Сравнительная оценка вариабельности артериального давления в динамике лечения фиксированными комбинациями антигипертензивных препаратов

Abstract

Increased variability of blood pressure (BPV) is associated with the development of cardiovascular complications regardless of the average blood pressure (BP) values. The problem of BPV remains open today. The conducted prospective studies confirm the significance of this indicator. However, such studies are few, while new information about this indicator will help determine the prognostic capability of modern antihypertensive drugs in preventing the progression of cardiovascular diseases. The purpose — to comparatively assess BPV in patients with 2–3 degree hypertension, when taking two different fixed combinations (FC) of antihypertensive drug. Material and methods. The study involved 80 patients who were divided into 2 groups of 40 people in a randomized manner. Group 1 took FC of losartan plus amlodipine. Group 2 took FC of losartan plus hydrochlorothiazide. With the help of an automatic tonometer with the function of BPV assessment, this indicator was determined before the start of treatment (first visit) and after 3 months (second visit). Systolic and diastolic BPV were evaluated during visits (short-term) and between visits (long-term). Results. In each of the studied groups, a decrease in short-term BPV was registered during three months of treatment. When comparing two groups of patients receiving different FC of antihypertensive drugs, a statistically significant decrease in systolic and diastolic short-term BPV was achieved only when taking the FC of losartan plus amlodipine (p < 0.01). At the same time, the long-term BPV practically did not differ between the groups. Conclusion. At the end of the three-month study, all patients reached the target blood pressure level. Short-term BPV decreased by the third month of treatment in both groups of patients. When comparing two groups receiving different FC of antihypertensive drug, a statistically significant decrease in short-term BPV was achieved when taking losartan with amlodipine. Long-term BPV, practically did not differ between the groups. The problem of the value of a short-term BPV currently remains open and requires further study.