[Effect of combined antihypertensive and lipid lowering therapy on the level of coronary risk and tissue insulin resistance in patients with metabolic syndrome].
OBJECTIVE
To assess effect of combined antihypertensive and lipid lowering therapy on main characteristics of metabolic syndrome and total coronary risk.


METHODS
Seventy five patients with metabolic syndrome aged 40-59 years were included into an open study with parallel groups in which the following combinations of lipid lowering and antihypertensive drugs were used for sweeksinch: atorvastatin + perindopril (n=17, group 1); simvastatin + atenolol (n=17, group 2); fenofibrate + atenolol (n=21, group 3), and simvastatin + indapamide (n=20, group 4). Systolic and diastolic blood pressures (BP), blood serum concentrations of total cholesterol (CH), low density lipoprotein (LDL) and high density lipoprotein (HDL) CH, glucose and immunoreactive insulin were measured before and after treatment. Total coronary risk was calculated according to the PROCAM model.


RESULTS
Treatment was associated with decreases of systolic and diastolic BP (from 11% in group 1 to 18,4% in group 2), lowering of total CH (by one third in groups 1 and 2, by 20% in groups 3 and 4), and triglycerides (by 2 times in group 3 and by 7-21% in other groups). Increases of HDL CH were observed in groups 2-4. There were no significant changes of markers of insulin resistance. Baseline total coronary risk was high (37%). Treatment was accompanied with lowering of total risk by 57.4-70%.


CONCLUSIONS
Combined antihypertensive and lipid lowering therapy leads to pronounced lowering of high coronary risk in metabolic syndrome.
Mamedov
M N
MN
Perova
N V
NV
Kosmatova
O V
OV
Khadipash
L A
LA
Kiseleva
N V
NV
Oganov
R G
RG
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D000069059:Atorvastatin; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D011345:Fenofibrate / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007190:Indapamide / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D020913:Perindopril / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D019821:Simvastatin / Q000627:therapeutic use; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D000960:Hypolipidemic Agents; D011758:Pyrroles; D001262:Atenolol; D000069059:Atorvastatin; D019821:Simvastatin; D007190:Indapamide; D011345:Fenofibrate; D020913:Perindopril