Кардиоваскулярная терапия и профилактика (Aug 2013)
COMPARISON OF THE EFFECTS OF FOUR ANTIHYPERTENSIVE THERAPY VARIANTS ON ARTERIAL WALL ELASTICITY IN ELDERLY PATIENTS WITH NONVALVULAR ATRIAL FIBRILLATION
Abstract
Aim. To compare the effects of various antihypertensive therapy (AHT) variants on the ultrasound-assessed elasticity of common carotid arteries (CCA) and thoracic aorta in elderly patients with nonvalvular atrial fibrillation (AF).Material and methods. In total, 364 patients (208 men and 156 women) with nonvalvular AF, aged 65–80 years, were randomised into four groups. Group I (n=91) received perindopril (5–10 mg/d); Group II (n=92) and Group III (n=90) were administered valsartan only (80–160 mg/d) or valsartan (80–160 mg/d) plus rosuvastatin (10 mg/d), respectively; and Group IV (n=91) received lercanidipine (10–20 mg/d). Vascular ultrasound methods were used to assess the thoracic aorta and CCA elasticity and ankle-brachial index.Results. The two-year therapy with perindopril, valsartan, valsartan plus rosuvastatin, and lercanidipine was associated with the increased CCA distensibility index, reduced aortic wall stiffness, and decreased pulse wave velocity, compared to the respective baseline levels. Out of four AHT variants, the combination of valsartan (80–160 mg/d) and rosuvastatin (10 mg/d) demonstrated the largest effect on the arterial wall elasticity and the greatest reduction in the risk of ischemic stroke, myocardial infarction, and death.Conclusion. While choosing AHT in elderly patients with nonvalvular AF, the combination of valsartan and rosuvastatin could be regarded as the optimal therapeutic regimen, which improves arterial wall elasticity and reduces the risk of cardiovascular complications.
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