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

Abstract

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.

Keywords

• arterial hypertension
• metabolic syndrome
• antihypertension therapy
• rational fixed combination
• treatment adherence