scholarly journals Antihypertensive efficacy of a fixed full-dose perindopril A-indapamide combination in patients with grades 2–3 arterial hypertension

2013 ◽  
Vol 10 (1) ◽  
pp. 66-69
Author(s):  
T V Glukhova ◽  
S A Solgalova ◽  
V V Alferov

Aim: to study the antihypertensive efficacy of a fixed full-dose perindopril arginine-indapamide combination in patients with grades 2–3 arterial hypertension (AH) who do not receive antihypertensive therapy or those who do not achieve blood pressure (BP) control with other antihypertensive drugs. Subjects and methods. The trial enrolled 30 patients: 20 (66,6%) males and 10 (33,3%) females aged 30 to 60 years (mean age 50,5±7,1 years). Grades 2 and 3 AH was recorded in 28 (93,3%) and 2 (6,6%) patients, respectively. According to office measurements, the baseline BP (systolic BP (SBP)/diastolic BP (DBP) averaged 169±13,3/100,3±6,9 mm Hg in the group. Before included into the trial, 25 (83,4%) patients had taken antihypertensive agents, of them 10 (40%) and 2 (5%) examinees had combination therapy and fixed-dose combinations, respectively. Results. During therapy with a fixed-dosed combination of perindopril arginine 10 mg and indapamide 2,5 mg, there was generally a trend for SBP and DPB to lower at week 2 of therapy and there was a significant reduction in SBP by 42,4±11,2 mm Hg and in DBP by 20,1±9,3 mm Hg by the end of month 3. The goal BP (lower than 140/90 mm Hg) was achieved in 96,6% of the patients. Conclusion. The fixed full-dose perindopril arginine-indapamide combination allows therapeutic efficiency to be enhanced in grades 2–3 AH patients having no target BP values.

2019 ◽  
Vol 15 (4) ◽  
pp. 502-509
Author(s):  
N. B. Perepech ◽  
V. D. Shurygina ◽  
A. V. Tregubov

Aim. Examination of knowledge of the basic provisions of clinical guidelines for the management of patients with arterial hypertension and finding out the readiness of doctors for the practical application of updated recommendationsMaterial and methods. Anonymous questionnaires of 306 doctors served as material for the study. The questionnaire consisted of two parts. The introductory part included questions that allow to find out the specialty, work experience, gender, age, and whether the respondent has cardiovascular risk factors. The main part of the questionnaire included 16 questions regarding provisions of the guidelines on the diagnosis and treatment of arterial hypertension in force at the time of the survey (2017/2018 academic year). Statistical processing of the results was carried out using the Microsoft Excel 2010 software package. Differences were regarded as significant at p<0.05.Results. The findings suggest that both therapists and cardiologists do not give due importance to the risk stratification of cardiovascular complications in patients with arterial hypertension and are not sufficiently aware of the possibilities and limitations of the use of combinations of antihypertensive drugs. Therapists worse than cardiologists know the main points of the clinical guidelines for the management of patients with arterial hypertension (target blood pressure levels during treatment [64.6% vs 87.7%, p<0.001], indications for combination antihypertensive therapy starting, the possibility of fixed dose combinations using [52.3% vs 83.9%, p<0.001]). A significant part of physicians (both cardiologists and therapists) adequately assess the antihypertensive treatment effectiveness, not enough frequent achievement of the target blood pressure level in their patients and is willing to provide more strict control of blood pressure.Conclusion. The results of the survey indicate the need of the active education of doctors in the management of patients with arterial hypertension. The most attention should be paid to the training of therapists and general practitioners on the cardiovascular complications risk stratification, the using of the antihypertensive drugs combinations use and methods to increase patient adherence to antihypertensive therapy.


2003 ◽  
Vol 9 (5) ◽  
pp. 151-154
Author(s):  
Yu. N. Belenkov ◽  
I. Ye. Chazova

ROBIS is the first large multicenter study performed in Russia. The Objective of the study was to compare the efficiency, safely, and impact of two treatment policies (the application of an algorithm to the stepwise use of 4 classes of antihypertensive agents in an intensive care group and random antihypertensive therapy in a routine treatment group) on the incidence of cardiovascular events in patients with arterial hypertension. Design: This is a national multicenter open consecutive prospective study. The patients meeting the criteria of inclusion were randomly divided into two equal groups, one of them (an intensive care group) received therapy with a nifedipine retard in Fixed dose for 4 weeks. In patients who failed to achieve the target level of blood pressure (BP), the therapy was supplemented by enalapril, 20 mg, hydrochlorothiazide, 25 mg, and metoprolol, 50 mg, at a 4-week interval. After achieving the target BP level, the patients continued the treatment with which the level had been attained. If the antihypertensive effect of therapy was found to disappear, the above drugs were successively supplemented. The other group (a routine treatment group) continued to be treated with the antihypertensive drugs prescribed in the polyclinic (Fig. 1). BP and heart rate were monitored and the patients' complaints and adverse reactions were recorded on repeated visits 4, 8, 12, 16, 24, 52, 64, 70, 88, and 104 weeks after the initiation of therapy. Control blood and urine analyses and ECG studies were made 12, 16, 52, and 104 weeks after therapy.


2018 ◽  
Vol 10 (1) ◽  
pp. 41-45
Author(s):  
Stelina Alkagiet ◽  
Konstantinos Tziomalos

Suboptimal adherence to antihypertensive treatment is very common and is associated with poor control of blood pressure and increased risk for cardiovascular events. Therefore, frequent evaluation of compliance is essential in all hypertensive patients. Simplifying treatment regimens, using fixed-dose combinations and long-acting agents improves adherence, facilitates achievement of treatment targets and reduces cardiovascular morbidity and healthcare expenditures. Accordingly, physicians should be educated to implement these changes in hypertensive patients, particularly in those who require multiple antihypertensive agents to achieve blood pressure controls and in those who receive additional medications for comorbidities.


2020 ◽  
Vol 1-2 (211-212) ◽  
pp. 31-39
Author(s):  
Gulnara Junusbekova ◽  
◽  
Meiramgul Tundybayeva ◽  
Tatyana Leonovich ◽  
Manshuk Yeshniyazova ◽  
...  

Arterial hypertension (AH) remains one of the most common diseases in the world. Reducing cardiovascular risk of mortality from cardiovascular complications is a priority in the treatment of hypertension. Targets of hypertension therapy is to achieve SBP/DBP <140/80 mm Hg. article, regardless of cardiovascular risk and comorbidity. The choice of antihypertensive therapy depends on blood pressure levels, the presence or absence of concomitant diseases, lesion of target organs. Effective and long-lasting control of AH proved by the use of combinations of antihypertensive drugs, including antagonists and ACE inhibitors. The purpose of the study. Evaluation of clinical efficacy and safety of fixed combination antihypertensive therapy using lisinopril combined with amlodipine in patients with hypertension. Material and methods. The study included 30 respondents from essential hypertension II-III degree (ESH/ESC, 2018) aged 35 to 75 years. Patients were treated with the schema a (lisinopril 10 mg, amlodipine 5 mg) and scheme b (lisinopril 20 mg, amlodipine 10 mg) fixed combination therapy with the drug VivaCor® once in the morning. The period of observation was 3 months. At the time of inclusion and at the end of the study all respondents was performed echocardiography, daily monitoring of blood pressure, evaluation of laboratory and instrumental methods of research. Results and discussion. The combination of lisinopril with amlodipine has a fairly high antihypertensive activity, provides a significant cardioprotective effect and is an integral part of antihypertensive therapy in the long-term strategy of administering patients with high hypertensive / very high total cardiovascular risk. Conclusions: 1. The use of a fixed combination of lisinopril and amlodipine in patients with hypertension instead of free or other two-component combinations leads to its target level within 3 months of therapy. 2. Taking a fixed combination of lisinopril and amlodipine is effective and safe. 3. Therapy using the combined drug VivaCor® in patients with high / very high risk of hypertension prevents further pathological remodeling of the heart. 4. The combination of amlodipine and lisinopril is metabolically neutral and well tolerated by patients. Keywords: arterial hypertension, lisinopril, amlodipine, VivaCor.


2017 ◽  
Vol 158 (11) ◽  
pp. 403-408 ◽  
Author(s):  
Viktor László Nagy

Abstract: The diuretics are essential medicaments of antihypertensive therapy. They reduce blood pressure and cardiovascular events optimally. With increasing doses of thiazides and thiazide analogs do not come further powerful effect of reducing blood pressure or cardiovascular mortality and morbidity, but clearly elevate the side effects. Because of it, the minimum effective dose level and the fixed-dose combination therapy should be preferred. The use these drugs leads to especially positive outcome in elder patients, isolated systolic hypertension, heart failure, after stroke and in black population. Loop diuretics as antihypertensive therapy can be used only by renal impairment. The use of aldosterone antagonists can have a good effect not only on heart failure but also on prevention of atrial fibrillation. Furthermore, using it in a combination therapy with thiazides, it reduces the risk of hypokalemia. Therefore, the diuretic treatment in hypertension is flourishing again. Orv. Hetil., 2017, 158(11), 403–408.


2021 ◽  
pp. 61-66
Author(s):  
Viacheslav Zhdan ◽  
Yevdokiia Kitura ◽  
Maryna Babanina ◽  
Oksana Kitura ◽  
Maksym Tkachenko

The prevalence of arterial hypertension (AH) increases with age: among people over 60 years old this index is more than 2 times higher in the general population, 2/3 of people over 65 years old suffer from hypertension. Among patients 65–89 years old with hypertension, 2/3 patients have isolated systolic hypertension (ISAG). Features of hypertension in the elderly patients are: lability of blood pressure (BP), increasing frequency of pseudohypertension, high frequency of «white coat hypertension», decreased sensitivity of pressor factors for antihypertensive drugs, high frequency of resistant to treatment of hypertension. The new recommendations of the European Society of Cardiology for the diagnosis and treatment of hypertension emphasize 2 groups of elderly patients: 65–79 years old and ≥80 years old, which described the epidemiological features, the prevalence of risk factors for cardiovascular events, blood pressure levels for antihypertensive therapy and target blood pressure, and the recommended principles of drug therapy that are different from young and middle-aged patients. For most patients, fixed combinations are indicated as starting AGT, but monotherapy is recommended for the treatment of hypertension in very elderly patients (over 80 years old) and elderly patients over 65 years old with senile asthenia. The decreasing of blood pressure should be gradual, taking into consideration the increased risk of orthostatic reactions at this age. European and American experts recommend os first-line drugs low doses of thiazide diuretics and calcium channel antagonists (mainly dihydropyridine), which are especially indicated in isolated systolic arterial hypertension to effectively reduce the frequency of cardiovascular complications in the treatment of elderly patients with hypertension.


Author(s):  
Z. M. Galeyeva ◽  
A. S. Galyavich ◽  
L. V. Baleyeva ◽  
E. G. Safina ◽  
O. V. Sorokina

The article presents data about the prevalence and expected prognosis for arterial hypertension. Emphasis is placed on the selection of antihypertensive therapy in elderly patients. The features concerning the positive effect of the calcium channelblocking agent — amlodipine, thiazid­like diuretic — indapamide retard in the form of monotherapy and a combination of the above drugs on the course and prognosis of arterial hypertension in elderly patients are investigated. A clinical example of the use of the fixed dose combination amlodipine + indapamide retard is also introduced.


2017 ◽  
Vol 89 (8) ◽  
pp. 29-36
Author(s):  
O D Ostroumova

Aim. To study the effect of a fixed-dose combination of perindopril arginine/amlodipine (prestans) on the goal levels and variability of blood pressure (BP) according to its office visit-to-visit measurements and self-measurement (OVVM and SM) in a subgroup of 483 people from the population of the Russian observational SUPERIORITY program, most cases of whom are given the combination replacing the previously ineffective mono- and combination antihypertensive therapy (AHT). Subjects and methods. The subanalysis included data on 483 patients (34% men) aged 57.9±10.8 years with uncontrolled hypertension, who were both untreated and treated with antihypertensive mono- or combination therapy using a free or fixed-dose combination of 2—3 antihypertensive drugs and in whom the physicians decided to use prestans to correct AHT. The follow-up period was 24 weeks. Results. At the end of the investigation, the patients received prestans in the following doses: 5/5 mg (34% of the patients), 10/5 mg (39.5%), 5/10 mg (3.9%), and 10/10 mg (22%). In the analyzed patient group, the baseline BP was 160.8±8.8/92.6±7.4 mm Hg and dropped to 125.9±7.9/77.8±5.0 mm Hg at 24 weeks (p


Author(s):  
L.V. Pavlyushchenko ◽  
◽  
E.E. Filimonova ◽  
M.A. Esina ◽  
◽  
...  

Purpose. Analysis of the frequency and structure of arterial hypertension (AH) among ophthalmic surgical patients, assessment of the adequacy of prescribed antihypertensive therapy. Material and methods. Clinical material is presented by 157 patients with hypertension. Its structure was assessed. Its structure was assessed according to the stage, the degree of increase in the level of blood pressure (BP) and the category of cardiovascular risk. We analyzed the proportion of cases of uncontrolled hypertension, including those with a sudden pronounced individually significant increase in blood pressure without affecting target organs. Results. The prevalence of patients was stage III hypertension (62.4%), grade 3 hypertension (53.5%), with a very high and high risk of cardiovascular complications (73.2 and 20.4%, respectively). 93.6% of patients received antihypertensive therapy, but only 57.1% of them, mostly women (69.1%), regularly took medications and monitored their blood pressure. With a sudden pronounced individually significant increase in blood pressure, we used oral antihypertensive drugs – captopril and nifedipine, which made it possible to achieve a decrease in blood pressure and relief of clinical symptoms in all cases. Conclusion. 33.1% of patients had no hypertension control at the time of hospitalization. The proportion of patients with a sudden pronounced individually significant increase in blood pressure was 12.7%. Typical reasons for loss of control over hypertension were interruptions in taking antihypertensive drugs and high stress levels before surgery. The use of standard dosage captopril and nifedipine was effective in all cases. Key words: arterial hypertension, sudden pronounced individually significant increase in blood pressure, antihypertensive therapy.


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