Abstract:
The aim: To evaluate the dynamics of structural and functional parameters of the heart, vessels in patients with hypertension of the II-nd stage under the influence of combined
antihypertensive treatment depending on the type of the left ventricle remodelling and the profile of blood pressure (BP).
Materials and methods: The study involved 110 patients with hypertension of the II-nd stage. The ambulatory blood pressure monitoring, echocardiography and doppler
examination of the shoulder arteries were performed. Initial treatment included bisoprolol, lisinopril, hydrochlorothiazide. With impossibility of BP lowering to the target level,
amlodipine has been added.
Results: higher levels of BP in the “non-dipper” patients have led to the development of more pronounced changes in the heart and vessels compared with “dipper” patients.
Three-component therapy was effective in patients with lower BP. The prescription of amlodipine has been found to be necessary for the majority of “non-dipper” patients and
for the minority of “dipper”. Combined therapy effectively controlled the BP at the level of the target and contributed to a decrease in the displays of remodelling of the heart
and blood vessels.
Conclusions: combined therapy used for 6 months reduces displays of disadaptive heart and vascular remodelling, diastolic, endothelial dysfunction. With the lack of efficacy
of the therapy, which includes bisoprolol, lisinopril, hydrochlorothiazide, the adding of amlodipine to it can reach the target level of BP
