The effect of three-component antihypertensive treatment on the structural and functional state of the heart and daily blood pressure profile in patients with hypertension grade 3

Aim. To study the effect of a fixed combination of perindopril arginine (10 mg) + indapamide (2.5 mg) + amlodipine (5 mg) on the daily profile of blood pressure and the structural and functional state of the heart in patients with hypertension grade 3.

Methods. 80 patients with hypertension receiving various variants of treatment [50 patients (experimental group) receiving fixed combination of perindopril arginine (10 mg) + indapamide (2.5 mg) + amlodipine (5 mg) and 30 patients (control group) receiving combination of lisinopril with hydrochlorothiazide (10/12.5–20/25 mg) and amlodipine (5 mg)] underwent electrocardiography, Doppler echocardiography, daily monitoring of blood pressure at there points: at the beginning, after 2 weeks and 6 months of the treatment. Statistical significance of the indicators was determined by Student’s t-test. To compare the double changes, χ2 was used. Statistical difference between the groups was considered significant if p <0.05.

Results. In 86% of patients from the experimental group, a decrease in systolic blood pressure by 20 mm Hg or more and/or diastolic blood pressure by 10 mm Hg was noted, which persisted for 6 months. After 6 months of treatment, according to daily monitoring of arterial pressure, the average daily systolic and diastolic blood pressure significantly decreased by 15.9 and 18.6% (р <0.001), and the values of variability of average systolic and average diastolic pressure at night and daytime — by 4 and 4.2%, respectively (р <0.001). A decrease in the morning rise rate of systolic and diastolic blood pressure was also achieved (р <0.001). During treatment, a number of patients with a daily curve of the dipper type increased due to a decrease in non-dippers and night pickers (р <0.001).

Conclusion. Positive antihypertensive result after treatment with a combination of perindopril arqinine + indapamide + amlodipin was achieved in the early stages of treatment and was observed as a long-term stable hypotensive effect; a number of patients with normal daily rhythm of blood pressure increased, decrease of the severity of hypertrophy and size of the left ventricle was observed and its diastolic function became normal.