The experience of a comprehensive assessment of the effectiveness of antihypertensive therapy in clinical practice
https://doi.org/10.21886/2219-8075-2019-10-3-62-71
Abstract
Objective: to study the antihypertensive efficacy of a new dosage form of perindopril A — tablets dispersed in the oral cavity — in the group of patients with arterial hypertension (AH) on an outpatient basis.
Material and methods: the study included 30 patients (mean age 53.8 ± 0.9 years) with the presence of arterial hypertension, diagnosed initially, or with no control of blood pressure at the background of previous antihypertensive therapy. All investigators were administered perindopril A in the form of a dispersible form in a dose of 10 mg in monotherapy or in combination with indapamide – in case of failure to achieve target blood pressure after 2 weeks of observation. The total duration of the study is 3 months.
Results: by the end of the observation, the SBP / DBP decreased by 35.6 ± 2.3 / 16.5 ± 1.0 mm Hg. Correction of therapy with the addition of indapamide-retard was required in 6 (20%) patients. Effective antihypertensive therapy was accompanied by a significant decrease in daily (according to ICBP data), intravisit, and visit-to-visit variability of the SBP, which was 4.4 mm Hg in terms of standard deviation by the end of the observation. The use of a new dosage form of perindopril A was accompanied by a significant increase in adherence to therapy.
Conclusion: the use of a new dosage form of perindopril A — tablets dispersed in the oral cavity — in monotherapy or in combination with indapamide-retard can improve the treatment of patients with hypertension who do not have target BP values.
About the Authors
S. A. Solgalova
Stavropol State Medical University
Russian Federation
Russian Federation
Svetlana A. Solgalova - C.Med.Sci., Associate Professor, the Department of Medical and Social Expertise, Rehabilitation with Geriatrics Course.
StavropolT. V. Glukhova
Stavropol State Medical University
Tatiana V. Glukhova - C.Med.Sci., Associate Professor, the Department of Therapy with a Course of Dietetics.
StavropolI. A. Znamenskaya
Stavropol State Medical University
Ilona A. Znamenskaya - C.Med.Sci., Associate Professor of the Hospital Therapy Department.
StavropolI. B. Romanova
Stavropol State Medical University
Irina B. Romanova - PhD student, the Department of clinical pharmacology.
StavropolReferences
1. Chazova IE, Ratova LG, Boytsov SA, Nebieridze DV. Diagnosis and treatment of hypertension (Recommendations of the Russian Medical Society of hypertension and the Russian Society of Cardiology). Sistemnye Gipertenzii 2010; (3): 5-26. (in Russ.)
2. Oganov R.G., Timofeeva T. N., Koltunov I. E., Konstantinov V.V., Balanova Yu.A., Kapustina A.V., et al. Arterial hypertension epidemiology in Russia; the results of 2003–2010 federal monitoring Cardiovascular therapy and prevention. 2011; 10 (1):9–13. (in Russ.)
3. Karpov YuA, Gorbunov VM., Deev AD. PRORYV 2 Study: the effect of a fixed combination of perindopril/ amlodipine on blood pressure measured in the doctor’s office, with daily monitoring and selfmonitoring, in patients with uncontrolled arterial hypertension. Atmosphere. Cardiology news 2014; 1: 28. (in Russ.)
4. Leonova M.V. New dosage forms and drug delivery systems: features of oral dosage forms. // Medical business. - 2009. № 3. - P. 18–26.
5. Roberto Ferrari. Prestarium A in terms of evidence-based medicine. 2014. - 27 p.
6. Recommendations for the treatment of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC), 2013 // Russian Journal of Cardiology. - 2014. - № 1 (105). - p. 7-94.
7. Kikuya, M., Ohkubo, T., Metoki, H., Asayama, K., Hara, A., Obara, et al. Day-by-Day Variability of Blood Pressure and Heart Rate at Home as a Novel Predictor of Prognosis. Hypertension, 2008;52(6), pp.1045-1050. doi:10.1161/hypertensionaha.107.104620
8. Bliziotis, I., Destounis, A. and Stergiou, G. Home versus ambulatory and office blood pressure in predicting target organ damage in hypertension. Journal of Hypertension, 2012;30(7), pp.1289-1299. doi: 10.1097/hjh.0b013e3283531eaf
9. Gaborieau, V., Delarche, N. and Gosse, P. Ambulatory blood pressure monitoring versus self-measurement of blood pressure at home: correlation with target organ damage. Journal of Hypertension, 2008;26(10), pp.1919-1927. doi: 10.1097/hjh.0b013e32830c4368
10. Stergiou, G., Siontis, K. and Ioannidis, J. Home Blood Pressure as a Cardiovascular Outcome Predictor. Hypertension, 2010;55(6), pp.1301-1303. doi: 10.1161/hypertensionaha.110.150771
11. Ward, A., Takahashi, O., Stevens, R. and Heneghan, C. Home measurement of blood pressure and cardiovascular disease. Journal of Hypertension, 2012;30(3), pp.449-456. doi: 10.1097/hjh.0b013e32834e4aed
12. Boggia, J., Li, Y., Thijs, L., Hansen, T., Kikuya, M., Björklund-Bodegård, K., et al. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study. The Lancet, 2007;370(9594), pp.1219-1229. doi: 10.1016/s0140-6736(07)61538-4
13. Conen, D. and Bamberg, F. Noninvasive 24-h ambulatory blood pressure and cardiovascular disease: a systematic review and meta-analysis. Journal of Hypertension, 2008;26(7), pp.1290-1299. doi: 10.1097/hjh.0b013e3282f97854
14. Fagard, R., Celis, H., Thijs, L., Staessen, J., Clement, D., De Buyzere, M. et al. Daytime and Nighttime Blood Pressure as Predictors of Death and Cause-Specific Cardiovascular Events in Hypertension. Hypertension, 2008;51(1), pp.55-61. doi: 10.1161/hypertensionaha.107.100727
15. Rothwell, P., Howard, S., Dolan, E., O'Brien, E., Dobson, J., Dahlöf, B., et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. The Lancet, 2010;375(9718), pp.895-905. doi: 10.1016/s0140-6736(10)60308-x
16. Muntner, P., Shimbo, D., Tonelli, M., Reynolds, K., Arnett, D. and Oparil, S. The Relationship Between Visit-to-Visit Variability in Systolic Blood Pressure and All-Cause Mortality in the general population: findings from NHANES III, 1988 to 1994. Hypertension, 2011;57(2), pp.160-166. doi: 10.1161/hypertensionaha.110.162255
17. Webb, A., Fischer, U., Mehta, Z. and Rothwell, P. Effects of antihypertensive-drug class on interindividual variation in blood pressure and risk of stroke: a systematic review and meta-analysis. The Lancet, 2010;375(9718), pp.906-915. doi: 10.1016/s0140-6736(10)60235-8
18. Rothwell, P. Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. The Lancet, 2010;375(9718), pp.938-948. doi: 10.1016/s0140-6736(10)60309-1
19. Mancia, G., Facchetti, R., Parati, G. and Zanchetti, A. Visit-to-visit blood pressure variability in the European Lacidipine Study on Atherosclerosis. Journal of Hypertension, 2012;30(6), pp.1241-1251. doi: 10.1097/hjh.0b013e32835339ac
20. Kobalava, Zh.D., Kotovskaya Yu.V., Troitskaya E.A. Visit-to-visit variability of arterial pressure: clinical and prognostic significance, practical application / Zh.D. Kobalava, Yu.V. Kotovskaya, E.A. Troitskaya. - Moscow 2013. - 23 p.
21. Glukhova TV, Solgalova SA, Putrenok LS. The study of variability of blood pressure in clinical practice. Population health and habitat : materials of scientific and practical conference. 19th annual Week of medicine of Stavropol. Stavropol: Stavropol publishing house “Paragraph”; 2015. (in Russ.)
22. Glukhova TV, Solgalova SA. Blood pressure variability: the importance in ambulatory practice. Topical issues of modern medicine and geriatrics: materials of VII interregional scientific and practical geriatric conference of primary health care physicians of the North Caucasus Federal district, I interregional scientific and practical geriatric conference of primary health care physicians of the Republic of Crimea. Stavropol – Simferopol: Publishing house SGMU, 2016. – 278 p. (in Russ.)
23. Glukhova TV, Solgalova SA. Characteristics of adherence to therapy in patients with arterial hypertension. Topical issues of modern medicine: materials of scientific and practical conferences of the Forum dedicated to the 50th anniversary of additional professional medical education in the North Caucasus. Part I. – Stavropol: Publishing house SGMU, 2015. – 328 p. (in Russ.)
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For citations:
Solgalova S.A., Glukhova T.V., Znamenskaya I.A., Romanova I.B. The experience of a comprehensive assessment of the effectiveness of antihypertensive therapy in clinical practice. Medical Herald of the South of Russia. 2019;10(3):62-71. (In Russ.) https://doi.org/10.21886/2219-8075-2019-10-3-62-71
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