FIXE FULL-DOSE COMBINATION PERINDOPRIL/INDAPAMIDE/AMLODIPINE IN SEVERE DIABETIC HYPERTENSIVES

Abstract

Objective: Hypertension is worldwide spread and represents the leading cause of death. Diabetes rich epidemic levels in global population. Hypertension and diabetes are frequently present in the same patient and represents independent cardiovascular risk factors. Both hypertension and diabetes are associated with left ventricular hypertrophy and diastolic dysfunction. New ESC/ESH 2018 guidelines suggest the use of fixed-dose combination from the beginning of therapy, better in a single tablet, witch improves adherence. The most rationale combinations appear to be a blocker of renin-angiotensin system, a calcium antagonist and a diuretic. The aim of our study was to evaluate the efficacy of fix full-dose combination perindopril/indapamide/amlodipine 10/2.5/10 mg on blood pressure, left ventricular hypertrophy, and diastolic dysfunction in patients with grade 3 hypertension and type2 diabetes. Design and method: We performed a prospective study, lasting 3 months, in which 28 grade 3 hypertensives with type 2 diabetes, medium age 58 ± 10 years, received once a day, fix full-dose combination perindopril/indapamide/amlodipine 10/2.5/10 mg. Office blood pressure was measured at baseline, 1 month and 3 months. Left ventricular echocardiographic parameters ware assessed at baseline and after 3 months of treatment. We rated patient general condition or well-being as excellent, improved, appropriate or worse at baseline and after 3 months. Results: Both systolic (182 ± 16 vs 138 ± 11 mmHg, p < 0.01) and diastolic (112 ± 8.5 vs 84 ± 7 mmHg, p < 0.01) BP were significantly reduced. 85.71% of the patients reached blood pressure target. LVMI was decreased from155 ± 29 to 132.5 ± 18.9 g/m2 (p < 0.001). E/A ratio increased from 0.86 ± 0.21 to 1.27 ± 0.3 (p < 0.001). After 3 months of therapy, patient well-being was rated as excellent in 53.57%, improved in 35.72%, appropriate in 10.71% and worse in 0%. Conclusions: Treatment with fix full-dose combination perindopril/indapamide/amlodipine 10/2.5/10 mg in grade 3 hypertensives with type 2diabetes proved a good control of blood pressure, riched the therapeutic target, and was accompanied by regression of cardiac hypertrophy and improvement in left ventricular diastolic function. Treatment was well tolerated.