased, witnessing the improvement of functional capacity of kidneys as a result of treatment.Conclusion. The fixed combination of perindopril arginine and amlodipine besilate can be successfully applied into treatment of AH and CHF patients with the signs of CKD.

Keywords

• хроническая сердечная недостаточность
• хроническая болезнь почек
• артериальная гипертензия