EFFECTIVE COMBINED THERAPY IN PATIENTS OF CHRONIK HEART FAILURE WITH HYPERTENSION: PP.1.33

Abstract

Objectives: Aim of the study was comparative assesment of hypertension and effect of left ventricular (LV) diastolic function of converting enzyme inhibitor, blockers of β adrenoreseptors and blockers of angiotensin 22 reseptors. Resistant hypertension (RH) is that specific condition where a pharmacological intervention a based combination of at least 3 antihypertensive drugs BP values. Methods: 104 patients with NYHA class 1 -2 CHF, LV ejection fraction <50%, with RH were included in investigation. Mean age of patients was 44 ± 15 years (57 males, 47 females) with RH treated with combained therapy whith was partly ineffective on BP control. The subjects were administered Ramipril 5 mg/day, Kandensartan 32 mg/day and Nebivolol 5 mg/day and were studied for 4 months. Those who still had no controled BP after 2 weeks were also administered hydrclorotiazide (HCTZ). During the study 26 subjects were administered HCTZ. Design of the study before and after the follow-up included: clinical measurement of BP; M-mode LV mass (g/m2) and B-mode common carotid artery distensibility were assed by ehography in 104 patients; ambulatory BP measurement (ABPM) during 24 hours;quality of life measurement through SF-12 questionnaire. Results: After 4 months follow-up subjects with hypertension showed: 1. BP:SBP- 188 + 19 vs mm Hg, 128 + 10 vs mm Hg (p < 0,01); DBP-114 + 8 vs, 82+8 vs mm Hg(p < 0,01). 2. Carotid doppler tissular imaging (DTI) velosity (Vmax) and carotid B-mode distensibility where lowest and PWV highest in patients with LVH. LV EF >50% in all patients. 3. After the investigation 79% of patients showed an improvement in quality of life rates. Conclusion: Combined therapy included 3 antihypertensive drugs:ramipril 5 mg/day, kandensartan 32 mg/day, nebivolol 5 mg/day shows a good effectivenes in patients NYHA class 1–2 CHF with RH and produses an improvement in the quality of life irrespective of gender, age duration and hypertension degree simultaneus DTI measurement of LV and common carotid wall motion velocity is easily performed and may be an indicator of the link between arterial stiffness and LV function.