ADDITIONAL ANGIOPROTECTION AND METAbOLIC DISORDERS CORRECTION IN TREATMENT   OF ARTERIAL HYPERTENSION PATIENTS REACHED TARGET bLOOD PRESSURE LEVELS,   WITH FIxED COMbINATION OF PERINDOPRIL AND INDAPAMIDE

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

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. 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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