S.D. MAYANSKAYA¹, F.R. GUMEROV¹, I.A. GREBENKINA²

 ¹Kazan State Medical University, Kazan

²Novosibirsk State Medical University, Novosibirsk

Contact details:

Mayanskaya S.D. — MD, Professor of the Department of Hospital TherapyAddress: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-905-316-99-66, e-mail: Smayanskaya@mail.ru

 This study is aimed at studying the daily profile of blood pressure in the treatment with the most common fixed combinations of antihypertensive drugs in actual clinical practice.

The purpose — to conduct a comparative assessment of the dynamics of the daily blood pressure profile in patients with arterial hypertension of II–III degree when taking fixed combinations of amlodipine or hydrochlorothiazide with losartan for the optimal approach to their personalized use in actual clinical practice.

Material and methods. Fixed combinations of antihypertensive drugs were randomly assigned to 60 patients. Group 1 received losartan with amlolipin, group 2 received losartan with hydrochlorothiazide. By ambulatory monitoring of blood pressure (ABPM), indicators were evaluated before and after 3 months of treatment.

Results. In group 1, during three months of treatment, there was a statistically significant decrease in almost all indicators of ABPM, except the nighttime variability of diastolic blood pressure (DBP) and its minimum daily values, the degree of nighttime decrease in systolic blood pressure (SBP), as well as the rate of morning rise in SBP and DBP. In group 2, mean SBP, DBP, and time index also decreased, while nocturnal variability, the degree of nocturnal BP decrease, and the magnitude and speed of the morning increase in SBP and DBP remained virtually unchanged during treatment. When comparing the two groups, a statistically significant difference was obtained for the decrease in the average daily SBP and DBP, the magnitude of the morning rise in SBP, as well as its maximum value during the day.

Conclusion. The results obtained require further study, however,  it can be assumed that in choosing one or another combination, it is advisable to take into account the characteristics of ABPM indicators, including the degree of decrease in nighttime blood pressure, as well as the magnitude and speed of its morning rise.

Key words: arterial hypertension, fixed combinations, losartan with amlodipine, losartan with hydrochlorothiazide, ambulatory blood pressure monitoring.

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