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COMPARATIVE EFFICACY OF COMBINED ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH MODERATE ARTERIAL HYPERTENSION ACCOMPANIED BY TYPE 2 DIABETES

https://doi.org/10.20996/1819-6446-2011-7-6-703-707

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Abstract

Aim. To compare efficacy of different fixed antihypertensive combinations in achievement of the target level of blood pressure (BP), to evaluate the dynamics of endothelium-dependent vasodilation (EDVD) and microalbuminuria (MAU) and to calculate cost-effectiveness ratio (CER). Material and methods. Patients (n=75) with moderate hypertension (HT) accompanied by type 2 diabetes (DM) were studied. The patients were randomized in groups A, B or C. Patients of group A (n=25) received a fixed combination of the original perindopril+indapamide, patients of group B (n=30) — a fixed combination of the generic enalapril+indapamide, patients of group C (n=20) — a fixed combination of the original enalapril+hydrochlorothiazide. Office BP was examined within the 4, 8 and 12 weeks, EDVD and MAU were determined initially and after 12 weeks of therapy. CER was also calculated. Results. The maximal antihypertensive effect was observed in group C (systolic BP (SBP) decreased in 46.6±1.3 mm Hg), followed by group A (SBP decreased in 43.1±0.8 mm Hg) and B (SBP decreased in 40.0±0.8 mm Hg). The groups were distributed as follows (in descending order): according to EDVD rise - group A (Δ4.52%), C (Δ3.14%) B (Δ3%); according to MAU prevalence rate reduction - group A (from 48% to 8%), B (from 40% to 23%) and C (from 40% to 25%). The “C” combination provided the lowest cost of BP reduction (12.33 rubles/mm Hg) and correction of MAU prevalence rate (1 514 rubles/case). According to EDVD improvement combination “A” had the lowest CER (2 805 rubles/case). Conclusion. According to pharmacoeconomic analysis the fixed combination of original enalapril+hydrochlorothiazide and the fixed combination of original perindopril+indapamide should be used in patients with moderate arterial hypertension, endothelial dysfunction and/or MAU.

About the Authors

E. I. Tarlovskaya
Kirov State Medical Academy
Russian Federation


Yu. A. Balandina
Kirov State Medical Academy
Russian Federation


I. E. Sapozhnikova
Kirov State Medical Academy
Russian Federation


N. S. Maksimchuk
Kirov State Medical Academy
Russian Federation


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For citation:


Tarlovskaya E.I., Balandina Yu.A., Sapozhnikova I.E., Maksimchuk N.S. COMPARATIVE EFFICACY OF COMBINED ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH MODERATE ARTERIAL HYPERTENSION ACCOMPANIED BY TYPE 2 DIABETES. Rational Pharmacotherapy in Cardiology. 2011;7(6):703-707. (In Russ.) https://doi.org/10.20996/1819-6446-2011-7-6-703-707

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ISSN 1819-6446 (Print)
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