Pleiotropic effect of chronotherapy with a fixed combination of amlodipine, lisinopril and rosuvastatin on the psychological state in elderly hypertensive patients with metabolic syndrome

Background. Hypertension (HTN) in metabolic syndrome (MS) in the elderly contributes to the formation of cognitive disorders and anxiety-depressive disorders. Objective. 
To study the psychological state of elderly patients with HTN and MS treated by evening versus morning dosing of a fixed combination (FC) of amlodipine, lisinopril and rosuvastatin. 
Design and methods. In a randomized, double-blind, controlled trial 63 patients aged 60–74 years with HTN and MS received a FC of amlodipine, liiznopril and rosuvastatin at a dose of 5/10/10 mg in the evening (after 20:00 hours) (study group) And 58 patients aged 60–74 years with HTN and MS took the drug in the morning (control group). Cognitive dysfunction was assessed by Mini-Mental State Examination (MMSE), anxiety and depressive disorders were assessed by State-Trait Anxiety Inventory adapted by Yu. Khanin and scale of the Center for Epidemiologic Studies-Depression (CES-D). 
Results. In evening dosing group, MMSE result increased from 17,8 ± of 0,3 to 23,5 ± 0,4 points (р = 0,13) vs. 16,9 ± of 0,3 to 20,4 ± 0,4 points (р = 0,148) in morning dosing. Situational anxiety score decreased from 40,0 ± 2,2 to 30,6 ± 1,8 points (р = 0,009) vs. from 40,8 ± of 2,5 to 33,5 ± 1,9 points (р = 0,011), and personal anxiety score from 48,8 ± 2,0 to 26,4 ± of 1,9 points (р = 0,003) and from 44,9 ± of 1,9 to 30,7 ± of 1,7 points (р = 0,008) in evening and morning dosing, respectively. Depressive disorders decreased similarly and slightly in both groups (14,1% versus 7,7% in evening and morning dosing, respectibely, p = 0,214). 
Conclusions. The results indicate that chronotherapy is more effective than the traditional use of a FC of amlodipine, lisinopril and rosuvastatin in HTN associated with MS.

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