Safe combination therapy in patients with hypertension and metabolic syndrome: the STAR-LET study

Unfavorable metabolic effects and possible diabetes type 2 development in patients with arterial hypertension and metabolic syndrome taking diuretics over a long period of time are under discussion. According to the results of the STAR study fixed-dose combination drug «TARKA» trandolapril + verapamil CP (T/V) had a definite advantage over combination therapy with angiotensin II receptor antagonists (ARA) lozartan and hydrochlorthyazide (L/H) considering glycemia control and the risk of diabetes development. A sample of patients included in STAR study took part in a 6-month-long project STAR-LET. Those who were prescribed for the T/V therapy initially continued this treatment, and the ones taking L/H began T/V therapy. The results of oral glucose tolerance test (the 2 hour glucose level) are the following: the glucose level did not change significantly in the group of patients taking T/V from the beginning of the STAR study as compared to the initial level (7,7 ± 2,4 vs 8,1 ± 3,3, p > 0,05), and it improved in subjects taking T/V after L/H therapy (8,5 ± 3,0 vs 7,2 ± 2,3, p < 0,001). Thus, STAR-LET study showed benefits of «TARKA» in subjects with metabolic syndrome and arterial hypertension - its metabolic neutrality as well as its ability to improve impaired glucose tolerance resulting from thiazide diuretic therapy.