COMBINED ANTIHYPERTENSIVE THERAPY: FOCUS ON A FIXED-DOSE COMBINATION OF AN ACE INHIBITOR AND A DIURETIC

Abstract

The study aimed to assess the effectiveness and safety of a fixed-dose combination of an ACE inhibitor (losartan) and a diuretic (hydrochlorothiazide) in patients with arterial hypertension (AH) and high or very high cardiovascular risk. The study included 30 patients with Stage I-III AH (13 men and 17 women; mean age 51,9±1,9 years). For 12 weeks, the participants were administered a combination of losartan (50 mg) and hydrochlorothiazide (12,5 mg; once a day, in the morning). Echocardiography and 24-hour blood pressure monitoring (BPM) were performed. In 2 and 4 weeks, a reduction in office systolic BP (SBP) and office diastolic BP (DBP), respectively, was observed. In 12 weeks, BP reduction was even more pronounced, with a reduction in 24-hour SBP (from 141,9±1,9 to 128,6±0,8 mm Hg; p<0,001), daytime SBP (from 146,8±2,6 to 135,8±1,0 mm Hg; p><0,01), and nighttime SBP (from 131,5±1,9 to 118,8±1,9 mm Hg; p><0,001). A reduction was also observed for 24-hour DBP (from 91,7±1,8 to 78,7±1,6 mm Hg; p><0,05), daytime DBP (from 94,3±1,3 to 85,0±1,2 mm Hg; p><0,05), and nighttime DBP (from 83,5±2,0 to 71,2±1,7 mm Hg; p><0,01). Circadian BP variability, time BP index, and morning BP surge were also decreased (from 37,6±2,0 to 23,9±1,9 mm Hg; p><0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p><0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,001), daytime SBP (from 146,8±2,6 to 135,8±1,0 mm Hg; p<0,01), and nighttime SBP (from 131,5±1,9 to 118,8±1,9 mm Hg; p><0,001). A reduction was also observed for 24-hour DBP (from 91,7±1,8 to 78,7±1,6 mm Hg; p><0,05), daytime DBP (from 94,3±1,3 to 85,0±1,2 mm Hg; p><0,05), and nighttime DBP (from 83,5±2,0 to 71,2±1,7 mm Hg; p><0,01). Circadian BP variability, time BP index, and morning BP surge were also decreased (from 37,6±2,0 to 23,9±1,9 mm Hg; p><0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p><0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,01), and nighttime SBP (from 131,5±1,9 to 118,8±1,9 mm Hg; p<0,001). A reduction was also observed for 24-hour DBP (from 91,7±1,8 to 78,7±1,6 mm Hg; p><0,05), daytime DBP (from 94,3±1,3 to 85,0±1,2 mm Hg; p><0,05), and nighttime DBP (from 83,5±2,0 to 71,2±1,7 mm Hg; p><0,01). Circadian BP variability, time BP index, and morning BP surge were also decreased (from 37,6±2,0 to 23,9±1,9 mm Hg; p><0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p><0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,001). A reduction was also observed for 24-hour DBP (from 91,7±1,8 to 78,7±1,6 mm Hg; p<0,05), daytime DBP (from 94,3±1,3 to 85,0±1,2 mm Hg; p><0,05), and nighttime DBP (from 83,5±2,0 to 71,2±1,7 mm Hg; p><0,01). Circadian BP variability, time BP index, and morning BP surge were also decreased (from 37,6±2,0 to 23,9±1,9 mm Hg; p><0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p><0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,05), daytime DBP (from 94,3±1,3 to 85,0±1,2 mm Hg; p<0,05), and nighttime DBP (from 83,5±2,0 to 71,2±1,7 mm Hg; p><0,01). Circadian BP variability, time BP index, and morning BP surge were also decreased (from 37,6±2,0 to 23,9±1,9 mm Hg; p><0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p><0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,05), and nighttime DBP (from 83,5±2,0 to 71,2±1,7 mm Hg; p<0,01). Circadian BP variability, time BP index, and morning BP surge were also decreased (from 37,6±2,0 to 23,9±1,9 mm Hg; p><0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p><0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,01). Circadian BP variability, time BP index, and morning BP surge were also decreased (from 37,6±2,0 to 23,9±1,9 mm Hg; p<0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p><0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,001). After 12 weeks of the combined therapy with losartan and hydrochlorothiazide, circadian BP profile was normalized in most participants. There was a reduction in the percentage of the patients with myocardial hypertrophy (from 50% to 30%; p<0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p><0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,01) or left ventricular diastolic dysfunction (from 43,3% to 30%; p<0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.>< 0,05). Therefore, a fixed-dose combination of losartan and hydrochlorothiazide (50 mg + 12,5 mg) demonstrated good antihypertensive and cardioprotective effectiveness.

Keywords

• arterial hypertension
• myocardial hypertrophy
• losartan
• hydrochlorothiazide