russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2018-4-49-55russjcardiol-2690Research ArticleКЛИНИКА И ФАРМАКОТЕРАПИЯGUIDELINES FOR THE PRACTITIONERОПТИМИЗАЦИЯ КОНТРОЛЯ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ, ОРГАНОПРОТЕКЦИИ  И МЕТАбОЛИЧЕСКИХ НАРУШЕНИЙ С ПОМОЩЬЮ ФИКСИРОВАННОЙ КОМбИНАЦИИ   ЛИЗИНОПРИЛ+АМЛОДИПИН+РОЗУВАСТАТИН У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ OPTIMAL ORGANOPROTECTION, CONTROL OF bLOOD PRESSURE AND METAbOLIC DISORDER  WITH THE FIxED COMbINATION OF LISINOPRIL, AMLODIPINE AND ROSUVASTATIN IN SYSTEMIC  HYPERTENSIONНедогодаС. В.NedogodaS. V.

 д. м.н., профессор, зав. кафедрой терапии и эндокринологии факультета усовершенствования врачей ФУВ.

Волгоград.

Volgograd.

hyvetvma@yandex.ruЧумачекЕ. В.ChumachekE. V.

к. м.н., ассистент кафедры терапии и эндокринологии ФУВ.

Волгоград.

Volgograd.

ЛедяеваА. А.LedyaevaA. A.

к. м.н., ассистент кафедры терапии и эндокринологии ФУВ.

Волгоград.

Volgograd.

ЦомаВ. В.TsomaV. V.

к. м.н., ассистент кафедры терапии и эндокринологии ФУВ.

Волгоград.

Volgograd.

СаласюкА. С.SalasyukA. S.

к. м.н., ассистент кафедры терапии и эндокринологии ФУВ.

Волгоград.

Volgograd.

СмирноваВ. О.SmirnovaV. O.

аспирант кафедры терапии и эндокринологии ФУВ.

Волгоград.

Volgograd.

ХрипаеваВ. Ю.HripaevaV. Yu.

аспирант кафедры терапии и эндокринологии ФУВ.

Волгоград.

Volgograd.

ПалашкинР. В.PalashkinR. V.

аспирант кафедры терапии и эндокринологии ФУВ.

Волгоград.

 

Volgograd.

ПоповаЕ. А.PopovaE. A.

аспирант кафедры терапии и эндокринологии ФУВ.

Волгоград.

Volgograd.

ФГБОУ ВО Волгоградский государственный медицинский университет Минздрава России.РоссияVolgograd State Medical University of the Ministry of Health.Russian Federation201809052018044955Copyright © Недогода С.В., Чумачек Е.В., Ледяева А.А., Цома В.В., Саласюк А.С., Смирнова В.О., Хрипаева В.Ю., Палашкин Р.В., Попова Е.А., 20182018Недогода С.В., Чумачек Е.В., Ледяева А.А., Цома В.В., Саласюк А.С., Смирнова В.О., Хрипаева В.Ю., Палашкин Р.В., Попова Е.А.Nedogoda S.V., Chumachek E.V., Ledyaeva A.A., Tsoma V.V., Salasyuk A.S., Smirnova V.O., Hripaeva V.Y., Palashkin R.V., Popova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/2690Цель

Цель. Оценка возможности фиксированной комбинации лизиноприл+амлодипин+розувастатин (Эквамер) в достижении дополнительной ангиопротекции у пациентов с артериальной гипертензией (АГ) и высокой скоростью распространения пульсовой волны (СПВ), несмотря на предшествующую комбинированную антигипертензивную терапию (АГТ).

Материал и методы

Материал и методы. В открытое многоцентровое наблюдательное исследование длительностью 24 нед. были включены 60 пациентов, получавших двойную комбинированную АГТ на протяжении 6 мес. Всем пациентам проводилось суточное мониторирование артериального давления (АД), аппланационная тонометрия (определение индекса аугментации и центрального АД), измерение скорости распространения пульсовой волны, лабораторные тесты (липидный состав крови, глюкоза натощак, индекс инсулинорезистентности (НОМА), лептин, высокочувствительный С-реактивный белок (вчСРБ) до и после перевода на фиксированную комбинацию лизиноприл+амлодипин+ ро зувастатин (Эквамер).

Результаты

Результаты. По данным измерений офисного АД после перевода пациентов с двойных комбинаций на фиксированную комбинацию лизиноприл+амлодип ин+розувастатин наблюдалось дополнительное снижение систолического АД (САД) на 14,3% и диастолического АД (ДАД) на 18,5%. По данным суточного мониторирования АД, снижение САД составило 16,1% и ДАД — 21,8%. Комбинация лизиноприл+амлодипин+розувастатин снизила СПВ на 14,4%, индекса аугментации на 14,5%, центрального САД на 8,1% (p<0,01 для всех сравнений с исходным значением). Фиксированная комбинация лизиноприл+амлодипин+розувастатин обеспечила снижение липопротеидов низкой плотности на 44%, триглицеридов на 36,1% и повышение липопротеидов высокой плотности на 10,3% (p<0,01 для всех сравнений с исходным значением). Применение фиксированной комбинации лизиноприл+амлодипин+розувастатин обеспечивало достоверное уменьшение инсулинорезистетности, уровня вчСРБ и лептина.

Заключение

Заключение.  Фиксированная комбинация лизиноприл+амлодипин+розувастатин обеспечивает лучший контроль АД, улучшение показателей эластичности сосудов (индекс аугментации, СПВ, центральное АД), а также способствует улучшению показателей липидного и углеводного обмена у пациентов, уменьшению воспаления и лептинорезистетности у исходно получающих двойную комбинированную антигипертензивную терапию.

Aim

Aim. Evaluation of the ability of the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer) in achievement of additional angioprotection in patients with systemic arterial hypertension (AH) and high pulse wave velocity (PWV), regardless of previous antihypertensive therapy (AHT).

Material and methods

Material and methods. To the open multicenter observational study 24 weeks duration, 60 patients included, taking double AHT during 6 months. All participants underwent ambulatory 24 hour blood pressure (BP) monitoring, applanation tonometry (augmentation index and central BP), pulse wave velocity assessment, laboratory tests (lipids, fasting glucose, insulin resistance index (HOMA), leptin, high sensitive C-reactive protein (hsCRP) before and after transition to the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer).

Results

Results. By the data from office BP measurement, after transition of patients from the double combinations to fixed combination of lisinopril, amlodipine and rosuvastatin, there was additional decrease of systolic BP (SBP) by 14,3% and diastolic BP (DBP) by 18,5%. By the data from ABPM, decrease of SBP was 16,1%, and DBP — 21,8%. Combination of lisinopril, amlodipine and rosuvastatin decreased PWV by 14,4%, augmentation index by 14,5%, central SBP by 8,1% (p<0,01 for all comparisons with baseline). Fixed combination of lisinopril, amlodipine and rosuvastatin made it to decrease low density lipoproteides by 44%, triglycerides by 36,1% and increase of high density lipoproteides by 10,3% (p<0,01 for all with baseline). Usage of combination of lisinopril, amlodipine and rosuvastatin showed significant decrease of insulin resistance, hsCRP and leptin levels.

Conclusion

Conclusion. Fixed combination of lisinopril, amlodipine and rosuvastatin makes it to better control BP, improve vascular elasticity parameters (augmentation index, PWV, central BP) and facilitates the improvement of lipid and glucose metabolism, decrease of inflammation, leptin resistance in patients taking at baseline double antihypertensive therapy.

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The authors declare that there are no conflicts of interest present.