Vol 12, No 1 (2015)

The aim of the studyis to evaluate the efficacy of the fixed combination of beta adrenergic receptor blocking agents (β-AB) bisoprolol and dihydropyridine calcium channel inhibitor (CCI) amlodipine in patients with uncontrolled arterial hypertension (AH), stableischemic heart disease (IHD) and metabolic syndrome (MS) in actual clinical practice.Material and methods. The study enrolled 61 patients with uncontrolled AH, stable IHD and MS in the open prospective randomized study. The patients were randomized into 2 groups, using opaque and sealed envelopes. Patients in group 1 (n =30) had been receiving angiotensin-converting enzyme inhibitor (ACE inhibitor or ACE-i) - ramipril in dose of 10 mg/day (Hartil, Egis), fixed combination of bisoprolol and amlodipine (Concor AM, Takeda) in different doses. Patients in group 2 (control, n=31) should have been treated at the discretion of the doctor, necessarily the treatment should have included the free combination of ACE inhibitors, generic b-AB and dihydropyridine CCI. Initially, and after 12 weeks of treatment we conducted 24-hour ambulatory blood pressure monitoring (APBM) with the assessment of key indicators of 24-hour blood pressure monitoring results, the parameters of the blood vessel hardness and central blood pressure. The Statistical analyses of the results were carried out using the software package Statistica 6.1 (StatSoft Inc., United States).Results. After 12 weeks of therapy, the target level of BP was - 96,7% in the 1st group and 87,1% in the 2nd group of patients. The application of Concor AM was accompanied by significant improvements of the indicators of APBM and of the blood vessel hardness and central blood pressure characteristics. In addition, the usage of Concor AM provides the normalization of 24-hour ambulatory blood pressure monitoring results in 73% of patients. In the control group we determined the positive, but less significant changes in the indicators of APBM and rarer normalization of 24-hour ambulatory blood pressure monitoring results than in the group of patients, administrating Concor AM.Conclusion. In patients with AH, IHD and MS the administration of Concor AM is provided a significant antihypertensive and vasoprotective effects, which are more effective by the side of using free combination of β-AB and dihydropyridine CCI.

Aims: to study the effects of the amlodipine and atorvastatin on the blood levels of vasoactive mediators in patients with metabolic syndrome (MS). Design and methods. There were included 60 patients with MS, hypertension and dyslipidemia who were randomized into three treatment groups: monotherapy with amlodipine, atorvastatin monotherapy and a combination therapy with amlodipine and atorvastatin. Office blood pressure, 24-hour ambulatory blood pressure monitoring, measurements of the NO metabolite levels, endothelin-1, thromboxane B2 (TxB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α) were performed at baseline and after 24 weeks of the therapy.Results. Amlodipine and atorvastatin in monotherapy or in a combination were associated with the significant improvement of certain studied parameters. Amlodipine treatment significantly decreased TxB2 and 6-keto-PGF1α levels. There was a significant reduction of TxB2, 6-keto-PGF1a levels and increase of NO metabolite in atorvastatin group. Treatment with combination of amlodipine and atorvastatin was characterized by significant decrease of TxB2 and endothelin-1 and increase of NO metabolite.Conclusion. Amlodipine and atorvastatin treatment showed positive effects on the levels of vasoactive mediators thereby leading to the improvementof endothelial function in patients with MS.

The risk of cardiovascular complications increases steadily with increases in arterial pressure and is significantly intensified in the presence of other risk factors for cardiovascular disease (smoking, sedentary lifestyle, alcohol abuse, stress, dyslipidemia, metabolic syndrome, diabetes mellitus). It reduces the quality of life, which is especially important for people, engaged in heavy physical labor. The most common medical and social risk factors for cardiovascular disease and hypertension in coal miners are the following: overweight and obesity, bad habits and lack of education. The further study of the prevalence pattern of risk factors for cardiovascular disease in coal miners is required to develop, implement and evaluate the efficiency of preventive measures towards reducing cardiovascular risk factors.

Disorders and neuropathy are the leading cause of disability. Their partof total morbidity and disability is increasing due to the global growth of vascular diseases of the brain: the acute and the chronic disorders of cerebral circulation. The clinical characteristics of chronic disorders of cerebral circulation have been forming gradually, and include the development of cognitive impairments, up to dementia. The base for their development can serve thelong-term cardiovascular diseases (CVD). The problem of cognitive impairments in patients with CVD, particularly with arterial hypertension (AH), is a leading one, taking into consideration the fact that these disorders are continuing to grow in the population. There is a real possibility to impact on the cognitive functions condition in patients with AH, using traditional antihypertensive drugs such assartans to achieve the target blood pressure levels. However, there is the additional benefit of special drugs in this group, such as Micardis and Twynsta, in the correction of cognitive function disorders.

This article deals with the epidemiological datashowing higher frequency of arterial hypertension (AH) in patients with ischemic heart disease (IHD). We discussed the basic characteristics of modern domestic and foreign recommendations for treating patients with combination of AH and IHD. We showed the target of blood pressure (BP) in this category of patients. This article deals with the priority groups of antihypertensive drugs, which have the advantages in the combination usage in patients with association of these diseases. We fixed special attention to the problem of BP variability (BPV) as a new risk factor for the development of coronary complications in patients with AH. We showed the possibility of fixed combination of perindopril and amlodipine in reducing interand intervisit BPV in patients with AH and IHD in actual clinical practice.

The problem of the compliance is relevant in the treatment of patients with arterial hypertension. The review presents the data to identify mechanisms for improving the compliance in the context of one of the most studied drugs, such as - perindopril. We have indicated the aspects of perindopril monotherapy, as well as in combination with indapamide and amlodipine. We have showed the advantages of fixed combinations. The individual aspect of the easy medicine administration isdispersion form of the drug. This article shows the advantages of usage PrestariumR ORO - innovative form of perindopril, mouth dissolving tablets.