RATIONAL SELECTION OF COMBINATION OF ANTIHYPERTENSIVE DRUGS IN ARTERIAL HYPERTENSION WITH CORROSIVE ATHEROSCLEROSIS OF LOWER LIMBS IN AMBULATORY PRACTICE
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i4.9734Keywords:
arterial hypertension, antihypertensive therapy, obliterating atherosclerosis, carvedilol, telmisartan, amlodipineAbstract
Introduction. The study of the effect of a combination of antihypertensive drugs on the main indicators of central and peripheral hemodynamics of 96 patients with arterial hypertension with atherosclerotic lesions of the peripheral arteries of the lower extremities has been conducted.
The aim of the study – to learn the effect of antihypertensive drugs of different groups of the first line on central, peripheral and intracardiac hemodynamics in order to select the optimal combination of these drugs for the treatment of patients with arterial hypertension with peripheral arterial lesions in the lower limbs at the primary care stage.
Conclusions. The comparative assessment of the effects of combinations of carvedilol+hydrochlorothiazide, telmisartan+hydrochlorothiazide and lisinopril+amlodipine stated: 1) These combinations of antihypertensive drugs provide a stable and uniform antihypertensive effect during the day and have a corrective effect on the daily blood pressure profile, significantly lowering the average daily, midday and middle systolic and diastolic blood pressure, as well as heart rate; 2) the indicated combinations of antihypertensive drugs in patients with hypertension, which is combined with atherosclerotic lesions of the major arteries of the lower extremities, with hyperkinetic or eukinetic type of central hemodynamics with the prevalence of the sympathetic nervous system positively affects the main indicators of central and peripheral hemodynamics; 3) the antihypertensive combination of lisinopril + amlodipine should be considered the most successful treatment for patients with arterial hypertension in combination with atherosclerotic lesions of the major arteries of the lower extremities for the effect on achievement of the target blood pressure level for 6 months, for the total effect on parameters of general and specific peripheral vascular resistance and the level of vascular remodeling (according to the thickness of the intima-media complex); 4) the positive effect of the studied combinations of antihypertensive drugs on peripheral hemodynamics may give the opportunity to reduce the dose of vasodilators used for the treatment of chronic arterial ischemia of the lower extremities.
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