Substantial amount of epidemiologic studies showed that hyperuricemia is highly associated with cardiovascular disorders, chronic renal disease, and diabetes mellitus development risk. This fact shows necessity of increased focus on uric acid level in serum not only in relation to rheumatic disorders but also in relation to cardiovascular and renal risk. European Society of Cardiology and Russian Arterial Hypertension Society experts included tests on uric acid level serum concentration in routine tests for hypertensive patients. Important steps in increase of hyperuricemia control in clinical practice are increase of awareness as a risk factor of cardiovascular disorders, development of risk management algorithm for patients with hyperuricemia and high cardiovascular risk, and increase of treatment adherence. Decrease of uric acid level in serum achieved after treatment with urate decreasing therapy mostly with xanthine oxidase inhibitor is associated with improvement of blood pressure control and decrease of cardiovascular adverse events frequency.
The aim of the study was to assess the possibility of fixed combination Lisinopril + amlodipine + rozuvastatin to improve arterial elesticity in patients with hypertension and high pulse wave velocity, despite previous diuretic-based combination antihypertensive therapy. Materials and methods. In an open, observational study duration of 24 weeks was included 60 patients on previous diuretic-based combination antihypertensive therapy. All participants underwent 24-hour blood pressure monitoring, applanation tonometry (augmentation index and central blood pressure), pulse wave velocity measurement, laboratory tests (lipid profile, fasting glucose, insulin resistance index - NOMA), leptin, high-sensitivity C-reactive protein before and after the switching to a fixed combination of lisinopril + amlodipine + rosuvastatin. Results. According to measurements of office blood pressure switching of patients on double combinations based on diuretics to a fixed combination of lisinopril + amlodipine + rosuvastatin, a further decrease in systolic blood pressure (SBP) by 13.7% and diastolic BP (DBP) by 18.8% was observed. According to the ABPM, the decline in the average daily SBP was 15.8%, DBP - 22.5%, average SBP - 16.2%, DBP - 19.8%. The combination of lisinopril + amlodipine + rosuvastatin reduced PWV by 15.9%, augmentation index by 13.5%, central SBP by 8.4% (p
Objective - to explore influence of valsartan monotherapy use and its use in combination with hydrochlorothiazide (HCTZ) on pulse-wave velocity (PWV) and central arterial pressure (CAP) in patients with arterial hypertension (AH) of 1-2 grades in international VICTORY clinical trial. Materials and methods. The international multicenter prospective randomized clinical study VICTORY that lasted for 16 weeks included patients with 1-2 grades AH. In patients who previously received antihypertensive therapy a 7 days washout period was carried out. All patients started their therapy with 80 mg valsartan (Valsacor®, KRKA, Slovenia); in Russia the starter dose of Valsacor®, KRKA was 160 mg in previously treated patients that did not influence the study results. If after 4 weeks of treatment BP was more than 140/90 mm hg (more than 130/80 mm hg in high risk patients or in diabetes mellitus patients) the dose of valsartan was increased to 160 mg (320 mg in Russia) or diuretic in fixed combination with valsartan was added (160 mg valsartan/12.5 mg HCTZ): Valsacor® H 160 (KRKA, Slovenia). If target BP after 8 weeks of treatment was not reached valsartan dose was increased to 320 mg or fixed combination of valsartan and diuretic (160 mg/12.5 mg) was used. If target BP after 12 weeks of treatment was not reached - valsartan and diuretic 320 mg/12.5 mg were used. PWV and CAP (SphygmoCor®, AtCorMedical) were assessed at baseline and after 16 weeks of treatment. The primary endpoints were assessment of the impact of studied medications on aortic stiffness, aortic augmentation index and comparison of absolute medians of reached central and peripheral BP reduction with baseline value. Results. Of 365 patients included in the study 74 were included in PWV and CAP study subgroup. Valsartan and its combination with HCTZ were effective in CBP reduction. The mean absolute reduction of central systolic and diastolic BP after 16 weeks of treatment was 19.7±12.9 mm hg and 13.9±8.5 mm hg, respectively (р
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