Эффективность фиксированной комбинации бисопролола и амлодипина у пациентов с артериальной гипертонией, ишемической болезнью сердца и метаболическим синдромом

Abstract

The aim of the studyis to evaluate the efficacy of the fixed combination of beta adrenergic receptor blocking agents (β-AB) bisoprolol and dihydropyridine calcium channel inhibitor (CCI) amlodipine in patients with uncontrolled arterial hypertension (AH), stableischemic heart disease (IHD) and metabolic syndrome (MS) in actual clinical practice.Material and methods. The study enrolled 61 patients with uncontrolled AH, stable IHD and MS in the open prospective randomized study. The patients were randomized into 2 groups, using opaque and sealed envelopes. Patients in group 1 (n =30) had been receiving angiotensin-converting enzyme inhibitor (ACE inhibitor or ACE-i) - ramipril in dose of 10 mg/day (Hartil, Egis), fixed combination of bisoprolol and amlodipine (Concor AM, Takeda) in different doses. Patients in group 2 (control, n=31) should have been treated at the discretion of the doctor, necessarily the treatment should have included the free combination of ACE inhibitors, generic b-AB and dihydropyridine CCI. Initially, and after 12 weeks of treatment we conducted 24-hour ambulatory blood pressure monitoring (APBM) with the assessment of key indicators of 24-hour blood pressure monitoring results, the parameters of the blood vessel hardness and central blood pressure. The Statistical analyses of the results were carried out using the software package Statistica 6.1 (StatSoft Inc., United States).Results. After 12 weeks of therapy, the target level of BP was - 96,7% in the 1st group and 87,1% in the 2nd group of patients. The application of Concor AM was accompanied by significant improvements of the indicators of APBM and of the blood vessel hardness and central blood pressure characteristics. In addition, the usage of Concor AM provides the normalization of 24-hour ambulatory blood pressure monitoring results in 73% of patients. In the control group we determined the positive, but less significant changes in the indicators of APBM and rarer normalization of 24-hour ambulatory blood pressure monitoring results than in the group of patients, administrating Concor AM.Conclusion. In patients with AH, IHD and MS the administration of Concor AM is provided a significant antihypertensive and vasoprotective effects, which are more effective by the side of using free combination of β-AB and dihydropyridine CCI.