I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Research Center of Neurology, Moscow, Russia.
Adv Ther. 2018 Oct;35(10):1698-1712. doi: 10.1007/s12325-018-0773-2. Epub 2018 Aug 20.
The objective of this study was to assess the impact of a single-pill combination (SPC) of perindopril/indapamide (PER/IND) at full doses (10/2.5 mg) on endothelial and cognitive function as a clinical intermediate marker of vascular improvement.
This open-label, uncontrolled, observational study enrolled 30 patients (20 females and 10 males) with grade II-III uncontrolled arterial hypertension (SBP/DBP ≥ 160/100 mmHg) and no evidence of cerebrovascular disease. All patients underwent assessment of macro- and microvascular endothelial function parameters at baseline and after 12 months of treatment with SPC PER/IND using photoplethysmography and video capillaroscopy. Cognitive function was assessed using the Montreal Cognitive Assessment scale (MoCA).
All patients (mean age 60.06 ± 10.19 years) were at high risk for cardiovascular events: mean body mass index (BMI) 31.2 ± 3.9 kg/m, 33% diagnosed with coronary artery disease angina class I, 30% with impaired glucose tolerance, and 7% with type 2 diabetes. Impaired endothelial function was observed at the both micro- and macrovascular levels. Endothelial function parameters improved after 12-month treatment with SPC PER/IND with an increase in occlusion index from 1.4 to 1.8 (P < 0.00005) and phase shift from 5.0 to 10.8 (P < 0.00001); all values achieved levels in the normal range. Resting capillary network density (CND) increased from 44.8 to 52 cap/mm (P < 0.00007), and CND after a venous occlusion test increased from 55 to 61 cap/mm (P < 0.006). Signs of cognitive impairment were present at baseline with a mean MoCA score of 23 (normal cognitive function score ≥ 26), but improved after 12-month treatment with a mean MoCA score of 27 (P< 0.0001). Treatment was well tolerated.
SPC PER/IND at full doses for 12 months improves endothelial function, structural and functional parameters of the microcirculation, as well as cognitive function in patients with arterial hypertension at high cardiovascular risk.
Les Laboratoires Servier.
本研究旨在评估培哚普利/吲达帕胺（PER/IND）单药治疗（全剂量 10/2.5mg）对内皮和认知功能的影响，内皮和认知功能作为血管改善的临床中间标志物。
这是一项开放、非对照、观察性研究，共纳入 30 名（20 名女性和 10 名男性）二级至三级未控制的动脉高血压患者（SBP/DBP≥160/100mmHg），且无脑血管疾病证据。所有患者均接受了光体积描记法和视频毛细血管镜检查，在基线时和使用培哚普利/吲达帕胺 SPC 治疗 12 个月后评估了宏观和微观血管内皮功能参数。认知功能采用蒙特利尔认知评估量表（MoCA）进行评估。
所有患者（平均年龄 60.06±10.19 岁）均有发生心血管事件的高风险：平均体重指数（BMI）为 31.2±3.9kg/m2，33%诊断为 I 级心绞痛的冠状动脉疾病，30%有糖耐量受损，7%患有 2 型糖尿病。在微血管和大血管水平均观察到内皮功能受损。使用培哚普利/吲达帕胺 SPC 治疗 12 个月后，内皮功能参数得到改善，闭塞指数从 1.4 增加到 1.8（P<0.00005），相位转移从 5.0 增加到 10.8（P<0.00001）；所有值均达到正常范围。静息毛细血管网络密度（CND）从 44.8 增加到 52cap/mm（P<0.00007），静脉阻塞试验后 CND 从 55 增加到 61cap/mm（P<0.006）。基线时存在认知障碍迹象，平均 MoCA 评分为 23 分（正常认知功能评分≥26 分），但经过 12 个月治疗后，平均 MoCA 评分提高到 27 分（P<0.0001）。治疗耐受性良好。
培哚普利/吲达帕胺全剂量治疗 12 个月可改善动脉高血压高心血管风险患者的内皮功能、微循环结构和功能参数以及认知功能。
赛诺菲。
