АНТИГИПЕРТЕНЗИВНАЯ И ОРГАНОПРОТЕКТИВНАЯ ЭФФЕКТИВНОСТЬ ШЕСТИМЕСЯЧНОЙ КОМБИНИРОВАННОЙ ТЕРАПИИ У БОЛЬНЫХ РЕЗИСТЕНТНОЙ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ

The aim was to study antihypertensive, organoprotective efficacy during multicomponent therapy with ACE inhibitors (or sartan) + amlodipine + indapamide + β-blocker (and / or aldesterone antagonist) during six-month therapy in patients with resistant arterial hypertension (RAH). Material and methods. The study included 23 patients with RAH of the II–III degree (ESC/ ESH, 2018) of both sexes. Patients were prescribed fixed combination therapy perindopril / indapamide / amlodipine or nonfixed combination therapy with valsartan, indapamide and amlodipine. If target BP levels were not achieved, nebivolol and/or spironolactone were added to therapy. Initially and at the end of six-month therapy, the parameters of intracardiac hemodynamics were studied by echocardiography, the thickness of the intimamedia complex of the common carotid artery was evaluated by duplex scanning, the level of microalbuminuria (MAU) in daily urine and the level of serum lipids, sugar, creatinine and uric acid determined by enzymatic analysis. Conclusion. Thus, multicomponent therapy with the inclusion of indapamide, amlodipine, the RAAS blocker, if necessary with the addition of nebivolol and/оr spirolonactone, is characterized by high antihypertensive efficacy, pronounced organoprotection, metabolic neutrality with a positive effect on the blood lipid spectrum, good tolerance, which generally characterizes this treatment regimen as the most optimal and effective in reducing the risk of cardiovascular complications in the majority of examined patients with RAH