Comparative efficacy of "first step" antihypertensive drug combinations in patients with arterial hypertension and obstructive sleep apnea syndrome

Hypertension in combination with obstructive sleep apnea syndrome (OSAS) is a common comorbid pathology that significantly reduces patients' quality of life and longevity. Blood pressure control in such patients is a serious problem, since there are no clear treatment algorithms due to insufficient evidence base. The objective of the paper is to compare the efficacy and tolerability of the initial two-drug antihypertensive combinations (perindopril / indapamide and perindopril / amlodipine) as "first step" treatment in patients with a hypertension associated with OSAS. Materials and Methods. Ninety patients with uncontrolled hypertension stages 1-2 and OSAS were divided into 2 groups. Group 1 patients were treated with perindopril (10 mg) and indapamide (2.5 mg), while Group 2 patients received perindopril (10 mg) and amlodipine (10 mg). Before treatment, the authors examined patients' complaints and medical history. All the patients underwent general clinical examination, respiratory sleep polygraphy and ABPM. After 4-week treatment, patients with target BP indicators underwent ABPM. The authors examined their new complaints and analyzed office BP. Results. During treatment, hypertension control was achieved in 34.4 % of patients. The nonresponders to dual therapy (Groups 1 and 2) were patients with moderate and severe OSAS (89.7 % and 90 %, respectively). When analyzing complaints, office blood pressure, and ABPM indicators in patients of both groups who responded to the two-drug therapy, a statistically comparable treatment efficacy was revealed both with perindopril/indapamide and perindopril/amlodipine combinations (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }