Application of fixed combinations in the treatment of arterial hypertension. Focus on ramipril and amlodipine

Abstract

In modern algorithms of arterial hypertension treatment, the main strategic approach aimed at increasing the therapy effectiveness is the use of fixed combinations (FC) of two antihypertensive drugs at the start of therapy and of three drugs (preferably in one tablet) when it is necessary to intensify pharmacotherapy. Starting therapy with two drugs in one tablet (FC) is recommended for more than 70 % of patients. The article provides up-to-date information on the choice of a fixed combination for the treatment of patients with arterial hypertension (AH) according to modern national and international recommendations. The place of a fixed combination of ramipril and amlodipine among antihypertensive drugs in achieving the goal of treating patients with arterial hypertension was determined. The advantages of the fixed combination of ramipril and amlodipine due to the wide range of indications and its effectiveness for patients with hypertension in combination with chronic kidney disease (CKD) and metabolic syndrome are discussed. The distinctive properties of the fixed combination of ramipril and amlodipine are emphasized: it allows achieving target values of blood pressure (BP), improves adherence to treatment, reduces the frequency of prescribing additional antihypertensive drugs, and increases patient satisfaction with treatment. In patients with diabetes mellitus and metabolic syndrome, the fixed combination of ramipril and amlodipine allows achieving target values of blood pressure, promotes adherence to treatment, reduces heart rate, improves biochemical parameters of lipid and carbohydrate metabolism and functional kidney indicators. Ramipril, along with perindopril, is widely prescribed for patients with arterial hypertension, and its combination with amlodipine can be considered the method of choice in arterial hypertension patients with diabetes mellitus, chronic kidney disease, and metabolic syndrome.