Efficacy of a fixed combination of losartan and amlodipine in patients with arterial hypertension: seasonal features

The goal is to evaluate the efficacy and security of treatment of patients with arterial hypertension (AH) during the heat wave of a fixed combination of ARBS+ACC (losartan+amlodipine). Materials and methods. Included 26 patients with hypertension 1 and 2 degrees from 42 to 81 years. All patients underwent measurement of office blood pressure, 24h ambulatory BP monitoring, Self-measurement of BP (Home BP ), electrocardiography, biochemical analysis of blood, estimation of osmolarity of blood, questionnaire: visual analogue scale, a questionnaire for patients exposed to heat, the test of adherence to treatment Moriscos-Green. Estimated diaries of self-control of blood pressure. The inclusion visit took place in spring 2016, 1st visit was in May-June 2016, 2nd - during heat waves, 3rd -September-October 2016. Results. The observed decrease in systolic blood pressure and diastolic blood pressure (p=0.000) to the target values, preserved for the whole period of observation. According to the diaries of selfcontrol of blood pressure controlled blood pressure 81% of patients. During a heat wave, this value decreased to 58%, in autumn - to 63%. The 3rd visit achieved a reduction in heart rate at -6.0 (-11.1; and 2.8) beats/min; p=0.007; the decline in uric acid level c of 415.3 to 346.2 mmol/l (p=0.04) and creatinine on the 2nd visit compared to baseline (p=0.02). According to 24h ambulatory BP monitoring, 24h ambulatory BP monitoring, during a single visit, the mean SBP decreased from 139 to 121 mm Hg. (P=0.04) and DBP from 88 to 76 mm Hg. (P=0.04) in the daytime and the tendency to decrease SBP variability from 12 to 10 mm (p=0.07). At the end of the study, the indicators remained stable. The mean value of SBP decreased at night to the third visit from 116 to 110.5 mm Hg. (P=0.04). During the heat wave, a larger mean SBP and DBP was recorded compared with the third visit (p=0.04). A correlation was found between the mean DBP value (r=0.725, p=0.03), the SBP time index (r=0.695, p=0.04) and the SBP time (r=0.787, p=0.02) at night and Quality of life Electrolyte shifts and increasing the osmolarity of the blood during heat waves have not been identified. There is a growing commitment therapy (p=0.04) and quality of life to 20.0 (7.4; 23.3); p=0.000 by visual analogue scale. Conclusion. Fixed combination of losartan and amlodipine (Lorenza) is an effective, safe and may be recommended for hypertensive patients during heat wave and seasonal cold snap.