Ostroumova O D
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
Ter Arkh. 2017;89(8):29-36. doi: 10.17116/terarkh201789829-36.
To study the effect of a fixed-dose combination of perindopril arginine/amlodipine (prestans) on the goal levels and variability of blood pressure (BP) according to its office visit-to-visit measurements and self-measurement (OVVM and SM) in a subgroup of 483 people from the population of the Russian observational SUPERIORITY program, most cases of whom are given the combination replacing the previously ineffective mono- and combination antihypertensive therapy (AHT).
The subanalysis included data on 483 patients (34% men) aged 57.9±10.8 years with uncontrolled hypertension, who were both untreated and treated with antihypertensive mono- or combination therapy using a free or fixed-dose combination of 2-3 antihypertensive drugs and in whom the physicians decided to use prestans to correct AHT. The follow-up period was 24 weeks.
At the end of the investigation, the patients received prestans in the following doses: 5/5 mg (34% of the patients), 10/5 mg (39.5%), 5/10 mg (3.9%), and 10/10 mg (22%). In the analyzed patient group, the baseline BP was 160.8±8.8/92.6±7.4 mm Hg and dropped to 125.9±7.9/77.8±5.0 mm Hg at 24 weeks (p<0.001). According to SM, the morning BP significantly decreased from 147.0±13.3/85.6±7.2 to 127.5±8.3/78,9±5.6 mm Hg at 24 weeks (p<0.001). The evening BP readings showed the similar trends. Target BP was achieved in 93 and 78% of the patients, as shown by OVVM and SM, respectively. According to SCM, the day-to-day variability of BP significantly decreased from 5.1±3.2/3.4±2.3 Hg mm at Visit 2 to 2.7±2/0/2,3±1/5 mm Hg at Visit 5 (p<0.001).
The use of the fixed-dose combination of perindopril arginine/amlodipine in hypertensive patients just at the beginning of treatment, by switching from insufficiently effective mono- or combination AHT to the fixed-dose combination of perindopril arginine/amlodipine, is an effective way to optimize AHT in clinical practice, which lowers the BP level and variability, as evidenced by both OVVM and SM.
在俄罗斯观察性“优势”项目人群中的483人亚组中，根据诊室随诊测量和自我测量（OVVM和SM），研究培哚普利精氨酸/氨氯地平固定剂量复方制剂（prestans）对血压（BP）目标水平及变异性的影响。该亚组中的大多数病例接受该复方制剂以替代先前无效的单药及联合抗高血压治疗（AHT）。
该亚组分析纳入了483例（34%为男性）年龄57.9±10.8岁、高血压未得到控制的患者，这些患者未接受治疗或接受过使用2 - 3种抗高血压药物的自由或固定剂量复方制剂的单药或联合抗高血压治疗，且医生决定使用prestans来纠正抗高血压治疗。随访期为24周。
在研究结束时，患者接受的prestans剂量如下：5/5 mg（34%的患者）、10/5 mg（39.5%）、5/10 mg（3.9%）和10/10 mg（22%）。在分析的患者组中，基线血压为160.8±8.8/92.6±7.4 mmHg，在24周时降至125.9±7.9/77.8±5.0 mmHg（p<0.001）。根据自我测量，早晨血压在24周时从147.0±13.3/85.6±7.2显著降至127.5±8.3/78.9±5.6 mmHg（p<0.001）。夜间血压读数显示出类似趋势。分别通过诊室随诊测量和自我测量显示，93%和78%的患者达到了目标血压。根据自我测量，血压的日间变异性从第2次就诊时的5.1±3.2/3.4±2.3 mmHg显著降至第5次就诊时的2.7±2.0/2.3±1.5 mmHg（p<0.001）。
在治疗刚开始时，对高血压患者使用培哚普利精氨酸/氨氯地平固定剂量复方制剂，即从不充分有效的单药或联合抗高血压治疗转换为培哚普利精氨酸/氨氯地平固定剂量复方制剂，是临床实践中优化抗高血压治疗有效方法，这降低了血压水平及变异性，诊室随诊测量和自我测量均证明了这一点。
