Experience of personalized therapy with a fixed-dose combination of amlodipine and indapamide in hypertensive patients with high pulse pressure

Aim. To evaluate the potential of a fixed-dose combination of amlodipine and indapamide in hypertensive (HTN) patients with high pulse pressure (PP).

Material and methods. The study included 39 male and female patients aged 20 to 75 years (56,2±7,8 years) with HTN. Patients were examined using a standard protocol, including collecting a history and complaints, a physical examination, and laboratory and functional diagnostic tests, including electrocardiography, 24-hour blood pressure (BP) monitoring, echocardiography, and volume sphygmography with arterial stiffness measurements. Investigations were performed at baseline and after 3-month antihypertensive therapy with amlodipine and indapamide at doses of 5/1,5 mg or 10/1,5 mg. Statistical analysis of the obtained data was performed using Microsoft Office XP and Statistica 10 (StatSoft Inc., USA).

Results. After 3-month therapy, significant improvements were recorded in office systolic and diastolic BP, which decreased from 163,2±6,72 to 134,6±5,81 mm Hg (p<0,001) and from 89,9±7,51 to 78,4±5,54 mm Hg (p<0,001), respectively. In addition, 24-hour BP profile were improved — the overwhelming majority of patients moved into "dipper" HTN phenotype (62%). Left ventricular mass index decreased from 115,6±7,1 to 95,3±5,21 g/m2 (p<0,01), and the transmitral E/A ratio increased from 0,88±0,04 to 0,94±0,06 (p<0,05). PP significantly decreased from 68,1±4,9 to 52,4±4,7 mm Hg (p<0,001). Initially elevated right and left CAVI decreased by 13,8% and 14,2%, respectively, reaching reference values (p<0,01), while the biological vascular age also decreased, reaching the rated value. Target BP values were achieved in 88% of patients.

Conclusion. Achieving target levels and improving the 24-hour BP profile, echocardiographic parameters, and vascular stiffness parameters, along with PP normalization in the vast majority of study patients after 3-month therapy support the high efficiency of the fixed-dose combination of amlodipine and indapamide in real-world practice for hypertensive patients with high PP.

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