G.D. Radchenko, L.O. Mushtenko, Yu.M. SirenkoRegression of the target organ damage under fixed dose combination perindopril/amlodipin in hypertensive patients with and without ischemic heart disease

The aim – to assess factors associated with regression of target organ damage under therapy with fixed dose combination (FDC) of perindopril and amlodipine in patients with arterial hypertension, depending on presence of the ischemic heart disease (according to the EPHES study results analysis).

Material and methods. The analysis included data of 60 patients (aged > 30 years) with arterial hypertension:

1st group – 30 patients without ischemic heart disease (IHD), 2nd group – 30 patients with IHD. All patients were administered FDC perindopril/amlodipine in daily baseline dose 5/5 mg with up-titration to 10/10 mg every two weeks. If target blood pressure (BP) was not achieved (> 140/90 mm Hg) after 6 weeks, the indapamide 1.5 mg was added. All patients were done: body mass index measurements, office and ambulatory BP measurements, pulse wave velocity (PWV) and central SBP evaluation, augmentation index adjusted to heart rate 75 (AIx75) evaluation, biochemical blood analysis, ECG, EchoCG with Doppler, ankle-brachial index, intima-media thickness (IMT). The follow-up period was 12 months.

Results. Effective BP decreasing treatment based on FDC led to significant target organ damage regression – improving arterial stiffness and left ventricular diastolic function, decreasing of urine albumin level, left ventricular hypertrophy and left atrium size. Lowering of aorta PWV was less in patients without IHD than in patients with IHD – by 2.5±0.2 vs 4.4±0.5 m/s (Р<0.005). Despite equal decreasing of left ventricular mass indices in both groups, improving of diastolic function (increasing of E/A and diminishing Е/Е′) was more in patients with IHD – 64.4 and 54.1 % vs 39.8 and 23.2 % (Р<0.05 for both respectively). IMTmax decreased significantly only in patients with IHD. Conclusions. The assessed common and different factors associated with target organ damage regression in patients with and without IHD might help in choice of antihypertensive therapy and management of patients with arterial hypertension.

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