S.D. Bablyak, V.A. Skybchyk, P.L. Sverdan, D.S. Tymchuk Resistant arterial hypertension coexisting with metabolic syndrome: search for effective combinations.

Our investigation was designed to find the best combination of antihypertensive and lipid-lowering drugs for the therapy of resistant arterial hypertension in patients with metabolic syndrome. 104 persons aged 45–75 years old with treated or untreated hypertension at baseline and predefined combinations of cardiovascular risk factors were included. The first-line drugs were ramipril and atorvastatin but after 2–4 weeks all the patients were divided into three groups. The group I consisted from the 38 persons who were treated with adding bisoprolol and later amlodipine, the group II – 34 persons with adding verapamil and later indapamide, the
group III – from 32 persons with adding moxonidine and later indapamide. All the patients were followed up for a period of 6 months. The authors analyzed the effects of therapy not only on the arterial pressure but also on the other hemodynamic and anthropometric parameters, changes of biochemical and echocardiographic markers. We found that blood pressure was reduced in all three groups but the therapy in group I was more
pronounced compared with the therapy in groups II and IIi, also the positive changes of anthropometric and echocardiogra-phic parameters were more significant in group I. In the situation where beta-blockers cannot
be used the therapy in the group II showed some advantages upon the therapy in the group III in relation to the effects on hemodynamic parameters.

Full article