Aim. To study the effects of fixed-dose indapamide/perindopril combination on endothelial function and arterial stiffness in patients with uncontrolled stage 1-2 hypertension (HTN) and chronic kidney disease (CKD).Material and methods. Total of 100 patients with uncured or uncontrolled with ≥3 months antihypertensive therapy HTN and CKD G3 (67% females, mean age 59,1±12,5 years) were included in the study. Each patient took indapamide/perindop combination in accordance with 1 of 3 existing regimes (depending on doses) for 3 months. Primary aim was to assess the effects of indapamide/perindopril combination on endothelial function and parameters of arterial stiffness after 12 weeks of treatment (assessment by AngioScan diagnostic complex). Secondary aims were achievement of target blood pressure (BP) after 4 and 12 weeks of therapy and assessment of glomerular filtration rate (GFR) and the albumin-tocreatinine ratio (ACR) changes after 12 weeks.Results. Initially, there was an increase in arterial stiffness parameters in all patients, and during treatment decrease was observed: central systolic BP (SBP) from 120±10,1 to 112,9±6,3 mm Hg, median augmentation index from 10,9% to 4,6%, stiffness index from 8,1±2,4 to 7,1±0,9, vascular age decreased by 9,6% (р< 0,001 for trend). Significant improvement of endothelial function was observed regardless of diabetes presence: occlusion index increased from 1,5±0,3 to 1,7±0,5, median phase shift — from -4,6 to -2,4 ms (p< 0,01). After 4 weeks, 27% of patients reached target BP, by the end of the study — 90%. A decrease in the median ACR from 16,3 to 15,0 mg/g, GFR increase from 50,2±7,6 to 53,6±8,7 ml/min/1,73 m2 were observed (p< 0,01 for trend).Conclusion. Therapy with a fixed-dose indapamide/perindopril combination in patients with uncontrolled stage 1-2 HTN and G3 CKD leads to a significant improvement in arterial stiffness, endothelial and renal function, and achievement of target BP in 90% of patients.

Aim. To study phenotypes of clinic and 24-hour ambulatory blood pressure (BP), to determine their associations with arterial stiffness parameters, and to assess global cardiovascular risk (CVR) in young patients with type 1 diabetes (T1D).Material and methods. The presented cross-sectional single-center study included 81 T1D patients without a history of hypertension (HTN) and other cardiovascular diseases (CVD) (men — 39%; median age — 27 years; median duration of T1D — 6 years). All participants underwent a routine clinical and laboratory testing, measurement of clinic and 24-hour ambulatory BP (BPLab Vasotens), assessment of central BP and arterial stiffness parameters using applanation tonometry technique. BP phenotypes were analyzed with diagnostic criteria for HTN by ESC/ESH 2018 guidelines. CVR was assessed using the SCORE 10-year risk calculator (ESC 2019). The differences were considered significant at p<0,05.Results. The prevalence of true HTN was 6,2%, masked HTN — 38,3%. Isolated nocturnal HTN was revealed in 30,7% of patients with clinic BP <140/90 mm Hg. The subgroup with masked HTN was dominated by patients with normal clinic BP (58,1%) and in most cases was characterized by isolated diastolic BP increase (64,5%). Masked HTN was associated with a higher carotid-femoral pulse wave velocity (PWV) (median — 7,2 versus 6,3 m/s, p=0,002). The most common profiles of nocturnal BP decrease were non-dipper (63.9%) and night-picker (16.6%). High and very high CVR was recorded in 87,7% of patients. Conclusion. Hypertension occurs in 44,5% of young patients with type 1 diabetes and is characterized by a high prevalence of masked isolated nocturnal HTN and non-dipping. Masked HTN is associated with a higher carotid-femoral PWV. High and very high 10-year CVR was recorded in 87,7% of patients.