The clinical effectiveness and safety of combinations of dlhydropyridine and non-dihydropyridinе derivatives of calcium blockers in the treatment of patients with moderate arterial hypertension

Abstract

The study was undertaken to evaluate the antihypertensive and antiischemic effects .mil safety of combined therapy with calcium blockers (CB) of the dihydropyridine and non-dihydropyridine series, and its impact on the structural and functional status of the heart. Forty-eight patients with stages II-II hypertensive disease and grade 2 (according to the All-Russian Cardiology Research Society classification, 2001) were examined. Of them, 31 patients were observed to have exercise induced anginal attacks. The data of 24-hour blood pressure (HP) monitoring, electrocardiography, and Doppler echocardiography were assessed The patients received combined therapy with amlodipine and isoptin SR for 24 weeks. With the therapy, its complete (BP < 140/90 mm Hg) and partial (a 10 mm Hg decrease in diastolic HP) antihypertensive effects were noted in 72,2 and 20,8 % of patients, respectively. The left ventricular myocardial index reduced by on average of 24,9±2,3 g/m² (p<0,01) and diastolic function improved: the E/A ratio increased 10,3 % (p<0,05); isovolumic relaxation time decreased by 13,6 % (p<0,01). There were also reductions in the depth of the maximum ST-segment depression (from 2,3±0,2 to l,5±0,1 mm) and in the duration and incidence of silent myocardial ischemia The rate of adverse reactions caused by combined therapy was 1,5-4 times less than that due to monotherapy. A combination of different classes of CB has rather high antihypertensive and cardioprotective effects and it is well tolerated.