Effectiveness of a fixed combination of amlodipine/indapamide in hypertensive patients in real clinical practice

Abstract

Objective. To assess the possibility of obtaining and the degree of additional antihypertensive effect, the dynamics of vascular wall stiffness parameters, vascular age indicators in patients with uncontrolled hypertension (HTN) when transferring from previous therapy to a fixed combination of amlodipine/indapamide in typical outpatient practice.Design and methods. Twenty-five patients with 1–3 degree HTN who got a prescription of a fixed combination of amlodipine/indapamide (ARIFAM 5/1,5 or 10/1,5 mg, Servier) were included in the study. The follow-up duration was 2 months and included the following methods: clinical assessment (systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate), with titration of the drug dose every two weeks; double assessment (at the beginning and at the end of the study) of arterial stiffness based on the determination of the cardio-ankle vascular index (CAVI), biological age of vessels using the VaSeraVS‑1500N volumetric sphygmography device, as well as quality of life indicators (SF‑36 questionnaire). The reliability of changes in the studied parameters during active outpatient management of patients was assessed.Results. Combined pharmacotherapy using a fixed combination of amlodipine/indapamide was well tolerated by all patients. We recorded a significant decrease in SBP on average by 31,0 ± 10,6 mmHg, DBP by 11,0 [7,0; 20,0] mmHg, and the achievement of the target SBP level at the end of the 2nd month was shown in 17 (68 %) patients, the target DBP level was found in 100 % of patients. A significant decrease in vascular wall stiffness parameters was shown as a decrease in the CAVI index (p = 0,034), a decrease in AI (p = 0,0001) and the PEP/ET ratio of the Veissler coefficient (p = 0,009), as well as in the calculated vascular age indicator (p = 0,00001). Significant (p = 0,0001) changes were recorded for most data of quality of life (SF‑36) in patients with HTN, with the exception of the social functioning scale.Conclusions. Combined pharmacotherapy of patients with 1–3 degree HTN with the inclusion of a fixed combination drug amlodipine/indapamide with prolonged release has a clear positive effect, i. e. improved hemodynamic parameters, a significant reduction in vascular stiffness, a decrease in vascular age and improved quality of life.