Influence of Therapy With Fixed Combination of Perindopril and Amlodipine on Parameters of Elasticity of Main Vessels and Microcirculation in Patients With Arterial Hypertension and Type 2 Diabetes Mellitus

OBJECTIVE: to assess in patients with arterial hypertension and type 2 diabetes the effect of perindopril / amlodipine fixed combination on arterial wall stiffness (AWF) and microcirculation, and relationship between AWF parameters and the state microcirculation. MATERIALS AND METHODS: We included in this study 30 patients aged 45-65 years. All patients received fixed perindopril arginine / amlodipine besylate combination for 12 weeks. Examination included measurement of AWF of main arterial blood vessels and evaluation of the state of microcirculation. RESULTS: Target blood pressure was achieved in 100 % of patients. Mean values of pulse wave velocity of elastic and muscle-type vessels decreased by 8.5 and 10.3 %, respectively; number of patients with paradoxical test also significantly decreased (p>0.05). Shunting index and myogenic tone significantly decreased by 21 and 33.6 %, respectively. We also observed significant reduction of endothelium-dependent tone component (Δ%=36.3 %), significant rise of mean value of perfusion (Δ%=19.7 %), and significant increase of the respiratory test index (Δ%=4.5 %). There was a statistically significant redistribution of patients by types of microcirculation: the percentage of patients with hyperemic type increased from 26.7 to 43.3 %. CONCLUSION: In patients with arterial hypertension and type 2 diabetes mellitus perindopril arginine / amlodipine besylate fixed combination demonstrated high antihypertensive efficacy, positive effect on parameters of elasticity of main vessels and microcirculation.