Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine

Aim: To assess the effect of a lipophilic angiotensin-converting enzyme inhibitor (ACEI) in combination with a calcium antagonist (CA) on the 24-hour blood pressure (BP) profile, systemic inflammation in patients with arterial hypertension (AH) and metabolic disorders (MD). Methods: Fifty-eight pati...

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Main Authors: Andrey A. Svistunov, Mikhail A. Osadchuk, Inna N. Vasileva, Maxim V. Trushin
Format: Article
Language:English
Published: Open Exploration Publishing Inc. 2025-06-01
Series:Exploration of Medicine
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Online Access:https://www.explorationpub.com/uploads/Article/A1001336/1001336.pdf
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author Andrey A. Svistunov
Mikhail A. Osadchuk
Inna N. Vasileva
Maxim V. Trushin
author_facet Andrey A. Svistunov
Mikhail A. Osadchuk
Inna N. Vasileva
Maxim V. Trushin
author_sort Andrey A. Svistunov
collection DOAJ
description Aim: To assess the effect of a lipophilic angiotensin-converting enzyme inhibitor (ACEI) in combination with a calcium antagonist (CA) on the 24-hour blood pressure (BP) profile, systemic inflammation in patients with arterial hypertension (AH) and metabolic disorders (MD). Methods: Fifty-eight patients with the ≥ 2nd degree of AH was divided into 3 groups: patients with AH without metabolic syndrome (MS), patients with AH and MS, and patients with AH and diabetes mellitus (DM). Taking into account the BP profile characteristics, therapy with ACEI perindopril and CA amlodipine in a fixed combination (FC) was prescribed. The observation period for patients was 12 weeks. Results: A profile with an insufficient decrease in BP at night was more often detected in persons with MS having DM and nocturnal hypertension. In patients with AH and DM, the values of daily BP variability exceeded those in persons without MS (P < 0.05). Patients with MS had a higher concentration of high-sensitivity C-reactive protein (hsCRP) compared to patients without MS (3.5 mg/L; P < 0.01). Patients with DM and AH achieved target BP in 60% of cases during treatment: office BP decreased to 134.8 (17.97 kPa) ± 8.7/83.2 (11.09 kPa) ± 6.7 mmHg (∆ = –31/–16 mmHg), 90% of patients required maximum therapeutic doses of antihypertensive therapy (AHT). A decrease in the hsCRP concentration was detected (P < 0.05) in patients of groups 2 and 3, which showed practical possibility of average/maximum therapeutic doses influence on the activity of systemic inflammation (∆ = –12.8% in patients group 2 and ∆ = –11.2% in patients of group 3). Conclusions: A combination of a lipophilic ACEI and a vasoselective СA promotes good BP control, a decrease in the activity of systemic inflammation, and hypersympathicotonia in patients with MD.
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spelling doaj-art-aa5e79b7dbb941238ec23d433cd175222025-08-20T03:32:19ZengOpen Exploration Publishing Inc.Exploration of Medicine2692-31062025-06-016100133610.37349/emed.2025.1001336Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipineAndrey A. Svistunov0https://orcid.org/0000-0003-1592-5703Mikhail A. Osadchuk1https://orcid.org/0000-0003-0485-6802Inna N. Vasileva2https://orcid.org/0000-0001-8335-1380Maxim V. Trushin3https://orcid.org/0000-0001-7467-011XFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119435 Moscow, Russian FederationFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119435 Moscow, Russian FederationFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119435 Moscow, Russian FederationKazan Federal University, 420008 Kazan, Russian FederationAim: To assess the effect of a lipophilic angiotensin-converting enzyme inhibitor (ACEI) in combination with a calcium antagonist (CA) on the 24-hour blood pressure (BP) profile, systemic inflammation in patients with arterial hypertension (AH) and metabolic disorders (MD). Methods: Fifty-eight patients with the ≥ 2nd degree of AH was divided into 3 groups: patients with AH without metabolic syndrome (MS), patients with AH and MS, and patients with AH and diabetes mellitus (DM). Taking into account the BP profile characteristics, therapy with ACEI perindopril and CA amlodipine in a fixed combination (FC) was prescribed. The observation period for patients was 12 weeks. Results: A profile with an insufficient decrease in BP at night was more often detected in persons with MS having DM and nocturnal hypertension. In patients with AH and DM, the values of daily BP variability exceeded those in persons without MS (P < 0.05). Patients with MS had a higher concentration of high-sensitivity C-reactive protein (hsCRP) compared to patients without MS (3.5 mg/L; P < 0.01). Patients with DM and AH achieved target BP in 60% of cases during treatment: office BP decreased to 134.8 (17.97 kPa) ± 8.7/83.2 (11.09 kPa) ± 6.7 mmHg (∆ = –31/–16 mmHg), 90% of patients required maximum therapeutic doses of antihypertensive therapy (AHT). A decrease in the hsCRP concentration was detected (P < 0.05) in patients of groups 2 and 3, which showed practical possibility of average/maximum therapeutic doses influence on the activity of systemic inflammation (∆ = –12.8% in patients group 2 and ∆ = –11.2% in patients of group 3). Conclusions: A combination of a lipophilic ACEI and a vasoselective СA promotes good BP control, a decrease in the activity of systemic inflammation, and hypersympathicotonia in patients with MD.https://www.explorationpub.com/uploads/Article/A1001336/1001336.pdfarterial hypertensionmetabolic syndromefixed combinationangiotensin-converting enzyme inhibitorperindoprilcalcium antagonistamlodipine
spellingShingle Andrey A. Svistunov
Mikhail A. Osadchuk
Inna N. Vasileva
Maxim V. Trushin
Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine
Exploration of Medicine
arterial hypertension
metabolic syndrome
fixed combination
angiotensin-converting enzyme inhibitor
perindopril
calcium antagonist
amlodipine
title Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine
title_full Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine
title_fullStr Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine
title_full_unstemmed Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine
title_short Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine
title_sort optimisation of arterial hypertension therapy in patients with metabolic disorders aspect of fixed combination lipophilic of perindopril and amlodipine
topic arterial hypertension
metabolic syndrome
fixed combination
angiotensin-converting enzyme inhibitor
perindopril
calcium antagonist
amlodipine
url https://www.explorationpub.com/uploads/Article/A1001336/1001336.pdf
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