Impact of vascular remodeling and of heart rate variability on antihypertensive and cardiovascular effects of indapamide retard in hypertensive patients
https://doi.org/10.18705/1607-419X-2010-16-3-250-255
Abstract
Objective. To compare the antihypertensive and cardiovascular protection effects of Indapamide retard in response to
arterial remodeling and heart rate variability (HRV) in hypertensive patients. Design and methods. Structural and functional
indices of heart and brachial artery (BA) by ultrasound examination, circadian blood pressure (BP) rhythm and HRV by 24-hour
ECG and BP monitoring were assessed at baseline and after 6-month therapy with Indapamide retard. Patients were divided
into 2 groups: 1st group included 37 patients without arterial remodeling; 2nd group - 48 patients with arterial remodeling.
Results. Antihypertensive effect of Indapamide retard did not differ in groups. Changes of HRV indices were signifi cantly
higher in 1st group, but the regression of vessel remodeling and increasing of endothelium-dependent vasodilation were
signifi cant in 2nd group. Conclusion. This study shows that cardiac protection and antihypertensive effects of Indapamide
retard realize through autonomic modulation effect in absence of vascular remodeling, but direct vascular effect is observed
in patients with vascular remodeling.
arterial remodeling and heart rate variability (HRV) in hypertensive patients. Design and methods. Structural and functional
indices of heart and brachial artery (BA) by ultrasound examination, circadian blood pressure (BP) rhythm and HRV by 24-hour
ECG and BP monitoring were assessed at baseline and after 6-month therapy with Indapamide retard. Patients were divided
into 2 groups: 1st group included 37 patients without arterial remodeling; 2nd group - 48 patients with arterial remodeling.
Results. Antihypertensive effect of Indapamide retard did not differ in groups. Changes of HRV indices were signifi cantly
higher in 1st group, but the regression of vessel remodeling and increasing of endothelium-dependent vasodilation were
signifi cant in 2nd group. Conclusion. This study shows that cardiac protection and antihypertensive effects of Indapamide
retard realize through autonomic modulation effect in absence of vascular remodeling, but direct vascular effect is observed
in patients with vascular remodeling.
About the Authors
B. Iskenderov
Penza Institute of Postgraduate Medical Training
Russian Federation
Russian Federation
O. N. Sisina
Penza Institute of Postgraduate Medical Training
Russian Federation
Russian Federation
T. M. Shibaeva
Medical Institute of Penza State University
Russian Federation
Russian Federation
References
1. Недогода С.В. Диуретики при артериальной гипертензии. - М.: МАИ, 2008. - 175 с.
2.
3. Robinson D.M., Wellington K. Indapamide sustained release. A review of its use in the treatment of hypertension // Drugs. - 2006. - Vol. 66, № 2. - P. 257-271.
4.
5. Сидоренко Б.А., Борисова Е.О. Диуретики // Рациональная фармакотерапия сердечно-сосудистых заболеваний: руководство для практикующих врачей / Под ред. Е.И. Чазова, Ю.Н. Беленкова. - М.: Литература, 2004. - C. 103-106.
6.
7. Donnely R. Clinical implications of indapamide sustained release 1,5 mg in hypertension // Clin. Pharmacokinetics. - 1999. - Vol. 37, (Suppl. 1). - P. 21-32.
8.
9. Chobanian A.V., Bakris G.L., Black H.R. et al. The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure: the JNC-7 report // J. Am. Med. Assoc. - 2003. - Vol. 289, № 19. - P. 2560-2572.
10.
11. Национальные рекомендации по диагностике и лечению ар- териальной гипертензии. Всероссийского научного общества кардио- логов (ВНОК), Российское медицинское общество по артериальной гипертензии // Кардиоваск. терапия и профилактика. - 2008. - № 6 (Прил. 2). - С. 3-32.
12.
13. Чазова И.Е., Бойцов С.А., Остроумова О.Д. Комбинированная терапия больных артериальной гипертонией: методическое письмо. - М.: Атмосфера, 2004. - 47 с.
14.
15. Emeriau J.P., Knauf H., Pujadas J.O. et al. European Study investigators. A comparison of indapamide SR 1,5 mg with both amlodipine 5 mg and hydrochlorothiazide 25 mg in the elderly hypertensive patients: a randomized double-blind controlled study // J. Hypertens. - 2001. - Vol. 19, № 2. - P. 343-350.
16.
17. Teichholz L., Kreulen T., Herman M. et al. Problems in echocardiographic volume determination echo-angiographic correlations // Circulation. - 1972. - Vol. 46, (Suppl. II). - P. 75-79.
18.
19. Devereux R., Reichek N. Echocardiographic assessment of left ventricular mass in man // Circulation. - 1977. - Vol. 55. - P. 613-618.
20.
21. Celermajer D.S., Sorensen K.E., Gooch V.M. et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis // Lancet. - 1992. - Vol. 340, № 8828. - P. 1111-1115.
22.
23. Кобалава Ж.Д., Котовская Ю.В. Мониторирование артериаль- ного давления: методические аспекты и клиническое значение. - М., 1999. - 234 с.
24.
25. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of measurement, physiological interpretation and clinical use // Circulation. - 1996. - Vol. 93, № 5. - P. 1043-1056.
26.
27. Akram J., Sheikh U.E., Mahmood M. et al. Antihypertensive effi cacy of indapamide SR in hypertensive patients uncontrolled with a background therapy: the NATIVE study // Curr. Med. Res. Opin. - 2007. - Vol. 23, № 12. - P. 29-36.
28.
29. London G., Asmar R., Schmieder R., Calvo C. Antihypertensive effi cacy of Indapamide SR vs candesartan and amlodipine in hypertensive patients and in isolated hypertensive patients // Am. J. Hypertens. - 2004. - Vol. 17. - P. 183A.
30.
31. Mussalo H., Vanninen E., Ikaheimo R. et al. Heart rate variability and its determinants in patients with severe or mild essential hypertension // Clin. Physiol. - 2001. - Vol. 21, № 5. - P. 594-604.
32.
33. Миронов В.А., Миронова Т.Ф., Саночкин А.В. и др. Вариа- бельность сердечного ритма при гипертонической болезни // Вестн. аритмологии. - 1999. - № 13. - С. 41-47.
34.
Review
For citations:
Iskenderov B., Sisina O.N., Shibaeva T.M. Impact of vascular remodeling and of heart rate variability on antihypertensive and cardiovascular effects of indapamide retard in hypertensive patients. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2010;16(3):250-255. (In Russ.) https://doi.org/10.18705/1607-419X-2010-16-3-250-255
Views:
821
Email this article 