OPTIMAL ORGANOPROTECTION, CONTROL OF bLOOD PRESSURE AND METAbOLIC DISORDER WITH THE FIxED COMbINATION OF LISINOPRIL, AMLODIPINE AND ROSUVASTATIN IN SYSTEMIC HYPERTENSION

Aim. Evaluation of the ability of the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer) in achievement of additional angioprotection in patients with systemic arterial hypertension (AH) and high pulse wave velocity (PWV), regardless of previous antihypertensive therapy (AHT).Material and methods. To the open multicenter observational study 24 weeks duration, 60 patients included, taking double AHT during 6 months. All participants underwent ambulatory 24 hour blood pressure (BP) monitoring, applanation tonometry (augmentation index and central BP), pulse wave velocity assessment, laboratory tests (lipids, fasting glucose, insulin resistance index (HOMA), leptin, high sensitive C-reactive protein (hsCRP) before and after transition to the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer).Results. By the data from office BP measurement, after transition of patients from the double combinations to fixed combination of lisinopril, amlodipine and rosuvastatin, there was additional decrease of systolic BP (SBP) by 14,3% and diastolic BP (DBP) by 18,5%. By the data from ABPM, decrease of SBP was 16,1%, and DBP — 21,8%. Combination of lisinopril, amlodipine and rosuvastatin decreased PWV by 14,4%, augmentation index by 14,5%, central SBP by 8,1% (p<0,01 for all comparisons with baseline). Fixed combination of lisinopril, amlodipine and rosuvastatin made it to decrease low density lipoproteides by 44%, triglycerides by 36,1% and increase of high density lipoproteides by 10,3% (p<0,01 for all with baseline). Usage of combination of lisinopril, amlodipine and rosuvastatin showed significant decrease of insulin resistance, hsCRP and leptin levels.Conclusion. Fixed combination of lisinopril, amlodipine and rosuvastatin makes it to better control BP, improve vascular elasticity parameters (augmentation index, PWV, central BP) and facilitates the improvement of lipid and glucose metabolism, decrease of inflammation, leptin resistance in patients taking at baseline double antihypertensive therapy

Blood pressure control and vascular protection with a fixed-dose combination of lisinopril + amlodipine + rosuvastatin in hypertensive patients

Aim: Assessment of the possibility of the fixed-dose combination of lisinopril + amlodipine + rosuvastatin (Equamer) to achieve further angioprotection in patients with arterial hypertension and high pulse wave velocity (PWV) despite the previous combination antihypertensive therapy (AHT).Methods: The 24-week open-label multi-center observational study involved 60 patients who received dual combination AHT for 6 months. All patients underwent 24 h blood pressure (BP) monitoring, applanation tonometry (determination of the augmentation index and central BP), measurement of the pulse wave velocity and laboratory tests [blood lipids, fasting glucose test, homeostasis model assessment of insulin resistance (HOMA-IR), leptin, ultra-sensitive C-reactive protein (us-CRP)] before and after switching to the fixed-dose combination of lisinopril + amlodipine + rosuvastatin (Equamer).Results: According to the office BP measurements, switching the patients from the dual combinations to the fixed-dose combination of lisinopril + amlodipine + rosuvastatin has resulted in a further decrease of 14.3% in systolic BP (SBP) and 18.5% in diastolic BP (DBP). According to the 24 h BP monitoring data, the SBP has decreased by 16.1% and the DBP by 21.8%. The combination of lisinopril + amlodipine + rosuvastatin has reduced the SBP by 14.4%, the augmentation index by 14.5% and the central SBP by 8.1% (P < 0.01 vs. baseline). The fixed-dose combination of lisinopril + amlodipine + rosuvastatin has provided a 44%-decrease in low-density lipoproteins, a 36.1%-decrease in triglycerids and a 10.3%-increase in high-density lipoproteins (P < 0.01 vs. baseline). The use of the fixed-dose combination of lisinopril + amlodipine + rosuvastatin has provided a definite decrease in the insulin resistance, as well as levels of us-CRP and leptin.Conclusions: The fixed-dose combination of lisinopril + amlodipine + rosuvastatin provides improved BP control, better vessel elasticity indicators (augmentation index, PWV, central BP), boosts the lipid and carbohydrate metabolism and helps to reduce the inflammation and leptin resistance in patients who initially received a dual combination AHT