Achievement of the main goals of therapy by using of a triple fixed combination of amlodipine, indapamide and perindopril (Co-Dalneva®) in patients with arterial hypertension

Introduction. Combined antihypertensive therapy is indicated in 94% of patients with hypertension. Fixed combinations are preferable to use as they have a high profile of effectiveness, safety, more convenient to use and significantly increase the adherence. Objective. To evaluate the effectiveness of triple fixed combination of amlodipine/indapamide/perindopril for the control of blood pressure in patients who did not achieve the target blood pressure level in the previous combined therapy. Materials and methods. The study included 44 patients with hypertension of high and very high risk of cardiovascular complications (mean age - 58.59±10.57 years, 17 men, 27 women). Blood pressure levels, quality of life, anxiety and depression levels, adherence, biochemical indices, levels of inflammation markers (CRP, IL-6, IL-10) and endothelial dysfunction (sVCAM-1, VEGF) were assessed in all patients at baseline and after 6 months of amlodipine/indapamide/perindopril therapy. Results. Against the backdrop of the treatment, all patients reached the target level of blood pressure (BP), pulse BP decreased by 30.3 mm Hg. (p<0.001), all quality of life indicators improved: significant changes (p<0.05) in physical functioning (from 58.1±27.7 to 71.3±20.5%), role-physical functioning (from 54.7±41.2 to 85.5±31.5%), role-emotional (from 53.3±46.0 to 77.3±40.1%), vitality (from 53,4±16.9 to 63.2±14.5%). The anxiety levels (from 5.9±2.8 to 3.5±2.6) and depression (from 5.9±2.5 to 3.7±2.1) significantly decreased. Adherence increased to a high level (from 3.4±1.8 to 6.5±1.0 points, p<0.01). There were no reliable dynamics of biochemical parameters and markers of inflammation. The level of sVCAM-1 decreased (from 1063.5±442.4 to 898.67±433.5 ng/ml, p<0.001). There were no cases of orthostatic hypotension. Conclusion. Therapy with a triple fixed combination of perindopril/indapamide/amlodipine (Ko-Dalneva®) achieves the target blood pressure level with a significant reduction in pulse BP, increases adherence and quality of life, reduces anxiety and depression with good tolerability and metabolic neutrality, and improves the vascular endothelial state, significantly lowering sVCAM-1.

arterial hypertension, triple fixed combination, antihypertensive therapy, adherence, quality of life, endothelial dysfunction

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