ABSTRACT
We compared effects of racemic amlodipine and S-amlodipine in 127 patients with 1-2 degree arterial hypertension (AH) on structural-functional parameters of the left ventricle and brachial artery as well as on characteristics of carbohydrate, lipid, electrolyte, and purine metabolism. Racemic amlodipine was given to 66 and S-amlodipine--to 61 patients. Duration of therapy was 24 weeks. In all patients we observed positive and comparable hypotensive effect while doses of S-amlodipine were significantly lower than those of racemic amlodipine (7.5 +/- 0.8 and 11.6 +/- 1.4 mg/day, respectively, p < 0.01). Monotherapy with S-amlodipine resulted in complete regression of left ventricular hypertrophy in 55% and normalization of left ventricular diastolic function in 62.4% of cases; significant improvement of brachial artery vasomotor function was also observed. In addition treatment with S-amlodipine for 24 weeks in patients with hyperlipidemia led to significant lowering of levels of atherogenic lipoproteins and total cholesterol.
Subject(s)
Amlodipine/therapeutic use , Blood Pressure/drug effects , Hypertension/drug therapy , Ventricular Function, Left/drug effects , Adult , Calcium Channel Blockers/therapeutic use , Female , Follow-Up Studies , Humans , Hypertension/metabolism , Hypertension/physiopathology , Male , Middle Aged , Treatment OutcomeABSTRACT
The influence of vascular remodeling and endothelial vasomotor function on the efficacy of indapamide retard was studied in 92 patients (49 men and 43 women) with stage I-II hypertensive disease and grade I-II arterial hypertension by observation of dynamics of the results of 24 hour AP monitoring and heart rhythm variability (HRV), cardio- and vasoprotective efects. The patients were divided into comparable groups. Group 1 was comprised of 40 patients without structural changes of the humeral artery (HA), group 2 included 52 patients undergoing HA remodeling. It was shown that antihypertensive efect of indapamide was virtually identical in both groups. Dynamics of left ventricular and HA structural/functional characteristics in group 2 was more pronounced than in group 1. Conversely, changes of spectral and time-dependent characteristics of HRV in group I were more significant than in group 2; they included suppression of reciprocal hyperactivity of the sympathetic nervous system. In the absence of structural vascular changes, the anti-hypertensive, cardio- and vasoprotective effects of indapamide retard were realized via neurohumoral blockade whereas direct vascular action of the drug prevailed in case of vascular remodeling and endothelial dysfunction
