title: [Cardio-Nephroprotection the Most Important Goal of Antihypertensive Therapy in Patients With Type 2 Diabetes].
abstract: OBJECTIVE
  to study the opportunities for cardio and nephroprotection by 6-month combined antihypertensive therapy with lisinopril and amlodipine in hypertensive patients with diabetes mellitus (DM) type 2.
  
  
  METHODS
  30 patients with arterial hypertension (AH) stage II-III, chronic kidney disease (CKD) stages 2-3 and type 2 DM were included in to research. We evaluated the results of the physical examination, blood pressure monitoring (ABPM), structural and functional state of the heart and kidneys. Combined analysis the risk of progression of CKD and cardiovascular complications (CVC) depending on the glomerular filtration rate (GFR) and albuminuria (AU) was performed. We also studied carbohydrate and lipid metabolism and estimated the severity of insulin resistance (IR).
  
  
  RESULTS
  Against the background of long-term therapy by Equator 100% of patients had achieved target BP values. The circadian BP profile was significantly improved. There was a significant decrease in the index of left ventricular mass by 8.0%, a decline of PU by 58% and AU by 43.6%, respectively. There was the redistribution of patients to assess the combined risk of CKD progression and CVC: 50% of patients in the group crossed a moderate risk by reducing the percentage of patients at high and very high risk of 36.7% and 13.4%, respectively (p<0,001), as well as significant improvement in metabolic parameters and reduction in IR. A statistically significant correlation between IR and condition of the heart and kidney was determined.
  
  
  CONCLUSIONS
  Long-term combined therapy with lisinopril and amlodipine fully meets the modern requirements for antihypertensive therapy - it leads to a significant reduction in the risk of progression of CKD and development of the CVC and is metabolically neutral. The decrease in the combined risk of CKD progression and development CVC was associated with cardio and nephroprotective action of the Equator, as well as with a reduction in the negative impact of IR in patients with AH and type 2 DM.
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: M E
authors.initials: ME
authors.lastname: Statsenko
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: M V
authors.initials: MV
authors.lastname: Derevyanchenko