Borisova E V, Kochetkov A I, Ostroumova O D
A. I. Yevdokimov Moscow State University of Medicine and Dentistry City Clinical Hospital named after E. O. Mukhin.
A. I. Yevdokimov Moscow State University of Medicine and Dentistry.
Kardiologiia. 2019 Apr 12;59(3):18-26. doi: 10.18087/cardio.2019.3.10236.
to investigate the impact of indapamide / perindopril single-pill combination (I / P SPC) on arterial stiffness parameters, blood pressure (BP) level and BP variability (BPV) in middle-aged patients with stage II grade 1-2 essential arterial hypertension (EAH). Materials and methods. We retrospectively formed a group of patients with stage II grade 1-2 EAH who had not previously received regular antihypertensive therapy (AHT) (n=52, mean age 52.9±6.0 years). All patients were treated with I / P SPC and all of them achieved target office BP level (less than 140 / 90 mm Hg). After 12 weeks of follow-up (from the time of reaching the target BP) assessment of AHT effectiveness (general clinical data, ambulatory blood pressure monitoring [ABPM], volume sphygmography, echocardiography), and vascular stiffness evaluation were performed.
At the end of follow-up office systolic BP (SBP), diastolic BP (DBP), pulse BP, day-time, night-time and 24‑hour SBP and DBP significantly (p<0.001 for all) decreased. According to the ABPM data day-time, nighttime, and 24‑hour systolic BPV significantly decreased (p=0.029, p=0.006 and p<0.001, respectively); day-time and 24‑hour diastolic BPV also significantly decreased (p=0.001 and p<0.001, respectively). Day-night standard deviation (SDdn) significantly decreased too (p=0.002 and p<0.001, respectively). Volumetric sphygmography showed significant decrease of right cardio-ankle vascular index (CAVI) (from 8.20±1.29 to 7.58±1.44, p=0.001) and of left CAVI (from 8.13±1.40 to 7.46±1.43, p<0.001), as well as reduction of the number o f patients with a right- and / or left-CAVI >9.0 (from 32.7 to 11.5 %, p=0.018). According to assessment of arterial stiffness using the Vasotens24 software package, the arterial stiffness index (ASI) significantly (p<0.001) decreased from 153.5±29.9 to 138.3±20.0 (by -9.2±13.1 %). Transthoracic echocardiography data demonstrated significant decrease (p<0.001) in effective arterial elastance (from 1.82±0.43 to 1.58±0.36 mm Hg; by -11.85±16.29 %) and significant (p<0.001) increase in the arterial compliance - from 1.27±0.34 to 1.54±0.38 mm Hg / ml (+26.95±38.06 %).
In AHT naive patients 40-65 years old with stage II grade 1-2 EAH therapy with I / P SPC provided effective 24‑hour BP control, reduced BPV and improved arterial stiffness parameters.
探讨吲达帕胺/培哚普利单片复方制剂（I/P SPC）对中年II期1-2级原发性高血压（EAH）患者动脉僵硬度参数、血压（BP）水平及血压变异性（BPV）的影响。材料与方法。我们回顾性地选取了一组此前未接受过正规降压治疗（AHT）的II期1-2级EAH患者（n = 52，平均年龄52.9±6.0岁）。所有患者均接受I/P SPC治疗，且所有患者均达到诊室血压目标水平（低于140/90 mmHg）。在随访12周后（从达到目标血压时起），对AHT疗效（一般临床数据、动态血压监测[ABPM]、容积脉搏波描记法、超声心动图）进行评估，并进行血管僵硬度评估。
随访结束时，诊室收缩压（SBP）、舒张压（DBP）、脉压、日间、夜间及24小时SBP和DBP均显著降低（所有p<0.001）。根据ABPM数据，日间、夜间及24小时收缩压变异性显著降低（分别为p = 0.029、p = 0.006及p<0.001）；日间及24小时舒张压变异性也显著降低（分别为p = 0.001及p<0.001）。昼夜标准差（SDdn）也显著降低（分别为p = 0.002及p<0.001）。容积脉搏波描记法显示右心踝血管指数（CAVI）显著降低（从8.20±1.29降至7.58±1.44，p = 0.001），左CAVI也显著降低（从8.13±1.40降至7.46±1.43，p<0.001），且右和/或左CAVI>9.0的患者数量减少（从32.7%降至11.5%，p = 0.018）。根据使用Vasotens24软件包对动脉僵硬度的评估，动脉僵硬度指数（ASI）显著降低（p<0.001），从153.5±29.9降至138.3±20.0（降低了-9.2±13.1%）。经胸超声心动图数据显示有效动脉弹性显著降低（p<0.001）（从1.82±0.43降至1.58±0.36 mmHg；降低了-11.85±16.29%），动脉顺应性显著增加（p<0.001）（从1.27±0.34升至1.54±0.38 mmHg/ml（增加了+26.95±38.06%）。
在40-65岁未接受过AHT的II期1-2级EAH患者中，I/P SPC治疗可实现有效的24小时血压控制，降低BPV并改善动脉僵硬度参数。
