The effectiveness of a multi‑target therapy polypill in patients with hypertension and dyslipidemia after novel coronavirus infection

Abstract

Objective. The aim is to study antihypertensive and lipid-lowering effects of polypill therapy in patients with arterial hypertension (HTN) grade 1–2 and dyslipidemia, who had a novel coronavirus infection. Design and methods. We enrolled 65 patients with HTN and dyslipidemia after COronaVIrus Disease-2019, of which 60 people (92,3 %) completed observation. During 24 weeks patients took polypill therapy, including indapamide, perindopril and rosuvastatin. Office blood pressure (BP) measurements using the Korotkov method and 24-hour ambulatory BP monitoring (ABPM) were performed; level of total cholesterol, triglycerides, high density lipoprotein cholesterol were assessed. Low-density lipoprotein cholesterol (LDL–C) and non-high-density lipoprotein cholesterol levels were calculated. Results. After 24 weeks of polypill therapy 54 patients (90 %) reached target BP levels. According to 24-hour ABPM data, there was a significant decrease in the average daily, average day and night BP values, reduction in blood pressure load and BP variability (p < 0,001). By the end of treatment, there was an increase in the number of patients with normal daily profile (dipper) (р < 0,05). After 24 weeks, an improvement of lipid profile indicators was recorded, target level of LDL–C was achieved in 28 (84,8 %) patients at high risk and 15 (55,6 %) patients at very high risk. Chances of simultaneous achievement of target values for BP and LDL–C in the high risk group were 4 times higher than in the very high risk group (odds ratio 4,2 [95 % confidence interval 1,3–13,4]; p = 0,028). Conclusions. According to 24-hour ABPM data, 24-week polypill therapy including indapamide, perindopril and rosuvastatin leads to a significant reduction in average daily BP values and contributes to the normalization of the daily profile. After 6-months therapy, target BP and LDL–C levels were achieved in 68,3 % patients with HTN and dyslipidemia who have had COVID-19.