Perindopril Research Articles

Fixed dose combinations for the treatment arterial hypertension: the real way to improve control

Insufficient control of blood pressure levels of the essential hypertension in Russia (less than 30% for women, less than 20% for men) was proven by epidemiology trials. This article is a review of the present opportunities to increase efficacy of treating hypertension by application of combined anti-hypertensive therapy and the advantages of fixed dose combinations (FDC). The authors scientifically prove the importance of using the combination, including angiotensin I-converting enzyme perindopril arginine and the long-half time dihydropyridine calcium channel blocker amlodipine in various clinical cases. Also the article summarizes the research of real clinical practice proving the high efficiency and safety of perindopril arginine /amlodipine FDC.

Perindopril/amlodipine (Prestalia(®)): a review in hypertension.

Perindopril, an ACE inhibitor, and amlodipine, a dihydropyridine calcium channel blocker, are established antihypertensive agents with complementary mechanisms of action. Recently, a once-daily, orally-administered, fixed-dose combination (FDC) of perindopril arginine plus amlodipine besylate (Prestalia(®); hereafter referred to as perindopril/amlodipine FDC) was approved in the USA for the treatment of hypertension. This article reviews the efficacy and tolerability of perindopril/amlodipine FDC and briefly summarizes the agent's pharmacologic properties. As demonstrated in short-term randomized controlled trials, perindopril/amlodipine FDC was significantly more effective in reducing blood pressure (BP) than monotherapy with either of the component drugs, and it appeared to be more effective than an up-titration scheme using valsartan and valsartan/amlodipine. The FDC agent was generally well tolerated, with the most common adverse events (peripheral edema, cough, headache, and dizziness) being consistent with the well-defined tolerability profiles of the individual component drugs. Furthermore, perindopril/amlodipine FDC was associated with a numerically lower incidence of peripheral edema compared with amlodipine monotherapy. Thus, perindopril/amlodipine FDC represents a useful option for the treatment of hypertension, including as initial therapy for patients likely to require multiple drugs to achieve their BP targets.

Novel ratio difference at coabsorptive point spectrophotometric method for determination of components with wide variation in their absorptivities

Different methods have been introduced to enhance selectivity of UV-spectrophotometry thus enabling accurate determination of co-formulated components, however mixtures whose components exhibit wide variation in absorptivities has been an obstacle against application of UV-spectrophotometry. The developed ratio difference at coabsorptive point method (RDC) represents a simple effective solution for the mentioned problem, where the additive property of light absorbance enabled the consideration of the two components as multiples of the lower absorptivity component at certain wavelength (coabsorptive point), at which their total concentration multiples could be determined, whereas the other component was selectively determined by applying the ratio difference method in a single step. Mixture of perindopril arginine (PA) and amlodipine besylate (AM) figures that problem, where the low absorptivity of PA relative to AM hinders selective spectrophotometric determination of PA. The developed method successfully determined both components in the overlapped region of their spectra with accuracy 99.39±1.60 and 100.51±1.21, for PA and AM, respectively. The method was validated as per the USP guidelines and showed no significant difference upon statistical comparison with reported chromatographic method.

Лечение артериальной гипертензии у больных хронической сердечной недостаточностью с признаками хронической болезни почек комбинированным препаратом периндоприла аргинина и амлодипина

to assess efficacy of a fixed combination of perindopril arginine and amlodipine besylate in the treatment of hypertensive patients with chronic heart failure (CHF) and signs of chronic kidney disease (CKD).Persons with CKD (n = 53, age 64.5 ± 8.2 years) were selected from 118 patients with grade 2-3 essential hypertension with CHF. Presence of CKD was confirmed by elevated blood levels of cystatin C and lowered glomerular filtration rate (GFR). Used doses of fixed perindopril/amlodipine combination were 5/5, 5/10, 10/10 mg. Efficacy was assessed after 2 months of therapy on the basis of results of the examination which included clinical blood pressure (BP), BP monitoring, 6-min walk test. Blood levels of creatinine, urea, cystatin C and GFR were also measured.Target BP was achieved in 92.6% of patients. Clinical BP was significantly decreased. Daily average systolic BP decreased by 14.7%, diastolic BP--by 14.4%. Systolic and diastolic BP load also decreased. Clinical condition improved. Tolerance to physical work increased. Level of cystatin C significantly decreased while GFR increased.Fixed perindopril/amlodipine combination produced good therapeutic effect in hypertensive patients with CHF and CKD.

Efficacy and safety of perindopril arginine + amlodipine in hypertension

To study the efficacy and safety of a new combination of perindopril arginine and amlodipine besylate, 837 subjects were enrolled in a three–arm, prospective, 59–center, randomized clinical trial. For 42 days, subjects (average seated blood pressure [BP], 158 ± 12/101 ± 5 mm Hg; age, 52 ± 10 years; 52% male; 34% black; 20% diabetic) received amlodipine/perindopril arginine (10/14 mg/d), perindopril erbumine (16 mg/d), or amlodipine (10 mg/d). Goal BP was <140/90 or <130/80 mm Hg in diabetics, per JNC 7 guidelines. The combination showed the largest change in seated BP (−23.7/−15.7 vs. −13.7/−9.5 vs. −19.3/−13.2 mm Hg, respectively; P < .0001), the highest proportion at goal BP (51% vs. 26% vs. 37%; P < .0001), and a lower incidence of pedal edema and adverse events compared with amlodipine. No deaths or significant differences across groups in early discontinuation, serum potassium, or rates of total or serious adverse events or glomerular filtration, were observed.

Rationale for a single-pill combination of perindopril arginine and amlodipine besylate

A systematic review identified 86 outcome–based clinical trials involving perindopril, amlodipine, or other antihypertensive drugs. In fixed–effects meta–analyses of 11 clinical trials (90,208 subjects), amlodipine was associated with a significant 24% increase in heart failure, but a significant decrease in death, cardiovascular death, stroke, coronary heart disease, and first major cardiovascular adverse event. In five clinical trials (52,565 subjects), perindopril was associated with a significant reduction in all six cardiovascular endpoints. Network and Bayesian meta–analyses suggested that (with the exception of amlodipine and heart failure), each agent was at least as effective as an initial diuretic to prevent these events. Short–term trials have demonstrated that the combination of perindopril and amlodipine is safe and effective, with statistically greater lowering of blood pressure than either agent alone and a potential synergistic effect on pedal edema. The single–pill combination of perindopril and amlodipine may be a useful addition to the antihypertensive armamentarium.

Фиксированные комбинации в лечении артериальной гипертензии – реальный путь улучшения контроля артериального давления

Insufficient control of blood pressure levels of the essential hypertension in Russia (less than 30% for women, less than 20% for men) was proven by epidemiology trials. This article is a review of the present opportunities to increase efficacy of treating hypertension by application of combined anti-hypertensive therapy and the advantages of fixed dose combinations (FDC). The authors scientifically prove the importance of using the combination, including angiotensin I-converting enzyme perindopril arginine and the long-half time dihydropyridine calcium channel blocker amlodipine in various clinical cases. Also the article summarizes the research of real clinical practice proving the high efficiency and safety of perindopril arginine /amlodipine FDC.

IMPROVEMENT OF AMLODIPINE CONTROL EFFICACY OVER HYPERTENSION USING FIXED COMBINATION OF PERINDOPRIL ARGININE AND AMLODIPINE

Aim. To evaluate possibilities of hypertension control improvement using fixed combination of perindopril arginine and amlodipine. Material and methods. Totally 46 patients studied (25 men, 21 women of the age 53,6±4,3y.)with arterial hypertension 2-3 grade. All patients underwent ABPM with analysis of the following: mean 24-hour BP, velocity of morning SBP and DBP rise, BP variability of Ps BP (VPsBPd, VPsBPn). The criteria of inclusion were insufficient control over hypertension while using free combinations of ACE inhibitor or angiotensin II receptor blockers and diuretic or calcium channel blocker. To control arterial hypertension all patients were prescribed the fixed combination of perindopril arginine/amlodipine it standard dosage 10/5 mg (Prestans, Les Laboratories Servier, France) with further possible increase of dosage up to 10/10 mg. Results. While receiving the therapy 84,7% patients reached BP. Mean 24-hour SBP decreased from 139,24±1,8to 121,13+1,22 mmHg (p<0,05), DBP decreased from 84,51±2,08 to 73,14±1,4 (p<0,05), mean BP decreased from 103,07±1,56 to 87,66±1,13 (p<0,05). 24-hour variability of SBP significantly decreased from 15,28±0,72 to 10,21±0,42 (p<0,05), DBP from 13,46±0,72 to 10,72±0,31 (p<0,001). Values of VMR after the treatment also decreased. Before treatment VMR of SBP was 27±3,26 mmHg/hour, on therapy — 15,3±5,04 mmHg/hour, (p<0,01); the same for DBP — VMR decreased from 23,6±2,37 mmHg/hour to 11±1,62mmHg, (p<0,01). Conclusion. The usage of combined perindopril arginine/amlodipine in patients with former uncontrolled arterial hypertension at the background of free chosen antihypertensive drugs combinations succeeded in the target BP values achievement in 84,7% cases. The reached control over BP was successful daily and during the night, as over variability of BP and velocity of morning BP rise. Usage of fixed combination of perindopril arginine/amlodipine was marked with good tolerability and high patients' compliance.

Efficiency of “Noliprel A Bi-forte” in male elderly population with chronic obstructive pulmonary disease and concomitant hypertension

Background. Chronic obstructive pulmonary disease (COPD) and hypertension (HTN) are linked to each other by different associated factors which are playing an important role in their clinical course and progression. “Pulmonigenic” mechanisms of HTN in COPD are discussed due to the frequent onset of HTN few years after the first clinical presentations of COPD and due to the association between blood pressure (BP) elevation and exacerbation of pulmonary disease with progression of bronchial obstruction and hypoxemia worsening. Design and methods. Our study group consisted of 30 male patients (mean age 62,4 ± 4,2 years) with COPD and concomitant HTN. The control group was formed by 30 male hypertensive patients (mean age 63,7 ± 3,9 years). The higher rate of patients with concomitant COPD and HTN demonstrated adverse BP daily profile «nightpeakers» than in control group. This might be an additional risk factor for cardiovascular complications such as a myocardial infarction and a brain stroke. The search for combinations of antihypertensive drugs not influencing the bronchial patency and having longer antihypertensive effect duration is ongoing in order to reduce the risk of complications. In our study “Noliprel A Bi-Forte” was an investigational drug (Perindopril Arginine 10 mg and Indapamide 2,5 mg). Administration of a single dose “Noliprel A Bi-Forte” led to a reliable BP decrease and stabilization according to the results of daily BP monitoring. Serious adverse effects were not registered during the study.

First results of the Russian database of international prospective observational registry variability of blood pressure in patients with hypertension

The article presents the results of an analysis of the Russian part of the international registry of variability in blood pressure. It is shown that in a real clinical practice antihypertensive therapy reduces inter-visit variability of systolic and diastolic blood pressure. It has been found that the fixed combination of perindopril arginine / amlodipine has antihypertensive effect and its impact on the variability of systolic blood pressure exceeds that for other modes of antihypertensive therapy. Revealed patterns are characteristic also for subgroups of patients with a combination of hypertension and coronary heart disease, hypertension and diabetes.

The impact of fixed combination of amlodipine and perindopril (drug Prestance)on the mechanisms of heat adaptation in patients with arterial hypertension

Relevance. The impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions, concerning heat waves, recent years. One of the points at issue is safety administration of calcium channel antagonists and ACE inhibitors during abnormal heat.Aim of the study is to assess the efficacy and safety of the fixed combination of perindopril arginine (drug Prestance, Servier Industries, Ltd.)/amlodipine in patients with arterial hypertension (AH) during the summer heat and the summer heat influence on the mechanisms of heat adaptation to abnormally high temperature.Material and methods: The study enrolled 165 patients with stages 1-2 AH: 69 patients with average risk and 91 patients with high/very high risk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, undergoing biochemical analysis of blood, running questionnaire survey: visual analogue scale (VAS), questionnaire for the patients who were exposed to heat, the level of products reacting with the 2-thiobarbituric acid (malonyldialdehyde, MDA) and activity of superoxide dismutase (SOD) using standard test-kits and the pulse ware velocity (PWV) was measured in 30 patients. The first visit was in the first half of June 2013, the second visit - during the heat (July 2013) and the third one in September 2013.Results: In the course of the study SBP (systolic BP) and DBP (diastolic BP) were reduced (р

Interactions between levetiracetam and cardiovascular drugs against electroconvulsions in mice

BackgroundHypertension and heart failure belong to common comorbid conditions with epilepsy so drug interactions between antiepileptics and cardiovascular drugs are possible in clinical practice. The aim of this study was to evaluate the effects of angiotensin AT1 receptor antagonists (losartan potassium and candesartan cilexetil), angiotensin-converting enzyme (ACE) inhibitors (captopril and perindopril arginine) and diuretics (hydrochlorothiazide and ethacrynic acid) on the anticonvulsant activity of levetiracetam (LEV) in mice. MethodsThe protective action of LEV was examined in the maximal electroshock seizure threshold test. Drugs were administered intraperitoneally (ip). Additionally, combinations of cardiovascular drugs with LEV were tested for adverse effects in the passive avoidance task and the chimney test. ResultsLosartan potassium (50mg/kg), candesartan cilexetil (8mg/kg), captopril (50mg/kg), hydrochlorothiazide (100mg/kg) and ethacrynic acid (100mg/kg) did not affect the anticonvulsant activity of LEV. Perindopril arginine (10mg/kg) raised the convulsive threshold for LEV administered at doses of 100, 300 and 500mg/kg. This interaction could be pharmacodynamic in nature because the brain concentration of LEV remained unchanged by perindopril. The adverse effects of the combined treatment with LEV and cardiovascular drugs were not observed in the passive avoidance task or the chimney test. ConclusionsAlthough experimental data can be hardly extrapolated to clinical practice, it is suggested that perindopril arginine may positively influence the anticonvulsant action of LEV in epileptic patients. The use of losartan potassium, candesartan cilexetil, captopril, hydrochlorothiazide or ethacrynic acid in patients treated with LEV seems neutral regarding its anticonvulsant activity.

Efficacy and safety of amlodipine and perindopril (Prestance) fixed combination in patients with arterial hypertension during the summer heat

Relevance. Impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions in recent years. One of the points at issue is safety calcium channel antagonists and ACE inhibitors treatment during abnormal heat. The aim of the study is to investigate the efficacy and safety of perindopril arginine (drug Prestance - Servier Industries, Ltd.) and amlodipine fixed combination in arterial hypertension (AH) patients during the summer heat and the summer heat influence on the adaptation mechanisms to abnormally high temperatures.Materials and methods. The study enrolled 165 patients with stages 1 and 2 AH: 69 patients with average risk and 91 patients with high andvery-highrisk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, biochemical blood assay and hematocrit and were running questionnaire survey: visual analogue scale (VAS), Morisky-Green test and questionnaire for the patients who were exposed to heat. Pulse ware velocity was measured in 30 patients. The first visit was done in the first half of June 2013, the second visit - during the heat (July 2013), the third one in September 2013. Results. In the course of the study systolic (SBP) and diastolic BP (DBP) were reduced (р

Development and in vitro/in vivo evaluation of immediate release perindopril tablets

Perindopril erbumine (PE) is a BCS (Biopharmaceutics Classification System) class 3 drug with high solubility and low permeability. It is an inhibitor of the enzyme that converts angiotensin I (Angiotensin Converting Enzyme, ACE) into angiotensin II as well as causing the degradation of the vasodilator bradykinin into an inactive heptapeptide. The aim of this study was to develop an alternative drug product by using a different salt of perindopril and to evaluate the bioequivalence between PE, not still licensed, and perindopril arginine (PA), licensed in many countries, and to prepare PE tablets by using direct compression method. Many different formulations were prepared, among which F3-coded formulation was only selected due to releasing of 98.03% active substance at 45th minute. Bioequivalence study was planned as a cross-designed, randomized, open-labeled, single-dose, single-center study and conducted in 24 male healthy volunteers via peroral route. The results of bioequivalence study were evaluated for Perindopril and Perindoprilat according to Cmax, tmax and AUC criteria. The geometric mean ratios (90% CI) of perindopril and perindoprilat followed test and reference drug were calculated for AUC0–t and Cmax, 105.946% (100.218–112.002%) and 110.437% (102.534–118.948%); 109.542% (98.364–121.992%) and 115.729% (101.031–132.565%), respectively. The 90% confidence intervals of them were found within the standard bioequivalence range (80–125%).

To evaluate the clinical curative effect of meglumine adenosine cyclophosphate combined with perindopril on patients with chronic congestive heart failure

Objective To explore the relationship of plasma NT-proBNP level and severity of chronic congestive heart failure (CHF) and investigate the curative effect and security of meglumine adenosine cyclophosphate (MAC) combined with perindopril on patients with CHF.Methods From June 2011 to June 2013,126 inpatients with chronic congestive heart failure were randomly divided into A group (42 cases,routine therapy),B group (41 cases,routine therapy and perindopril) and C group (43 cases,routine therapy and perindopril plus MAC),all cases treated for 14 days.The left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) by echocardiography and plasma NT-proBNP levels were evaluated before and after 14 days therapy.Results The plasma NT-proBNP levels in NYHA Ⅱ ～ Ⅳ classes were significantly difference compared each other between any two classes (P ＜0.05) and the levels was positively correlated with NYHA cardiac function class and LVEDD (r =0.617,P ＜ 0.01 ; r =0.412,P ＜ 0.01),negatively correlated with LVEF (r =-0.372,P ＜ 0.01).After 14 days therapy,compared with A group,the LVEF and LVEDD significantly improved (P ＜ 0.05) and NT-proBNP level significantly decreased (P ＜ 0.05) in B,C groups; Compared with B group,C group had lower NT-proBNP level (P ＜ 0.05) although no further improvement in cardiac function.Conclusions The plasma NT-proBNP level is correlated closely with the severity of CHF and it is a good examination of diagnose,therapy and evaluating prognosis of CHF.Perindopril may significantly decline plasma NT-proBNP level and improve cardiac function of CHF patients,combined with MAC may further decline plasma NT-proBNP level although not further improved LVEF.Giving MAC and perindopril to patients with CHF was secure and patients tolerated it well. Key words: Melamine adenosine cyclophosphate; Perindopril; N-terminal pro-brain natriuretic peptide; Congestive heart failure

Efficacy and safety of perindopril arginine + amlodipine in hypertension

Electronic, magnetic and transport properties of a triangle graphene quantum dot have been studied in the presence of Rashba type spin–orbit coupling. The non-interacting part is written in the tight-binding model, and we use the Kene–Mele–Hubbard (KMH) Hamiltonian to describe the electron–electron and the Rashba spin–orbit interaction. While the Hubbard term split the spin up and down states, the Rashba term mixed these states. The competition between these two effects produces an interesting situation in a nano-device. Our results indicate that the magnetization of zigzag edge and spin coherence are decreased due to the Rashba spin–orbit interaction in the triangle graphene quantum dot. It is shown that the reduction of spin coherence is non-negligible even in the case of weak Rashba spin–orbit interaction.

Evaluation of nutritional and biochemical parameters in spontaneously hypertensive rats following antihypertensive treatment

One side effect of antihypertensive drugs is their impact on nutritional status and metabolism. The purpose of this study was to assess the nutritional and biochemical parameters in spontaneously hypertensive rats following treatment with antihypertensive drugs. The experiment was performed on 50 male spontaneously hypertensive rats (SHR), which were assigned to five groups: control (C), with perindopril (PR), with metoprolol (MT), with indapamide (ID), and with amlodipine (AM). All rats were provided ad libitum standard diet (with or without drugs) and distilled water. After 45 days, the animals were weighed and killed. Liver, kidney, heart, spleen, pancreas, and blood samples were collected. Concentrations of glucose, cholesterol, triglycerides, and albumin were assayed in serum. Morphology parameters, such as white blood cell, red blood cell, hematocrit, and lymphocyte counts were measured in the blood. Blood pressure was measured using a tail-cuff plethysmograph. The results obtained indicate that the hypotensive drugs under investigation had no effect on the selected nutritional parameters. Perindopril significantly decreased the relative mass of the heart and amlodipine markedly decreased the relative mass of the pancreas. A markedly higher concentration of glucose in the group with indapamid, and a significantly lower concentration of triglycerides in the group with metoprolol, were observed. Indapamide and amlodipine markedly increased the value of red blood cells and hematocrit in the blood of SHR. Long-term therapy with antihypertension drugs may influence tissue mass and biochemical and morphological status in the body.

Первые результаты российской базы данных международного проспективного наблюдательного регистра вариабельности артериального давления у пациентов с артериальной гипертонией

The article presents the results of an analysis of the Russian part of the international registry of variability in blood pressure. It is shown that in a real clinical practice antihypertensive therapy reduces inter-visit variability of systolic and diastolic blood pressure. It has been found that the fixed combination of perindopril arginine / amlodipine has antihypertensive effect and its impact on the variability of systolic blood pressure exceeds that for other modes of antihypertensive therapy. Revealed patterns are characteristic also for subgroups of patients with a combination of hypertension and coronary heart disease, hypertension and diabetes.

Влияние фиксированной комбинации амлодипина и периндоприла (препарат Престанс) на механизмы тепловой адаптации у больных артериальной гипертонией

Relevance. The impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions, concerning heat waves, recent years. One of the points at issue is safety administration of calcium channel antagonists and ACE inhibitors during abnormal heat.Aim of the study is to assess the efficacy and safety of the fixed combination of perindopril arginine (drug Prestance, Servier Industries, Ltd.)/amlodipine in patients with arterial hypertension (AH) during the summer heat and the summer heat influence on the mechanisms of heat adaptation to abnormally high temperature.Material and methods: The study enrolled 165 patients with stages 1-2 AH: 69 patients with average risk and 91 patients with high/very high risk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, undergoing biochemical analysis of blood, running questionnaire survey: visual analogue scale (VAS), questionnaire for the patients who were exposed to heat, the level of products reacting with the 2-thiobarbituric acid (malonyldialdehyde, MDA) and activity of superoxide dismutase (SOD) using standard test-kits and the pulse ware velocity (PWV) was measured in 30 patients. The first visit was in the first half of June 2013, the second visit - during the heat (July 2013) and the third one in September 2013.Results: In the course of the study SBP (systolic BP) and DBP (diastolic BP) were reduced (р<0,00001), target level of SBP and DBP reached 73,9% (41,9% - the second visit).We observed the increase of VAS scores, hyperkalemia (р=0,0056), hyponatremia (р=0,00042), hypocreatinemia (р=0,018), hypocholesterolemia (р<0,00001), hypotrigliceridemia (р=0,027), hypoglucosemia (р=0,0035). We were observing the reduction of PWV and of the characteristics of oxidative stress (MDA, р<0,0001 and MDA/ SOD, р<0.001) during the peak of the heat, during the 3ed visit. Conclusion: Prestance therapy during the summer heat showed efficacy and safety and was well tolerated by AH patients without any signs of hypotension and electrolyte imbalance which were attributed to body heat. The improvement of adaptive human body response was associated with effective arterial elastance and reduction of oxidative stress.

Оценка эффективности и безопасности фиксированной комбинации амлодипина и периндоприла (препарат Престанс) у больных артериальной гипертензией во время летней жары

Relevance. Impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions in recent years. One of the points at issue is safety calcium channel antagonists and ACE inhibitors treatment during abnormal heat. The aim of the study is to investigate the efficacy and safety of perindopril arginine (drug Prestance - Servier Industries, Ltd.) and amlodipine fixed combination in arterial hypertension (AH) patients during the summer heat and the summer heat influence on the adaptation mechanisms to abnormally high temperatures.Materials and methods. The study enrolled 165 patients with stages 1 and 2 AH: 69 patients with average risk and 91 patients with high andvery-highrisk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, biochemical blood assay and hematocrit and were running questionnaire survey: visual analogue scale (VAS), Morisky-Green test and questionnaire for the patients who were exposed to heat. Pulse ware velocity was measured in 30 patients. The first visit was done in the first half of June 2013, the second visit - during the heat (July 2013), the third one in September 2013. Results. In the course of the study systolic (SBP) and diastolic BP (DBP) were reduced (р<0,00001) and the SBP and DBP target level reached 73,9% (41,9% - durig the second visit). We observed the increase of VAS and Morisky-Green test scores from 2,24±1,43 (Ме 2,0) to 3,26±0,91 (the 2ed visit) and to 3,49±0,91 (Ме 4,0) (3ed visit), hyperkalemia (р=0,0056), hyponatremia (р=0,00042), hypocreatinemia (р=0,018), hypocholesterolemia (р<0,00001), hypotrigliceridemia (р=0,027), hypoglucosemia (р=0,0035). We noted pulse ware velocity and hematocrit reduction (the 3ed visit). Conclusion. Therapy of Prestance was effective, safe and well tolerated by AH patients during the summer heat without any sings of hypotension and electrolyte imbalance which were attributed to bodyheat. Improvement of adaptive response in the human body was associated with effective arterial elastance and reduction in blood viscosity.