russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2018-4-67-74russjcardiol-2716Research ArticleКЛИНИКА И ФАРМАКОТЕРАПИЯGUIDELINES FOR THE PRACTITIONERВОЗМОЖНОСТИ ДОПОЛНИТЕЛЬНОЙ АНГИОПРОТЕКЦИИ И КОРРЕКЦИЯ МЕТАбОЛИЧЕСКИХ  НАРУШЕНИЙ ПРИ ЛЕЧЕНИИ ФИКСИРОВАННОЙ КОМбИНАЦИЕЙ ПЕРИНДОПРИЛ+ИНДАПАМИД  ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ, ДОСТИГШИХ ЦЕЛЕВОГО АРТЕРИАЛЬНОГО  ДАВЛЕНИЯADDITIONAL ANGIOPROTECTION AND METAbOLIC DISORDERS CORRECTION IN TREATMENT   OF ARTERIAL HYPERTENSION PATIENTS REACHED TARGET bLOOD PRESSURE LEVELS,   WITH FIxED COMbINATION OF PERINDOPRIL AND INDAPAMIDEНедогодаС. В.NedogodS. V.

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

Волгоград.

Volgograd.

hyvetvma@yandex.ruЛедяеваА. А.LedyaevaA. A.

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

Волгоград.

Volgograd.

ЧумачекЕ. В.ChumachekE. V.

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.KhripaevaV. 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 Federation201809052018046774Copyright © Недогода С.В., Ледяева А.А., Чумачек Е.В., Цома В.В., Саласюк А.С., Смирнова В.О., Хрипаева В.Ю., Палашкин Р.В., Попова Е.А., 20182018Недогода С.В., Ледяева А.А., Чумачек Е.В., Цома В.В., Саласюк А.С., Смирнова В.О., Хрипаева В.Ю., Палашкин Р.В., Попова Е.А.Nedogod S.V., Ledyaeva A.A., Chumachek E.V., Tsoma V.V., Salasyuk A.S., Smirnova V.O., Khripaeva 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/2716Цель

Цель. Оценка возможности фиксированной комбинации периндоприл+индапамид (Нолипрел Би Форте) в достижении дополнительной ангиопротекции у пациентов с артериальной гипертензией, достигших целевого артериального давления (АД) на фоне предшествующей комбинированной антигипертензивной терапии лозартан+гидрохлортиазид (ГХТЗ).

Материал и методы

Материал и методы. В открытое наблюдательное исследование длительностью 12 нед. было включено 25 пациентов, получавших ранее терапию лозартан+ГХТЗ 100/12,5 мг.

Результаты

Результаты. В ходе исследования всем пациентам проведены суточное мониторирование АД, аппланационная тонометрия (определение индекса аугментации и центрального АД), измерение скорости распространения пульсовой волны (СПВ), лабораторные тесты (липидный спектр, глюкоза натощак, индекс НОМА, гомоцистеин, лептин, адипонектин, высокочувствительный С-реактивный белок (вчСРБ), определение сосудистого возраста). После перевода пациентов с терапии лозартан+ГХТЗ на фиксированную комбинацию периндоприл+индапамид дополнительное снижение систолического АД составило 3,9%, диастолического АД — 5,4% (p<0,05). Отмечено уменьшение индекса аугментации на 9,4% и сосудистого возраста на 6,0% (p<0,05). Наблюдалось снижение уровня лептина на 14,4%, вчСРБ на 11,0%, повышение адипонектина на 9,9% (p<0,05).

Заключение

Заключение. Фиксированная комбинация периндоприл+индапамид обладает преимуществами перед комбинацией лозартан+ГХТЗ в достижении контроля АД, улучшении эластичности сосудов, способствует снижению индекса массы тела, инсулинорезистентности и неинфекционного воспаления.

Aim

Aim. Evaluation of the ability of fixed combination of perindopril and indapamide (Noliprel Bi Forte) to achieve additional angioprotection in patients with arterial hypertension already reached target blood pressure (BP) at previous antihypertension therapy with losartan and hydrochlorothiazide (HCT).

Material and methods

Material and methods. To open observational study, lasting 12 weeks, 25 patients included, those who had been taking losartan+HCT 100/12,5 mg.

Results

Results. During the study, all patients underwent 24 hour BP monitoring, applanation tonometry (augmentation index assessment and of central BP), measurement of pulse wave velocity (PWV), laboratory tests (lipids, fasting glucose, HOMA index, homocystein, leptin, adiponectin, high-sensitive C-reactive protein (hsCRP), vascular age assessment). After shifting the therapy with losartan and HCT to combination perindopril and indapamide, BP decreased additionally by 3,9%, and diastolic BP — 5,4% (p<0,05). There was decrease of augmentation index by 9,4% and vascular age by 6,0% (p<0,05). There was also decrease of leptin level by 14,5%, hsCRP by 11,0%, and increase of adiponectin by 9,9% (p<0,05).

Conclusion

Conclusion. The fixed combination perindopril and indapamide does have advantages for losartan and HCT combination in BP control, vascular elasticity improvement, and facilitates the decrease of body mass index, insulin resistance and non-infectious inflammation.

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