Clinical Efficacy of Combined Use of Azilsartan with Indapamide and Azilsartan with Nitrendipine in Patients with Arterial Hypertension

Abstract

The aim of our study was a comparative evaluation of the effectiveness of the combined use of azilsartan with indapamide, and azilsartan with nitrendipine in achieving antihypertensive and organ-protective effects in patients with arterial hypertension (AH). Methods and Results: The study included 101 patients aged 30-75 years (mean age of 53,1±11,2 years) with AH Grades 1-2 (ESC/ESH, 2018), who were on outpatient treatment at the Republican Specialized Scientific and Practical Medical Center for Cardiology. After the screening stage, all patients were discontinued from previous therapy and assigned to the 2 regimes of dual therapy. Group 1 included 50 AH patients treated with azilsartan (Az) and indapamide (Ind); Group 2 included 51 patients treated with Az and nitrendipine (Nit). The average daily dose of Az was 49.3±6.0 mg, Nit - 10.88±4.3 mg, and Ind - 1.69±0.5 mg. The effectiveness of the prescribed therapy was evaluated after 6 months of treatment. The 6-month dual therapy with Az+Ind and Az+Net is characterized by high antihypertensive efficacy with a significant positive effect on the parameters of diurnal blood pressure (BP) profile in AH patients. Achieving the target level of BP in both groups provided high organ-protective efficacy, expressed in a significant regression of LV hypertrophy and LV dimensions, a decrease in the carotid intima-media thickness (CMIT) and arterial rigidity. However, the best cardio- and vaso-protective efficacy was noted in Group 1, which was expressed in a more pronounced improvement in the left ventricular diastolic function, a decrease in the CIMT on both sides, and a significant improvement in the parameters of central hemodynamics and arterial stiffness. Dual therapy with Az+Ind and Az+Nit in AH patients was accompanied by a positive effect on the metabolic profile and excellent nephroprotection, with an advantage in the Az+Ind group. A significant decrease in the blood level of LDL-C, TC, and uric acid is characteristic in both groups of patients. A significant decrease in the levels of FBG and TG occurs only in the Az+Ind therapy.

Keywords

• arterial hypertension
• arterial stiffness
• left ventricular hypertrophy
• antihypertensive medication