Combined antihypertensive therapy in treating patients with metabolic syndrome

• Main Authors: V. B. Mychka, N. V. Flegontova, K. P. Ivanov, G. Kh. Sharipova, I. E. Chazova
• Format: Article
• Language: Russian
• Published: «SILICEA-POLIGRAF» LLC 2008-06-01
• Series: Кардиоваскулярная терапия и профилактика
• Subjects: arterial hypertension; metabolic syndrome; insulin resistance; trandolapril
• Online Access: https://cardiovascular.elpub.ru/jour/article/view/1373
• ISSN: 1728-8800; 2619-0125

Aim. To study the effects of 24-week treatment with trandolapril, as monotherapy or combined with verapamil, on parameters of 24-hour blood pressure monitoring (BPM), carbohydrate, lipid, and purine metabolism, tissue insulin sensitivity and microalbuminuria (MAU) in patients with mild to moderate arterial hypertension (AH) and metabolic syndrome (MS).Material and methods. The study included 20 patients with Stage I-II AH and MS. Initial dose of trandolapril was 2 mg/d, administered in the morning. If needed, trandolapril dose was doubled one week later. One more week later, all patients not achieving target BP levels were administered verapamil SR (240 mg/d). At baseline and 24 weeks after therapy start, levels of MAU, carbohydrate and lipid metabolism, 24-hour BPM were measured.Results. Six patients achieved target BP levels receiving trandolapril monotherapy only (4 mg/d). For 14 participants, additional treatment with verapamil SR (240 mg/d) was necessary for achieving target BP levels. Fasting glucose and postprandial C-reactive protein levels significantly decreased (p<0,05), as well as the levels of total cholesterol (CH) and low-density lipoprotein CH. MAU levels were similar to baseline parameters: 13,0+5,8 and 12,9+4,33 mg/1.Conclusion. Trandolapril and verapamil combination, being metabolically neutral, demonstrated good antihypertensive effects and improvement of carbohydrate and lipid metabolism parameters.