Arterial hypertension in perimenopause: effects of lisinopril and Femo-Clim combination on the hypotensive effect, functional state of endothelium, cardiac remodeling and quality of life

The paper presents the experience of combined therapy with an angiotensin-converting enzyme inhibitor (lisinopril) and Femo-Clim in female patients with arterial hypertension (AH) and its effects on the structural geometric changes of left ventricle (LV), endothelium-dependent vasodilation (EVD) of peripheral arteries, blood pressure (BP) values, the marked clinical manifestations of perimenopause. Material and methods. The study followed 77 women with stage II AH during perimenopause with left ventricular myocardial hypertrophy (LVMH) and peripheral arterial endothelial dysfunction. Mean age was 50.3±4.2 years, mean systolic BP was 171.67±2.81 mm Hg, diastolic BP, 99.7±0.63 mm Hg; mean estradiol level, 0.20±0.05 pkg/mL; mean follicle-stimulating hormone, 24.89±1.12 IU/mL; complaints of hyperhidrosis, hot flashes, disturbance of the general sense of well-being, uneasy sleep, poor appetite and impaired mood. Patients received lisinopril 10 mg daily for 6 months and Femo-Clim 2 tablets daily for 1 month. The patients’ condition was monitored: BP, heart rate, ECG, EKVD test, echocardiography. The study did not include patients with coronary heart disease, chronic heart failure, dyslipidemia, diabetes mellitus, and renovascular disease. Results. The use of lisinopril in patients with AH during perimenopause showed a good antihypertensive effect, slowed the development of LVMH, and had a positive effect on LV remodeling (primarily, on the concentric type). Lysinopril and Femo-Clim combination had a positive effect on peripheral arterial endothelial dysfunction and was well tolerated by the patients. Femo-Klim is combined with cardiotropic therapy and is effective in the therapy of clinical manifestations in patients with AH during perimenopause.