EFFECTIVENESS OF FIXED COMBINATION OF PERINDOPRILARGININE AND AMLODIPINE FOR THE TREATMENT OF ARTERIAL HYPERTENSION WITH CONCOMITANT CHRONIC CARDIAC INSUFFICIENCY AND SIGNS OF CHRONIC KIDNEY DISEASE

• Published in: Klinicheskaia meditsina Vol. 93; no. 7; p. 62
• Main Authors: Kuznetsova, T E, Borovkova, N Yu
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2015
• Subjects: Aged; Amlodipine - administration & dosage; Amlodipine - adverse effects; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - adverse effects; Blood Pressure - drug effects; Drug Combinations; Drug Monitoring; Female; Follow-Up Studies; Heart Failure - complications; Heart Failure - physiopathology; Humans; Hypertension - complications; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - physiopathology; Kidney Function Tests - methods; Male; Middle Aged; Perindopril - administration & dosage; Perindopril - adverse effects; Prospective Studies; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - physiopathology; Russia; Severity of Illness Index; Treatment Outcome; Russia
• ISSN: 0023-2149

to study effectiveness of a fixed combination of perindopril arginine and amlodipine besylate for the treatment of arterial hypertension with concomitant chronic cardiac insufficiency and signs of chronic kidney disease Materials and methods: 53 (44.9%) patients aged 64.5±8.2 yr with signs of chronic kidney disease (CKD) were selected from 118 subjects with grade II-III essential AH and chronic cardiac insufficiency They had an increased blood cystatin C level (mean 1.4±0.3 mg/l) and/or decreased glomerular filtration rate (GFR) calculated by 3 formulas: 77.6±15.9 (MDRD), 79.3±17.1 (CKD-EPI) and 57.7±15.2 ml/min/1. 73 m3 (from cystatin C level). Fixed combinations of perindopril arginine and amlodipine besylate (5/5, 5/10, 10/10 mg) were used to treat the patients. Their effectiveness was evaluated 2 months after the onset of therapy based on results of AP measurement, 24 hr AP monitoring, assessment of clinical conditions and 6 min walk test. Blood creatinine, urea and cystatin C levels and GFR were measured.
Target AP was achieved in 82.6% of the patients. Systolic AP (SAP) decreased significantly from 172±11.2 to 135.7±8.2 mmHg (p<0.01), diastolic AP (DAP)from 110±6.9 to 85.3±7.2 mm Hg (p<0.5). Mean daily SAP and DAP decreased by 14.7 and 14.4% respectively. SAP and DAP load also decreased Clinical conditions estimated in terms of the CCI functional class improved (a decrease from 6.2±1.1 to 4.2±1.3 scores (p<0.01)). Tolerance of physical activity increased from 157.2±12.6 to 320.4±32.2 m (p<0.05). Blood cystatin C level decreased and GFR increased.
The fixed combination of perindopril arginine and amlodipine besylate ensures high therapeutic effect in patients with arterial hypertension and concomitant chronic cardiac insufficiency having signs of chronic kidney disease.