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STUDY OF THE PARAMETERS OF TOLERABILITY AND ADHERENCE TO THERAPY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION ON THE BACKGROUND OF TREATMENT WITH FIXED COMBINATION OF RAMIPRIL AND AMLODIPINE (ACCORDING TO THE RESULTS OF OBSERVATIONAL STUDY "GRANAT-2")

https://doi.org/10.20996/1819-6446-2017-13-2-229-237

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Abstract

Working group of the “GRANAT-2” study: Tula - Trubitsyn G.I., Ivanov Yu.V., Mirenkova O.K., Eskova R.A., Simonova R.P., Milon M.E., Telegina E.V., Kuznetsov A.M., Zhukova N.A., Zainullina I.K.; Rostov-on-Don - Budanov O.V., London E.M., Minosyan L.V., Nedashkovskaya N.G., Ter-Ananyants Ye.A.; Tomsk - Proskokova I.Yu., Permyakova O.V., Politova L.V., Maneeva I.D., Ivanova S.Yu.; Nizhny Novgorod - Larina O.V., Pokrovskaya I.N., Patselt E.A.; Moscow - Sladkova T.A., Zelenova Т.V. 

Aim. To study the tolerability and adherence to antihypertensive therapy in patients with hypertension and chronic obstructive pulmonary disease (COPD) using the fixed combination of ramipril and amlodipine in the observational program for patients with arterial hypertension and COPD (GRANAT-2). Material and methods. Patients with hypertension and COPD (n=52) with all inclusion criteria and without exclusion criteria who signed informed consent to participate in the GRANAT-2 program were included into the study. The use of a fixed combination of ramipril and amlodipine was recommended in all patients. The doses were determined by the treating physicians in accordance with the official drug instruction. The patients had 4 visits, and the duration of the study was 5 months. The Morisky-Green test was used to assess an adherence of patients to treatment. Assessments of blood pressure, adverse events were performed at all visits. Results. 50 of 52 patients completed the study: 45 patients used the studied fixed combination in the recommended doses, and 5 patients used other antihypertensive drugs, 2 patients withdrew from the study. Systolic blood pressure after 1 month of treatment decreased by an average of 20 mm Hg from the baseline, and diastolic blood pressure – by 10 mmHg. These rates after 5 months of therapy were 29 mm Hg and 15 mm Hg, respectively. Target blood pressure level was achieved in all patients. Increase in adherence of patients to treatment (according to the Morisky-Green test from 21.1% to 65.1%) was found. 2 cases of adverse events (dry cough) were registered. The discrepancy in adherence assessment was revealed between the results from the Morisky-Green test and the data from program case report forms. Conclusion. Regular patient visits to the doctor and the rapid achievement of an antihypertensive effect with good tolerability of a fixed combination of ramipril and amlodipine contributed to the increase in adherence of patients to treatment. Undesirable effects of the drug therapy are significant, but not leading factors that have a negative impact on the patient adherence to treatment.

About the Authors

S. Y. Martsevich
State Research Center for Preventive Medicine
Russian Federation

Sergey Y. Martsevich - MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990




Yu. V. Lukina
State Research Center for Preventive Medicine
Russian Federation

Yulia V. Lukina - MD, PhD, Senior Researcher, Laboratory for Pharmacoepidemiological Studies, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990




N. P. Kutishenko
State Research Center for Preventive Medicine
Russian Federation

Natalia P. Kutishenko - MD, PhD, Head of Laboratory for Pharmacoepidemiological Studies, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990




V. P. Voronina
State Research Center for Preventive Medicine
Russian Federation

Victoria P. Voronina - MD, PhD, Senior Researcher, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990




N. A. Dmitrieva
State Research Center for Preventive Medicine
Russian Federation

Nadezhda A. Dmitrieva - MD, PhD, Senior Researcher, Laboratory for Pharmacoepidemiological Studies, Department of Preventive Pharmacotherap 

Petroverigsky per. 10, Moscow, 101990




A. V. Zakharova
State Research Center for Preventive Medicine
Russian Federation

Alla V. Zakharova - MD, PhD, Senior Researcher, Laboratory for Pharmacoepidemiological Studies, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990




O. V. Lerman
State Research Center for Preventive Medicine
Russian Federation

Olga V. Lerman - MD, PhD, Senior Researcher, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990



A. A. Garganeyeva
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Alla A. Garganeyeva - MD, PhD, Professor, Head of Department of General Clinical Cardiology and Epidemiology of Cardiovascular Diseases 

Kooperativny per. 5, Tomsk, 634050




T. A. Gomova
Tula State University
Russian Federation

Tatiana A. Gomova - MD, PhD, Associate Professor, Chair of Internal Medicine, Medical faculty 

Lenina Prospect 92, Tula, 300012



S. A. Drozdetsky
Nizhny Novgorod State Medical Academy
Russian Federation

Sergei I. Drozdetsky - MD, PhD, Professor, Chair of Faculty and Polyclinic Therapy 

Minin and Pozharsky pl. 10/1, Nizhny Novgorod, 603005 

 




A. I. Chesnikova
Rostov State Medical University
Russian Federation

Anna I. Chesnikova - MD, PhD, Professor, Chair of Internal Medicine №1 

Nakhichevansky per. 29, Rostov-on-Don, 344022



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For citation:


Martsevich S.Y., Lukina Y.V., Kutishenko N.P., Voronina V.P., Dmitrieva N.A., Zakharova A.V., Lerman O.V., Garganeyeva A.A., Gomova T.A., Drozdetsky S.A., Chesnikova A.I. STUDY OF THE PARAMETERS OF TOLERABILITY AND ADHERENCE TO THERAPY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION ON THE BACKGROUND OF TREATMENT WITH FIXED COMBINATION OF RAMIPRIL AND AMLODIPINE (ACCORDING TO THE RESULTS OF OBSERVATIONAL STUDY "GRANAT-2"). Rational Pharmacotherapy in Cardiology. 2017;13(2):229-237. (In Russ.) https://doi.org/10.20996/1819-6446-2017-13-2-229-237

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ISSN 1819-6446 (Print)
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