Key result
In perimenopausal women with arterial hypertension, combined antihypertensive therapy provided a more pronounced organoprotective effect than monotherapy, significantly reducing the proportion of patients with elevated albuminuria (19% vs 26%, p=0.004).
Why the study?
Does combined antihypertensive therapy improve endothelial and kidney function compared to monotherapy in perimenopausal women with essential hypertension?
Cohort (n=75)
Open-label
Simple randomization (for initial drug choice only)
No
Does combined antihypertensive therapy improve endothelial and kidney function compared to monotherapy in perimenopausal women with essential hypertension?
Combined antihypertensive therapy provides better organoprotective effects than monotherapy in perimenopausal women with moderate-risk essential hypertension.
Answers are grounded in this paper and cite their sources.
May support combined therapy for albuminuria reduction; hypothesis-generating and requires randomized confirmation before practice change.
The study included 75 women with arterial hypertension, aged 48-51 years (Me 50,0 years [25%; 75%: 48,0; 52,0 years]), who according to the clinical laboratory and instrumental examination was diagnosed essential hypertension (EH) I–II stage of 1–2 degrees. The duration of arterial hypertension did not exceed 5 years (Me 1 year [25%; 75%: 1; 3 years]) and all women had moderate risk of cardiovascular complications on the SCORE scale. All patients were in the perimenopausal period, confirmed by laboratory of hormonal status. After 14 weeks of monotherapy losartan or ramipril or combination with one of RAAS blockers and bisoprolol with low-dose hydrochlorothiazide was achieved target blood pressure and improvement of endothelial and kidney function, which was manifested by decrease in the level of albuminuria and ADMA concentration, significantly exceeding the reference values in the initial state. More pronounced organoprotective effect was in the group of women, receiving combined antihypertensive therapy.
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Stryuk et al. (2017) conducted a cohort in Arterial hypertension (n=75). Combined antihypertensive therapy (RAAS blocker + bisoprolol/hydrochlorothiazide) vs. Monotherapy (losartan 25-100 mg/day or ramipril 2.5-10 mg/day) was evaluated on Proportion of patients with elevated albuminuria at 14 weeks (p=0.004). In perimenopausal women with arterial hypertension, combined antihypertensive therapy provided a more pronounced organoprotective effect than monotherapy, significantly reducing the proportion of patients with elevated albuminuria (19% vs 26%, p=0.004).
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