Perspectives of arterial hypertension control improvement by rational diuretic therapy: Russian research and clinical program ARGUS-2 results

Aim. As a part of ARGUS-2 program, to demonstrate the reserves for arterial hypertension (AH) control improvement, by rational monotherapy or combined therapy with diuretics in patients with uncontrolled AH in anamnesis: individuals with isolated systolic AH (ISAH), diabetes mellitus (DM), chronic nephropathy (CN), and metabolic syndrome (MS). Material and methods. This open, non-comparative study, without wash-out period, included 1438 patients (mean age 57,3 +/- 10,7 years, blood pressure, BP 158,8 +/- 14,2/93,4 +/- 10,0 mm Hg), not achieving target BP levels (< 140/<90 mm Hg or < 130/<80 mm Hg for DM or CN), and receiving non-diuretic therapy. Slow-release indapamide (Arifon(R) retard), in the dose of 1,5 mg, was administered once per day. Follow-up period lasted for 3 months. To achieve target BP levels, the physician could modify antihypertensive treatment regimen. Results. In total, 1399 patients (97,3%) completed the study. Arifon(R) retard was administered as monotherapy in 13,7% of the participants; as an alternative to previous ineffective monotherapy - in 6,8%; in addition to inadequately effective monotherapy - in 31,9%; and in addition to inadequately effective non-diuretic therapy - in 47,6%. Three months later, target BP level rate was 84,5%, mean BP level reduced to 131,8 +/- 9,7/80,5 +/- 6,9 mm Hg. Target BP was achieved in 91,9% (n=477) of ISAH patients, in 74,8% (n=214) of DM participants, in 75,6% (n=82) of CN individuals, and in 85, 1% (n=745) of MS patients. Conclusion. The study results confirmed the importance of low-dose thiazide diuretic therapy, as a part of combined treatment, in achieving target BP levels among patients with high or very high cardiovascular risk.