Blood pressure control and vascular protection with a fixed-dose combination of lisinopril + amlodipine + rosuvastatin in hypertensive patients

Abstract

Aim: Assessment of the possibility of the fixed-dose combination of lisinopril + amlodipine + rosuvastatin (Equamer) to achieve further angioprotection in patients with arterial hypertension and high pulse wave velocity (PWV) despite the previous combination antihypertensive therapy (AHT).

Methods: The 24-week open-label multi-center observational study involved 60 patients who received dual combination AHT for 6 months. All patients underwent 24 h blood pressure (BP) monitoring, applanation tonometry (determination of the augmentation index and central BP), measurement of the pulse wave velocity and laboratory tests [blood lipids, fasting glucose test, homeostasis model assessment of insulin resistance (HOMA-IR), leptin, ultra-sensitive C-reactive protein (us-CRP)] before and after switching to the fixed-dose combination of lisinopril + amlodipine + rosuvastatin (Equamer).

Results: According to the office BP measurements, switching the patients from the dual combinations to the fixed-dose combination of lisinopril + amlodipine + rosuvastatin has resulted in a further decrease of 14.3% in systolic BP (SBP) and 18.5% in diastolic BP (DBP). According to the 24 h BP monitoring data, the SBP has decreased by 16.1% and the DBP by 21.8%. The combination of lisinopril + amlodipine + rosuvastatin has reduced the SBP by 14.4%, the augmentation index by 14.5% and the central SBP by 8.1% (P < 0.01 vs. baseline). The fixed-dose combination of lisinopril + amlodipine + rosuvastatin has provided a 44%-decrease in low-density lipoproteins, a 36.1%-decrease in triglycerids and a 10.3%-increase in high-density lipoproteins (P < 0.01 vs. baseline). The use of the fixed-dose combination of lisinopril + amlodipine + rosuvastatin has provided a definite decrease in the insulin resistance, as well as levels of us-CRP and leptin.

Conclusions: The fixed-dose combination of lisinopril + amlodipine + rosuvastatin provides improved BP control, better vessel elasticity indicators (augmentation index, PWV, central BP), boosts the lipid and carbohydrate metabolism and helps to reduce the inflammation and leptin resistance in patients who initially received a dual combination AHT.

Keywords

Arterial hypertension / pulse wave velocity / central blood pressure / augmentation index / leptin / inflammation / combination antihypertensive therapy / lisinopril / amlodipine / rosuvastatin

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