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This article provides an overview of data on the role of hypertension and dyslipidemia as the leading factors determining the clinical course of athero sclerotic diseases. The need for a multifactorial approach to the treatment of patients with multiple risk factors for the progression of such diseases is noted. The article describes the results of large-scale international studies confirming the clinical benefits of combined antihypertensive and lipid-lowering therapy. From the point of view of current clinical guidelines and the available evidence base, the potential for improving adherence to treatment using a combination of anti hypertensive and lipid-lowering drugs are presented. The article discusses the prospects for optimizing the therapy of comorbid patients using a triple fixed-dose combination, including amlodipine, atorvastatin and perindopril.

Aim. To assess expedience of metformin combination with long-acting insulin, determine optimal doses of metformin for patients with type 2 diabetesmellitus (DM2), and accomplish pharmacoeconomic analysis of clinical efficiency of various therapeutic modalities. Materials and methods. Patients with decompensated DM2 (n=126) were under observation for 1 year during which they received rational hypoglycemictherapy with metformin and long-acting insulin (LAI) at bedtime, with the dose being titrated until the desired level of glycemic control wasachieved. The patients were randomly allocated to the following 3 groups: group 1 (sulponylurea derivatives (SUD), LAI, and metformin at a doseof 1000 mg b.i.d.), group 2 (SUD, LAI, and metformin at 500 mg b.i.d.), group 3 (SUD and LAI). In case of postprandial glycemia >9 mmol/l at amaximum dose of SUD, it was replaced by short-acting insulin. Cost-effectiveness analysis of different therapeutic regimes was performed. Results. The cost of examination and treatment of patients given SUD and LAI in combination with metformin at a daily dose of 2000 mg to achievethe desired quality of glycemic control was lower compared with two other groups. Moreover, this therapy was most efficacious and ensured the desiredlevel of glycemic control in a greater number of patients. Cost-effectiveness analysis confirmed advantages of this treatment. Conclusion. Combined hypoglycemic therapy with SUD, LAI, and metformin (200 mg daily) has the advantage of lowest cost and maximum efficiencycompared with other modalities.