[Selection of rational combinations of indapamide with various of calcium antagonists in patients with arterial hypertension].

We studied 89 patients with II degree arterial hypertension (age 43-67 years). Before and in 24 weeks after therapy we carried out 24-hour monitoring of arterial pressure and Doppler echocardiography. Patients were divided into 2 groups. Combination therapy with indapamide and verapamil retard, indapamide and amlodipine were prescribed to patients of group 1 and 2, respectively. At the background of therapy circadian rhythm was normalized in 82.8 and 76.9% of patients in groups 1 and 2, respectively. In group1 therapy was especially effective in patients with type 1 left ventricular diastolic dysfunction (LVDD), 24-hour nondipper profile, and hyperkinetic type of circulation. In group 2 pronounced changes of parameters were seen in II-III type of LVDD and hypokinetic type of circulation.

[Efficacy of calcium antagonists depending on the functional state of parathyroid glands in patients with hypertensive disease].

Hypotensive and cardioprotective effects of amlodipine (normodipine) were evaluated in 65 patients (35 men and 30 women) with grade II essential arterial hypertension treated with regard for calcium-controlling parathyroid function. 24 hour Holter monitoring, Doppler-cardiography, and blood PTH measurement were performed before and 6 months after the onset of therapy. The patients were divided into 3 groups depending on PTH levels (0-25, 26-50, and over 51 pg/ml). Changes of structural and functional cardiac parameters and AD were most prominent in group 3 in the form of decreased left ventricular hypertrophy, improved ventricular diastolic function, and marked hypotensive effect. The group was significantly different from group 1 in terms of these characteristics. Univariate analysis revealed correlation of PTH levels with left ventricular mass, mean daily systolic and diastolic AD, and left ventricular diastolic function. It is concluded that evaluation of calcium-regulating parathyroid function is necessary for optimization of antihypertensive therapy with calcium antagonists.

[Evaluation of hypotensive and antiischemic effects of a combination of dihydropyridine and non-dihydropyridine calcium antagonists in patients suffering from coronary artery disease with arterial hypertension].

The hypotensive and antiischemic activity of combined therapy with dihydropyridine group (amlodipine) and non-dihydropyridine group (verapamil retard) calcium antagonists (CA) as well as tolerance to this therapy were studied in 43 patients suffering from coronary heart disease (CAD) with II-III functional class exertional angina and II degree essential hypertension during 24 weeks. Twenty-four-hour ECG and blood pressure (BP) monitoring and Doppler EchoCG were done. The combination of amlodipine and verapamil retard in different day doses made it possible to achieve target BP levels in 86% of cases, improved circadian BP pattern and decreased left ventricular myocardial mass index (18.5% on the average; p < 0.01). The study also demonstrated prominent antiischemic and antianginal effects of the therapy, including patients with left ventricular hypertrophy. A decrease in myocardial ischemic (both painful and painless) episode frequency and the total duration of ST segment depression were the most pronounced changes. The combination of amlodipine and verapamil retard had a substantially lower rate of adverse effects compared with that of each of the component when used separately thanks to mutual neutralization of their side-effects or a possibility to lower their doses. Thus, the combination of CA from different groups possesses high hypotensive and antiischemic activity and good tolerance, which allows recommending it for treatment of patients suffering from CAD with arterial hypertension.

[Efficacy of and tolerance to combined therapy with dihydropyridine and non-dihydropyridine Ca antagonists in patients with moderate arterial hypertension].

The authors of the article studied efficacy of combined therapy with dihydropyridine and non-dihydropyridine Ca antagonists, its influence on structural and functional condition of the heart in 53 patients (28 men and 25 women) with moderate arterial hypertension (AH), and their tolerance to the therapy. Before and during the treatment the patients underwent 24-hour arterial pressure (AP) monitoring and Doppler echoCG. Due to combined therapy with isoptin SR and corinfar retard complete hypotensive effect (AP < 140/90 mmHg) was achieved in 83% of cases, and partial effect (diastolic pressure lowered by 10 mmHg)--in 17%. The therapy significantly reduced left ventricular mass index (14.6% on the average; p < 0.01), and improved diastolic function: E/A increased by 10.3% (p < 0.05), and isovolumetric relaxation time decreased by 13.6% (p < 0.01). Combined therapy also resulted in a 1.5 to 4 time reduction in the frequency of side effects of isoptin SR and corinfar retard due to reduction in their doses and/or mutual neutralization of their side effects. The paper demonstrates high antihypertensive efficacy of and good tolerance to the combination of dihydropyridines and non-dihydropyridines when they are administered for prolonged therapy in patients with moderate AH.