Authors: Nagay AV, Khamidullaeva GA and Srojidiniva NZ
Aim of the study: evaluation of antihypertensive, organprotective efficacy and influence on metabolic disorders of triple combination antihypertensive therapy with valsartan, indapamide and amlodipine in hypertensive patients with pre-diabetes, who are resistant to bi-combination therapy.
Material and Methods: The study included 66 men with hypertension in average age of 56.06 ± 7.86 years, diagnosed abdominal obesity (waist circumference 103.11 ± 6.4 cm and body mass index 34.54 ± 3.83 kg/m²) and metabolic disorders, which were resistant to bi-combination antihypertensive therapy. The hypertensive patients with associated clinic conditions didn’t include to the study. Target organ damage (TOD) was diagnosed by Echocardiography and Ultrasound of brachiocephalic arteries. Microalbuminuria was determined on daily urine and glomerular filtration rate was calculated using EPI formulae. Lipids and fasten glucose levels, serum creatinine and uric acid were measurement by biochemical methods. All measurements were before and during 6 monthly therapies with valsartan (Nortivan, “Gedeon Richter”, Hungary), indapamide (Indap, PRO.MED. CS Praha, Czech Republic) and amlodipine (Normodipine, “Gedeon Richter”, Hungary) in average daily doses 135.65 ± 37.63 / 2.52 ± 1.4 / 7.5 ± 2.6 mg respectively.
Results: According to AH degree and founded risk factors and TOD, hypertensive patients with pre-diabetes were characterized as with high cardiovascular risk. Triple combination therapy showed high antihypertensive efficacy, achieving goal blood pressure level on 94% patients with decreased systolic BP on -22.26 ± 5.84% and diastolic BP on -21.1 ± 5.85%, significantly decreased of pulse BP. Heart rate beat didn’t change. Valsartan, indapamide and amlodipine combination characterized with significantly high cardioprotective, renoprotective efficacies and metabolic neutrality. Additional non-pharmacological interference, contributed to decrease of epicardial fat thickness and waist circumference, and positive influence to dyslipidemia.
Conclusion: During 6-monthly triple combination antihypertensive therapy with valsartan, indapamide and amlodipine 94% of hypertensive patients with pre-diabetes, who were resistant to bi-combination therapy achieved goal BP level with significantly target organ protection and positive influence to metabolic disorders.
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