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Aim: to study hypotensive and organo-protective efficacy of cornbination therapy with perindopril and indanarnide in patients with rnild and rnoderate arterial hypertension. Material and methods. According to the protocol in the study included 23 patients with I-II grade of arterial hypertension (ESC/ ESH 2013), of both genders. All patients took the cornbination preparation Arnra forte (GMP, Georgia), containing 4 тд of perindopril and 1.25 rrig of indaparnide. At the stage before the treatrnent and 12 weeks of therapy was rneasured an office blood pressure by Korotkov's rnethod and carried out arnbulatory blood pressure rnonitoring (ABPM) ("BR-102 plus Recorder" (SCHILLER, Switzerland)). Antirernodeling efficacy was assessed by the dynarnics of cardiac echo geornetry and ultrasound (US) of vessels pararneters. Also was evaluated the clinical tolerance and rnetabolic effects of the drug. The pararneters of central hernodynarnics and vascular stiffness were rneasured by applanation tonornetry. Results are presented as M±SD. Results of research. 12-week cornbination therapy with perindopril and indaparnide is characterized by high antihypertensive efficacy, with a decrease in rnean blood pressure to 18%, and achievernent the target level of blood pressure in 100% patients with rnild and rnoderate arterial hypertension. According to the ABPM showed a significant decrease of average daily SBP and DBP, as well as a significant decrease in the speed of rnorning SBP surge. Thus it was not iriarked episodes of hypotension at night. Reliable antirernodeling efficacy of perindopril and indaparnide is expressed in reducing LVMI, reducing of EDD and reliably reducing the thickness of IMC against the background of 12-week treatrnent. 12-week cornbination therapy with perindopril and indaparnide showed renal protection efficiency, expressing in a significant decrease in blood creatinine level and alrnost twofold reduction of MAU level. Perindopril and indaparnide in the rnode of cornbination therapy in patients with rnild and rnoderate arterial hypertension showed rnetabolic neutrality in relation to lipid and carbohydrate metabolism, clinical safety. A side effect as dry cough was observed in one patient only at the end of 12-weeks treatrnent (4.3%). Conclusion. Therefore, our research showed a high antihypertensive efficacy of cornbination therapy with perindopril and indaparnide with the available cardio-, vaso-, and nefroprotection, rnetabolic neutrality and clinical safety that recommends the preparation for the treatrnent of patients with rnild and moderate arterial hypertension.

Aim. To carry out a comparative pharmacoeconomic analysis of two different types of antihypertensive therapy in patients with arterial hypertension (HT). Material and methods. 38 patients with essential HT (aged 18 to 70 years, 11 males and 27 females) associated with metabolic syndrome, and having a history of previous ineffective antihypertensive therapy were included into the study. The patients were randomized into 2 groups. Patients of V/A group received a fixed combination of valsartan and amlodipine (Exforge, Novartis) in dose of 5/160 and 10/160 mg depending on blood pressure (BP) level. Patients of L/A group received losartan (Lorista, KRKA) in dose of 100 mg and amlodipine (Tenox, KRKA) in dose of 5 and 10 mg. Treatment duration was 24 weeks. If target level of BP was not achieved during 12 weeks, indapamide retard was added to the therapies (Ravel SR, KRKA). Dinamics of BP and left ventricular mass index (LVMI) were considered. Cost-effectiveness method of analysis was used. Results. In V/A group 75% of patients achieved target BP levels for 24 weeks, while in L/A group — 33.3% of patients, and 16.7% of patients more after indapamide addition. L/A therapy cost was lower in comparison with this of V/A therapy: 57864.24 vs 156671.0 rubles per 24 weeks, respectively. Calculation shows that additional cost of 669.23 rubles during 24 weeks is needed to achieve BP target level in every next patient when V/A therapy is used instead of L/A therapy. LVMI reduction by 1% took 1015.13 rubles cost in V/A group and almost 6 times more in L/A group. Conclusion. Pharmacoeconomic analysis revealed that generic combination of L/A is the most cost-effective for BP reduction. Very low cost is required to achieve additional effect with original fixed V/A combination. V/A combination is the most economical for the left ventricular hypertrophy reduction. Thus, V/A combination is rational for use in HT patients with severe target-organs damage.

The regress or left ventricular (LV) hypertrophy is a main end-point of antihypertensive therapy. The aim of the present study was to compare antihypertensive effects of two fixed combination preparations of ACE inhibitor and thiazide diuretic, enalapril 20 mg/hydrochlorthiazide 12,5 mg (Co-renitec) and losartan 50 mg/hydrochlorthiazide 12,5 mg (Hyzaar) on LV mass index (LVMI), types of left ventricular remodeling in patients with grade II-III arterial hypertension. First group was treated with Co-renitec, second group with Hyzaar during 24-weeks period. Results showed that both preparations significantly and to the same degree decrease LVMI. Number of patients with normal LV geometry increases with accompanying decrease in number of patients with concentric hypertrophy and concentric remodeling. The favorable effects were more remarkable in group treated with Hyzaar.