PP.21.10

Abstract

Objective: To compare cardiovascular outcomes depending on the albuminuria decrease due to combined antihypertensive therapy. Design and method: 59 patients with arterial hypertension (AH) 2–3 degrees were included in prospective study. We constructed a Markov model on the basis of the influence on albuminuria(AU) and glomerular filtration rate (GFR) and the results of a cohort study, containing the most comprehensive information on the incidence of cardiovascular hypertension complications and mortality depending on these parameters. As an alternative to the model were: the treatment of the original fixed combination of valsartan / amlodipine and generic free combination of losartan / amlodipine. Results: Antihypertensive drugs for 12 weeks allowed to firm decrease in urinary albumin excretion in both groups, with 19,2 ± 22,6 to 7,8 ± 9,9 ml / min / m2 (p < 0.05) in group V/A a and 17,6 ± 19,8 to 12,7 ± 14,6 (p < 0.05) in the L /A. There were obtained significant group differences in the more pronounced reduction of albuminuria due to influence of drugs B/A -44,8 ± 44,4 vs. -20,5 ± 31,6 (p < 0.05). Significant changes in GFR (increase) in the treatment from 74 ± 16,8 to 78,8 ± 16,2 (p < 0.05) were obtained in the group B/A. In group L/A showed a slight decline in GFR (74 ± 19,7 and 73,2 ± 16,2, respectively). In the modeling results was obtained that the death chance within 5 years in group B/A will be 81 per 1,000 people, in the groupL/A - 96 by 1000. The probability of stroke - 27 and 32 per 1,000 people; infarction - 54 and 61 respectively. That is a fixed combination therapy original V/A avoids 15 deaths, 5 strokes and 7 myocardial infarctions for every 1,000 patients. Conclusions: So that more pronounced nephroprotective effect of original fixed combination of V/A can further prevent fatal and non-fatal cardiovascular events.