Рациональная фармакотерапия в кардиологии (Jan 2019)
The Impact of Valsartan/Amlodipine Single-Pill Combination on Blood Pressure and Vascular Stiffness in Patients with Grade 1-2 Essential Arterial Hypertension
Abstract
Aim. To investigate the impact of valsartan/amlodipine single-pill combination (V/A SPC) on arterial stiffness parameters and 24-hours blood pressure (BP) level in the middle-aged patients with stage II grade 1-2 essential arterial hypertension (HT). Material and methods. A group of patients with stage II grade 1-2 HT who had not previously received regular antihypertensive therapy (n=38, age 49.7±7.0 years) was retrospectively formed. All the patients were treated with V/A SPC and all of them achieved target office BP (<140/90 mm Hg). 12 weeks after reaching the target BP the assessment of V/A SPC therapy effectiveness and vascular stiffness (general clinical data, ambulatory BP monitoring, volume sphygmography, echocardiography) were performed in all included HT patients. Sex- and age-matched healthy people with normal BP (n=86, age 48.8±5.8years) and in whom similar clinical and vascular stiffness data were available represented a control group. Results. According to the ambulatory BP monitoring data systolic, diastolic and pulse BP significantly (p<0.001) decreased after the treatment with V/A SPC. Volume sphygmography has showed significant decrease in right-CAVI value from 8.9±1.3 to 7.3±1.4 (p=0.021) as well as a reduction the number of patients with a right- and/or left-CAVI>9.0 from 31.6 to 10.5% (p=0,049). According to an assessment of arterial stiffness the augmentation index decreased significantly by 23.6±8.6% from -23.0±17.1 to -28.9±18.7 (p=0.034. Transthoracic echocardiography data has demonstrated decrease in effective arterial elastance from 1.73±0.35 to 1.60±0.32 mm Hg (p=0.016) and increase in the arterial compliance – from 1.30±0.38 to 1.43±0.34 mm Hg/ml (p=0.049). Conclusions. In naive patients 40-65 years old with stage II grade 1-2 HT antihypertensive therapy with V/A SPC provides effective 24 hours BP control and improves arterial stiffness parameters.
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