[PP.12.20] THE IMPACT OF COMBINED ANTIHYPERTENSIVE THERAPY WITH PERINDOPRIL A AND INDAPAMIDE ON MORPHOFUNCTIONAL PARAMETERS OF SMALL AND MEDIUM VESSELS IN PATIENTS WITH ARTERIAL HYPERTENSION

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Abstract

Objective:

Assess the impact of combined therapy with Perindopril A and Indopamide on cognitive function and microcirculation in patients with arterial hypertension (AH).

Design and method:

30 patients with AH II-III degree (20 women, 10 men) at the age of 40–70 years old (average age 60,06+10,19 years) were included in the study; the average duration of AH - 14,7 (3;32) years. All patients underwent assessment of endothelial function using photoplethysmography (PPG) (“Angioscan-01”, Angioscan, Russia) and reactive hyperemia test (RHT) (pressurization of air to the cuff at 220 mmHg for 5 minutes). The pulse wave amplitude was identified; according to the augmentation of pulse wave occlusion index (OI), which characterizes endothelial function, was calculated (N>1.8). The reflection index (RI), a parameter of arterioles’ remodeling, was also identified.

Design and method:

Structural and functional features of capillary net of finger skin were assessed, using computer video cappilaroscopy of finger skin (CS) (“Capillaroscan-1”, New energetic technologies, Russia). Structural parameters were identified: rest capillary net density (CNDr), CND after venous occlusion test (DCNvo). Functional parameters were identified: CND after RHT (DCNrh), percentage of capillary recovery (PCR), percentage of perfused capillaries (PPC). In all patients cognitive function was assessed by Montreal Scale of cognitive disorders (MSCD) at the beginning and after 12 months.

Results:

This study allowed us to reveal positive impact of Noliprel-Bi-Forte among patients with AH after 12 month therapy on endothelial function of the microcirculation vessels and small or medium-size arterial vessels: increase of OI 1.4 to 1.8 (p 0.00005), phase displacement increased 5.0 to 10.8 (p 0.00001), what characterizes the improvement of vessel wall elasticity and endothelium dependent vasodilatation. Positive impact of Noliprel-Bi-Forte therapy was noted relatively the parameters of capillary vessel remodeling: DCNr increased 44.8 to 52.0 cap/mm2 (p 0.00007) and DCNvo increased 55.0 to 61.0 cap/mm2 (p 0.006). In the research group statistically significant improvement of cognitive function was also revealed: increase of MSCD points 23 to 27 (p 0.0001).

Conclusions:

Combination therapy of perindopril A and indapamide improves endothelial function, structural and functional parameters of microcirculation and cognitive function in arterial hypertensive patients.

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