Objective. Optimization of drug therapy in patients with stable coronary heart disease and arterial hypertension (AH) in the application of ACE inhibitors: zofenopril compared with enalapril. Material and methods. We studied 80 patients with stable angina II-III functional class (FC) and AG 1-2 degree (Mean age 58.8±8.8 years) who were randomly divided into 2 groups of observation for 40 people in each: 1 - receiving zofenopril, 2 - enalapril - composed of basic therapy consisting of nitrates, .-blocker, statin, aspirin. The duration of follow-up was 6 months. At baseline and in the dynamics of all patients underwent clinical, laboratory and instrumental studies. It evaluated the quality of life through «Seattle questionnaire» for patients with angina. The daily monitoring of blood pressure at the same time with an electrocardiogram, treadmill test according to the modified protocol R.Bruce, echocardiography was conducted. Conclusion. The use of zofenopril, more than enalapril leads to significantly improved quality of life, exercise tolerance, normalizes the diurnal profile of blood pressure, reduces episodes of ischemia.
The wide prevalence (82%) of coronary heart disease (CHD) in combination with arterial hypertension (AH), as well as its initiating role in the development of fatal complications, such as myocardial infarction (MI) or heart failure, emphasise the need for the choice of optimal ACE inhibitors with organ-protective characteristics. This paper presents a literature review on the effectiveness of a SH-containing ACE inhibitor zofenopril in patients with CHD and AH, in terms of its anti-anginal and antihypertensive activity. The authors summarise the results of the international SMILE studies which included patients after acute MI. It was demonstrated that zofenopril therapy is associated with reduced combined incidence of cardiovascular death or cardiovascular hospitalisation, and is also safe in the acute post-MI period. In patients with preserved left ventricular function, zofenopril reduced the incidence of angina attacks and arrhythmias of coronary genesis, as well as improved exercise capacity. A clinical case of zofenopril therapy, as a part of a complex treatment regimen, is also presented.
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