title: [Optimization of Control of Blood Pressure, Metabolic Disorders and Target Organs Protection With Fixed Perindopril and Indapamide Combination in Treated Patients With Arterial Hypertension].
abstract: OBJECTIVE
  to assess the potential of fixed perindopril/indapamide combination (FPIC) to improve angioprotection in patients with arterial hypertension (AP) with various efficacy of preceding therapy with combination of losartan and hydrochlorothiazide (HCTZ).
  
  
  METHODS
  We included in this open study 50 patients with AP divided into two equal-sized groups in dependence on the achievement of target blood pressure (BP) less than 140/90 mm Hg on preceding therapy with losartan (100 mg) and HCTZ (12.5 mg). All patients underwent ambulatory BP monitoring (ABPM), applanation tonometry (assessment of augmentation index and central blood pressure), measurement of pulse wave velocity (PWV), laboratory tests (lipid profile, fasting glucose, HOMA index, homocysteine, leptin, adiponectin, high sensitivity C reactive protein [hsCRP]). Study duration was 12 weeks.
  
  
  RESULTS
  Treatment with FPIC in patients not at target BP provided 14.5 and 6.6% reduction of systolic and diastolic BP (SBP and DBP), respectively (p<0.01), while in patients with target BP it was associated with additional reductions of SBP and DBP by 3.9 and 5.4%, respectively (p<0.01). According to ABPM data average day- and nighttime SBP decreased by 16.9 and 15.0%, average day- and nighttime DBP - by 10.6 and 13.6% (p<0.01) in the group of patients not at target BP. Reductions of PWV (by 15.2 and 2.2%), augmentation index (by 10.7 and 9.4%), central SBP (by 10.9 and 2.1%), central pulse BP vascular age (by 8.7 and 6.0%) were observed in groups of patients without and with target BP on preceding therapy, respectively (p<0.01). Leptin level decreased by 10.0 and 14.4%, hsCRP - by 17.7 and 11.0%; while level of adiponectin increased by 6.7 and 9.9% (p<0.01).
  
  
  CONCLUSIONS
  Our results demonstrated advantages of FPIC over losartan+HCTZ combination relative to BP control, improvement of arterial elasticity, alleviation of insulin resistance and inflammation.
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: S V
authors.initials: SV
authors.lastname: Nedogoda
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: E V
authors.initials: EV
authors.lastname: Chumachek
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: A A
authors.initials: AA
authors.lastname: Ledyaeva
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: V V
authors.initials: VV
authors.lastname: Tsoma
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: A S
authors.initials: AS
authors.lastname: Salasyuk
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: V O
authors.initials: VO
authors.lastname: Smirnova
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: V Ju
authors.initials: VJ
authors.lastname: Hripaeva
authors.affiliation: Volgograd State Medical University, Volgograd, Russia.
authors.forename: R V
authors.initials: RV
authors.lastname: Palashkin
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D004338:Drug Combinations; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D007190:Indapamide / Q000627:therapeutic use*; D008659:Metabolic Diseases / Q000209:etiology / Q000517:prevention & control; D020913:Perindopril / Q000627:therapeutic use*; D063177:Pulse Wave Analysis
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; C494243:indapamide, perindopril drug combination; D007190:Indapamide; D020913:Perindopril
keywords: adipokines; arterial hypertension; augmentation index; central blood pressure; combined antihypertensive therapy; indapamide; perindopril; pulse wave velocity