[Single Pill Indapamide and Perindopril Arginine Combination: Optimal Coupling of Vascular Protection and Hemodynamic Risk Factors Reduction in Patients with Essential Arterial Hypertension].

Abstract

OBJECTIVE\nto investigate the impact of indapamide / perindopril single-pill combination (I / P SPC) on arterial stiffness parameters, blood\xa0pressure (BP) level and BP variability (BPV) in middle-aged patients with stage II grade 1-2 essential arterial hypertension (EAH).\xa0Materials and methods. We retrospectively formed a group of patients with stage II grade 1-2 EAH who had not previously received regular\xa0antihypertensive therapy (AHT) (n=52, mean age 52.9±6.0 years). All patients were treated with I / P SPC and all of them achieved target\xa0office BP level (less than 140 / 90 mm Hg). After 12 weeks of follow-up (from the time of reaching the target BP) assessment of AHT\xa0effectiveness (general clinical data, ambulatory blood pressure monitoring [ABPM], volume sphygmography, echocardiography), and\xa0vascular stiffness evaluation were performed.\n\n\nRESULTS\nAt the end of follow-up office systolic BP (SBP), diastolic BP (DBP), pulse BP,\xa0day-time, night-time and 24‑hour SBP and DBP significantly (p<0.001 for all) decreased. According to the ABPM data day-time, nighttime,\xa0and 24‑hour systolic BPV significantly decreased (p=0.029, p=0.006 and p<0.001, respectively); day-time and 24‑hour diastolic\xa0BPV also significantly decreased (p=0.001 and p<0.001, respectively). Day-night standard deviation (SDdn) significantly decreased\xa0too (p=0.002 and p<0.001, respectively). Volumetric sphygmography showed significant decrease of right cardio-ankle vascular index\xa0(CAVI) (from 8.20±1.29 to 7.58±1.44, p=0.001) and of left CAVI (from 8.13±1.40 to 7.46±1.43, p<0.001), as well as reduction of the\xa0number o f patients with a right- and / or left-CAVI >9.0 (from 32.7 to 11.5 %, p=0.018). According to assessment of arterial stiffness using\xa0the Vasotens24 software package, the arterial stiffness index (ASI) significantly (p<0.001) decreased from 153.5±29.9 to 138.3±20.0\xa0(by -9.2±13.1 %). Transthoracic echocardiography data demonstrated significant decrease (p<0.001) in effective arterial elastance (from\xa01.82±0.43 to 1.58±0.36 mm Hg; by -11.85±16.29 %) and significant (p<0.001) increase in the arterial compliance - from 1.27±0.34 to\xa01.54±0.38 mm Hg / ml (+26.95±38.06 %).\n\n\nCONCLUSION\nIn AHT naive patients 40-65 years old with stage II grade 1-2 EAH therapy with\xa0I / P SPC provided effective 24‑hour BP control, reduced BPV and improved arterial stiffness parameters.