ANTIHYPERTENSIVE EFFICACY OF FIXED COMBINATION AZILSARTAN MEDOXOMIL/CHLORTHALIDONE IN PATIENTS WITH UNCONTROLLED ARTERIAL HYPERTENSION
Aim. To study effects of a fixed azilsartan medoxomil/chlorthalidone combination (Edarbi Clo) on clinical, ambulatory and central blood pressure (BP) in patients with uncontrolled arterial hypertension (AH)). Materials and methods. Patients (n=25) with uncontrolled AH were given fixed azilsartan medoxomil/chlorthalidone combination (40/12.5 mg/day) for 4 weeks. After 4 weeks, in patients who did not achieve target BP levels the dose was increased up to 40/25 mg/day. Duration of the study was 12 weeks. Results. After 12 weeks of treatment 88% of patients achieved target clinical BP (< 140/90 mm Hg without diabetes, < 140/85 mm Hg with diabetes). According to 24-hour blood pressure monitoring (ABPM) decline of mean BP was 19.3/11.1 mm Hg, of mean daytime peripheral BP - 20.1/11.4 mm Hg, of mean nocturnal peripheral BP - 19.5/9.1 mm Hg, of central systolic (S), diastolic and pulse BP - 15.8, 10.1, 6.6 mm Hg, respectively. Target values of mean 24-hour BP were achieved in 40% of patients. Improvement of ABPM parameters led to normalization of the daily systolic BP index, associated with increase of the portion of "dippers" (from 60 to 64%) and reduction of that of "night-pickers" at the account of their transition into "non-dipper" and "dipper" categories. There were no adverse events either causing discontinuation after the first dose or serious. Conclusion. In patients with uncontrolled AP with/without diabetes therapy with fixed- azilsartan medoxomil/chlorthalidone combination was accompanied by pronounced antihypertensive effect (lowering of clinical, daily peripheral BP, improvement of the daily SBP profile). For the first time, the effectiveness of azilsartan medoxomil/chlorthalidone combination was demonstrated in relation to the central systolic, diastolic and pulse BP. Significant changes of parameters of carbohydrate or lipid metabolism, adverse events leading to drug discontinuation were not registered.