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Fixed combination of highly selective β-adrenoblocker bisoprolol and calcium antagonist amlodipine (Concor® AM) for arterial hypertension treatment in metabolic disorder patients

Abstract

Introduction. Combination therapy is widely used in treatment of patients with arterial hypertension (AH) of high and very high cardiovascular risk. Fixed combinations (FC) of medications are preferable and it is important to develop new effective and safe ones. Organ-protective effects are also significant. Objective. To study antihypertensive effectiveness of new FC of highly selective β-adrenoblocker bisoprolol and calcium antagonist amlodipine (Concor® AM), its influence on cardiometabolic risk factors and target lesions in metabolic disorder patients with AH of stages 1 or 2. Materials and methods. The study included 30 patients (13 male, 17 female, mean age 47.20±0.22 years) with AH of stages 1 or 2 and metabolic syndrome (MS). All patients underwent clinical assessment of blood pressure (BP); levels of serum cholesterol (SCL), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride, creatinine, and glucose in oral glucose tolerance test; 24-hour blood pressure monitoring; central systolic blood pressure (CSBP); carotid-femoral pulse wave velocity (cfPWV), and intima-media complex thickness which were determined initially and after 6 months of therapy with FC. Results. The target level of BP was reached by 88% patients after treatment with Concor® AM. Significant deceleration of heart rate (from 74.95±2.20 to 68.81±1.13 bpm) and CSBP (from 151.7 to 132.6 mm Hg) were observed. Treatment with Concor® AM led to artery stiffness decrease evaluated by cfPWV decrease (from 14.21±0.45 to 12.1±0.23 m/s, p≤0.05). Conclusion. FC of highly selective β-adrenoblocker bisoprolol and calcium antagonist amlodipine (Concor® AM) was shown effective for AH treatment in patients with MS. Future research is recommended to investigate the effectiveness of FC therapy in a larger cohort of patients.

About the Authors

Yu. V. Zhernakova
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation


T. V. Martyniuk
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation


O. A. Arkhipova
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation


M. O. Azimova
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation


A. N. Rogoza
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation


I. E. Chazova
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation


References

1. Law M.R, Wald N.J, Morris J.K, Jordan R.E. Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. BMJ 2003; 326: 1427-34.

2. Чазова И.Е., Ощепкова Е.В., Жернакова Ю.В. Диагностика и лечение артериальной гипертонии. Кардиол. вестн. 2015; 1: 5-30.

3. Wald D.S, Law M, Morris J.K et al. Combination Therapy Versus Monotherapy in Reducing Blood Pressure: Meta - analysis on 11,000 Participants from 42 Trials. Am J Med 2009; 122 (3): 290-300.

4. Rosenthal T, Gavras I. Fixed - dose combinations as first - line treatment for hypertension. Prog Cardiovasc Dis 2006; 48: 416-25.

5. Ryden L, Grant P.G, Anker S.D et al. ESC Guidelines on diabetes, pre - diabetes, and cardiovascular diseases developed in collaboration with the EASD. The Task Force on diabetes, pre - diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013; 34 (39): 3035-87. DOI: 10.1093/eurheartj/eht108

6. Рациональная фармакотерапия сердечно - сосудистых заболеваний. Руководство для практикующих врачей. Под общ. ред. Е.И.Чазова, Ю.А.Карпова. 2-е изд. М.: Литтерра, 2014.

7. Murdoch D, Heel R.C. Amlodipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in cardiovascular disease. Drugs 1991; 41: 478-505.

8. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281-357.

9. Shirure P.A, Tadvi N.A, Bajait C.S et al. Comparative effect of fixed dose combination of Amlodipine + Bisoprolol versus Amlodipine and Bisoprolol alone on blood pressure in stage-2 essential hypertensive patients. Int J Med Res Health Sci 2012; 1 (1): 13-9.

10. Czarnecka D, Koch E.M, Gottwald-Hostalek U. Benefits of a fixed - dose combination of bisoprolol and amlodipine in the treatment of hypertension in daily practice: results of more than 4000 patients. Curr Med Res Opin 2015; 31 (5): 875-81.

11. Rana R, Patil A. Efficacy and safety of bisoprolol plus amlodipine fixed dose combination in essential hypertension. Indian Pract 2008; 61: 225-34.

12. Mehta S, Shah M, Shah A et al. Efficacy and tolerability of a fixed dose combination of amlodipine and bisoprolol in essential hypertension. Indian Pract 2005; 58: 751-9.

13. Chen C.H, Nevo E, Fetics B et al. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation 1997; 95 (7): 1827-36.

14. Asmar R, Benetos A, Topouchian J et al. Assessment of Arterial Distensibility by Automatic Pulse Wave Velocity Measurement (Validation and Clinical Application Studies). Hypertension 1995; 26 (3): 485-90.

15. Жернакова Ю.В., Недогода С.В., Чазова Ю.В. и др. Рекомендации по ведению больных с метаболическими нарушениями. Кардиол. вестн. 2014; 1: 4-57.


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For citations:


Zhernakova Yu.V., Martyniuk T.V., Arkhipova O.A., Azimova M.O., Rogoza A.N., Chazova I.E. Fixed combination of highly selective β-adrenoblocker bisoprolol and calcium antagonist amlodipine (Concor® AM) for arterial hypertension treatment in metabolic disorder patients. Systemic Hypertension. 2017;14(1):45-50. (In Russ.)

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ISSN 2075-082X (Print)
ISSN 2542-2189 (Online)