Effect of anti-hypertensive therapy on arterial wall stiffness in patients with arterial hypertension

Abstract

The purpose of the study was to conduct a comparative analysis of the effect of 3-month therapy with a fixed combination of lisinopril dihydrate and amlodipine besylate on the clinical status, indicators of the daily profile of blood pressure, central aortic pressure and vascular stiffness, as well as the structural and functional state of the heart in patients with arterial hypertension with obesity and without it. 60 patients (average age 56.7±2.1 years) with stage 2 arterial hypertension were examined, 34 of which were diagnosed with Class 1 obesity (group 1) and 26 patients (group 2) without obesity who did not take regular antihypertensive therapy. After registration of baseline data, a fixed combination of lisinopril dihydrate and amlodipine besylate 10–20/5–10 mg/day was prescribed to the patients of both groups for 3 months. The control group consisted of 20 practically healthy people. After therapy, a significant improvement was found not only in the office systolic and diastolic blood pressure levels, but also in the daily profile of peripheral blood pressure and central blood pressure in both groups of patients. It was also established that the pulse wave propagation speed decreased by (1.0±0.2 m/s; p<0.01) in group 1 and by (1.5±0.2 m/s; p<0.01) in group 2. A significant decrease in the left ventricular myocardial mass index was found in both groups of patients. An increase in the E/A ratio was established by 33.3 % (p<0.001) in group 1 and by 26.3 % (p<0.01) in the patients of group 2. Thus, the long-term use of a fixed combination of lisinopril dihydrate and amlodipine besylate in arterial hypertension patients with obesity and without it, allows to control blood pressure effectively according to office measurement and daily blood pressure monitoring, has a positive effect on daily blood pressure profiles and indicators of arterial stiffness, as well as structural and functional parameters and status of diastolic function of the left ventricle, along with good tolerability of therapy.