The clinical efficacy of a fixed combination of angiotensin receptor blockers valsartan II with a calcium antagonist amlodipine - drug Exforge® smokers patients with cardiovascular disease and chronic obstructive pulmonary disease

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Abstract

The Aim. A study of the clinical efficacy and safety of a fixed combination of valsartan (ARB) with amlodipine (AK), appointed as part of the standard therapy of hypertension and coronary heart disease smoking patients with chronic obstructive pulmonary disease. Material. The study included 36 men aged 40 to 65 years. All patients were treated with statins, aspirin, selective b-blockers; 16.7% of patients received diuretics, and 19.4% - long-acting nitrates. After randomization, patients were divided into 2 groups: group 1 (n=18, mean age 55.8±5.9 years) in addition to those receiving treatment angiotensin-converting enzyme (ACE) and group 2 (n=18, average age 58.0±4.9 years) - combined preparation Eksforzh® (amlodipine 5-10/160 mg valsartan). Study duration - 4 months.Methods. In a study clinical examination wasconducted, bicycle stress test (HEM-test), echocardiography (echocardiography), daily monitoring of blood pressure (BP), spirometry, determination of the concentration of lipids and lipoproteins, glucose, fibrinogen, uric acid, creatinine with calculation of glomerular filtration rate by MDRD.Used questionnaires: Hospital Anxiety and Depression Scale (HADS), St George's Hospital (SGRQ) and quality of life (QOL) SF-36. The Results. The appointment of the drug to patients Eksforzh® accompanied by a significant reduction in levels of “office” in systolic blood pressure at 39.2±9.7 mm Hg. Art. ( p <0.001), diastolic blood pressure of 16.9±5.7 mm Hg. Art. ( p <0.001) and pulse pressure to 22.2±5.9 mm Hg. Art. ( p <0.001) versus no such favorable dynamics in patients of group 1. On therapy with Eksforzh® all 18 patients achieved target BP<140/90 mm Hg. Art. At the same time on therapy with Eksforzh® positive changes in circadian BP profile.After 4 months of taking the drug Eksforzh® in patients with comorbidity observed favorable growth of the basic parameters of physical performance: an increase in the duration of exercise performed (FN) for HEM-sample (22.2%, p <0.01), the power threshold FN (on 23.6%, p <0.01), lengthening the time before the onset of an attack of angina pectoris (8.6%, p <0.05) and ischemia (8.3%, p <0.05). In contrast, patients in group 1 receiving ACE inhibitors, there was a decrease in the duration of the FN (10.2%, p <0.05) and time (29%, p <0.05) to the development of angina attack.In patients in group 2 positive changes were found in the structural and functional parameters of the heart according to echocardiography due to lower average pressure in the pulmonary artery. While taking the drug Eksforzh® the improvement of respiratory function parameters was shown, as well as indicators of psychological status and quality of life against the negative dynamics of these parameters in patients in group 1. Conclusion. Combined preparation Eksforzh® should be considered as a first choice in patients with concomitant cardiovascular and bronchopulmonary diseases due to its high clinical efficacy and good tolerability.

About the authors

M. G Bubnova

State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation

Email: mbubnova@gnicpm.ru
д-р мед. наук, проф., рук. отд. реабилитации и вторичной профилактики сочетанной патологии с лабораторией профилактики атеросклероза и тромбоза ФГБУ ГНИЦ ПМ 101000, Russian Federation, Moscow, Petroverigskii per., d. 10, str.3

D. M Aronov

State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., засл. деят. науки РФ, рук. лаборатории кардиологической реабилитации ФГБУ ГНИЦ ПМ 101000, Russian Federation, Moscow, Petroverigskii per., d. 10, str.3

Yu. N Sulim

Nordic health center

врач-кардиолог отд-ния кардиологии и функциональной диагностики ООО «Скандинав- ский центр здоровья» 111024, Russian Federation, Moscow, ul. 2-ya Kabel’naia, d. 2

V. A Vygodin

State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation

вед. науч. сотр. ФГБУ ГНИЦ ПМ 101000, Russian Federation, Moscow, Petroverigskii per., d. 10, str.3

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