COMBINATION OF METAPROLOL AND CONJUNCTIVE FORM OF ENALAPRIL MALEAT AND HYDROCHLOTHIAZIDE IN SMALLER DOSES ALLOWS ACHIEVINGTHERAPEUTICAL EFFECT IN HYPERTENSION PATIENTS BETTER MODERATE PHARMACOARTERIAL

Abstract

The object of the present study was to evaluate the clinical effectiveness of the beta-blockers and ACE- inhibitors treatment of hypertension patients. The group of patients included 72 persons aged from 27 to 68 (47±6,97) with a moderate hypertension remaining for 7,4±5,2 years. All patients were divided into 3 groups. The first group (27 patients) received monotherapy of the conjunctive from of enalapril and hydrochlorothiazide (2 tablets twice a day), the second group (10 patient) was getting metaprolol (100 mg/daytwice a day). The third group of patients received both medications simultaneously once a day. Heart ratevariability was obtained by using “Cardiolab 2000“ device. The total power of spectrum (TP, ms2) wasevaluated as a measure of the total neuro-humoral regulation. Power of spectrum in the very low (VLF, ms2), low (LF, ms2) and high (HF, ms2) frequency areas reflected the humoral, sympathetic and parasympatheticinfluences correspondently. The low and high frequency areas ratio was obtained as an index of the sympatho-vagal balance (LF\HF). According to the ТР value obtained in the baseline the patients were divided into the sub-groups with a satisfactory (ТР>1000 мс2) and low (ТР<1000 мс2) power of the total regulation. The treatment effectiveness in each group was evaluated by comparing its results in sub-groups withdifferent basal regulation status. The reliability of the discrepancies was obtained by using the Studentcriterion for 95% confiding interval. Positive influence of the ACE inhibitors and beta-blockers was observednot only in the arterial pressure dynamics but also in the neuro-humoral regulation status. The optimisinginfluence on the regulation systems became apparent not only as a growth of the total regulation but also asnormalization of its branch balance (first of all the sympatho-vagal balance). The combined therapy providedmore pronounced clinical result with smaller doses then the regular therapy. It also made the treatment lessexpensive.