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EFFECTIVENESS OF LISINOPRIL AND AMLODIPINE COMBINATION AT HYPERTENSION WITH COMORBIDITY OF ARTERIOSCLEROSIS

Liliya S Babinets¹, Rostyslav D Levchuk¹, Iryna M Halabitska¹

¹I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)

|December 6, 2022

Insights

This study shows that combining lisinopril and amlodipine effectively treats hypertension with lower extremity artery disease. The treatment improved hemodynamics and achieved target blood pressure in patients.

Area of Science:

Cardiology
Pharmacology
Vascular Medicine

Background:

Hypertension is a major risk factor for cardiovascular disease.
Arterial occlusive disease of the lower extremities (AOLE) often coexists with hypertension.
Effective management requires addressing both conditions simultaneously.

Purpose of the Study:

To evaluate the hemodynamic effects of combined lisinopril and amlodipine therapy in hypertensive patients with AOLE.
To analyze changes in blood pressure, intracardiac, peripheral hemodynamics, and intima-media thickness.

Main Methods:

40 patients with hypertension (grades 2-3) and AOLE (stages I-III) were included.
Treatment involved fixed-dose lisinopril (10 mg) and amlodipine (5 mg), with dose adjustment if needed.
Hemodynamic parameters were monitored daily using echocardiography and lower extremity vessel ultrasound.

Main Results:

After 6 months, significant improvements were observed: pulse index increased by 24.8%, resistance index decreased by 21.1%.
Linear and volumetric blood flow velocity increased by 25.6% and 27.4%, respectively.
Target blood pressure levels were achieved in the study cohort.

Conclusions:

Combination therapy with lisinopril and amlodipine is an optimal and universal treatment for hypertension in patients with AOLE.
This regimen effectively improves central hemodynamics across different hypertension types.
The treatment is recommended in the absence of individual contraindications.

Read full analysis

Abstract

Objective:

The aim: To analyze the dynamics of daily monitoring of blood pressure, intracardiac (according to echocardiography), peripheral hemodynamics (according to ultrasound of the vessels of the lower extremity), the thickness of the intima-media complex (according to carotid sonography) in patients with hypertension the effect of treatment with a combination of lisinopril and amlodipine.

Patients And Methods:

Materials and methods: The study included 40 patients with hypertension with 2 (29 patients) and 3 (11 patients) degrees of hypertension in combination with AOLE with I-III stages of chronic insufficiency of the lower extremity, which revealed hyperkinetic, eukinetic, and hypokinetic types of hypertension with a predominance of the sympathetic nervous system. The groups are comparable in age, sex, duration of hypertension, and medications received in the previous stages. For antihypertensive therapy, the most common drugs for use were selected - lisinopril + amplodipine in fixed doses of 10 and 5 mg, respectively. If after 2 weeks we did not reduce the mean level of SBP and DBP by 10% or more from baseline, we doubled the dose of lisinopril without changing the dose of amlodipine.

Results:

Results: After 6 months of treatment, in particular, an increase in the pulse index - by 24.8%, a decrease in the resistance index - by 21.1%, an increase in linear and volumetric blood velocity - by 25.6% and 27.4%, respectively, while achieving the target blood pressure.

Conclusion:

Conclusions: It is proved that in the absence of individual contraindications the combination of lisinopril and amlodipine is optimal and universal for effective treatment of patients with hypertension in combination with AOLE in all types of central hemodynamics.

Keywords:

amlodipine arteriosclerosis obliterans hypertension lisinopril

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