Increment of the effectiveness of treating hypertension and dyslipidemia using a triple fixed-dose combination and the vascular age concept

Aim. To study the efficacy, safety and effect on vascular age of free-equivalent and fixed-dose combinations of amlodipine, a renin-angiotensin-aldosterone system blockers and rosuvastatin in patients with high and very high cardiovascular risk with uncontrolled hypertension and concomitant dyslipidemia.

Material and methods. This open-label case series study included 148 men and women (mean age 60,63±8,16 years). The patients were randomly divided into 2 groups: group 1 (n=76) received a triple fixed-dose combination of amlodipine, lisinopril, rosuvastatin; group 2 (n=72) received a dual free-equivalent antihypertensive combination (amlodipine/losartan) and rosuvastatin. The doses were selected by the attending physician and were not regulated by the researchers. The study included an assessment of blood pressure, lipid profile (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides), biochemical profile, ASCORE value, medication adherence, changes in the augmentation index (AI) at baseline and after 6 months of therapy (first and second visits, respectively). The results were considered significant at p<0,05.

Results. After 6 months of therapy, significant intragroup differences were noted in comparison with the baseline values. In group 1, the levels of TC (p=0,002), LDL-C (p=0,001), ASCORE value (p=0,01), and vascular age (p=0,01) significantly decreased; in group 2 — TC (p=0,03), LDL-C (p=0,005). In the group of triple fixed-dose therapy, the values of AI (p=0,04), TC (p=0,012), LDL-C (p=0,024), ASCORE value (p=0,02) and vascular age (p=0,01) were significantly lower than in the free-equivalent group.

Conclusion. The fixed-dose combination of amlodipine, lisinopril and rosuvastatin, is more effective and equally safe relative to the free-equivalent combination of amlodipine/losartan and rosuvastatin, not only in terms of effect on LDL-C and AI, but also on vascular age parameters calculated using the ASCORE scale. This can serve as an additional motivating factor for patients to receive therapy.

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