Key result
Starting therapy with a fixed combination of two antihypertensive drugs is recommended for >70% of patients, with ramipril and amlodipine highlighted as an effective choice for arterial hypertension.
Why the study?
Modern guidelines recommend fixed combinations for arterial hypertension, prompting an evaluation of the role and advantages of a fixed combination of ramipril and amlodipine.
Does a fixed combination of ramipril and amlodipine improve blood pressure control and adherence in patients with arterial hypertension and comorbidities?
Does a fixed combination of ramipril and amlodipine improve blood pressure control and adherence in patients with arterial hypertension and comorbidities?
A fixed combination of ramipril and amlodipine is an effective and recommended initial or intensification therapy for arterial hypertension, especially in patients with diabetes, CKD, or metabolic syndrome.
Answers are grounded in this paper and cite their sources.
Should not yet change FC selection in comorbid hypertension; leaves open outcome trials comparing ramipril-amlodipine to other dual FCs.
In modern algorithms of arterial hypertension treatment, the main strategic approach aimed at increasing the therapy effectiveness is the use of fixed combinations (FC) of two antihypertensive drugs at the start of therapy and of three drugs (preferably in one tablet) when it is necessary to intensify pharmacotherapy. Starting therapy with two drugs in one tablet (FC) is recommended for more than 70 % of patients. The article provides up-to-date information on the choice of a fixed combination for the treatment of patients with arterial hypertension (AH) according to modern national and international recommendations. The place of a fixed combination of ramipril and amlodipine among antihypertensive drugs in achieving the goal of treating patients with arterial hypertension was determined. The advantages of the fixed combination of ramipril and amlodipine due to the wide range of indications and its effectiveness for patients with hypertension in combination with chronic kidney disease (CKD) and metabolic syndrome are discussed. The distinctive properties of the fixed combination of ramipril and amlodipine are emphasized: it allows achieving target values of blood pressure (BP), improves adherence to treatment, reduces the frequency of prescribing additional antihypertensive drugs, and increases patient satisfaction with treatment. In patients with diabetes mellitus and metabolic syndrome, the fixed combination of ramipril and amlodipine allows achieving target values of blood pressure, promotes adherence to treatment, reduces heart rate, improves biochemical parameters of lipid and carbohydrate metabolism and functional kidney indicators. Ramipril, along with perindopril, is widely prescribed for patients with arterial hypertension, and its combination with amlodipine can be considered the method of choice in arterial hypertension patients with diabetes mellitus, chronic kidney disease, and metabolic syndrome.
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Максимов et al. (2023) conducted a review in Arterial hypertension. Fixed combination of ramipril and amlodipine was evaluated. Starting therapy with a fixed combination of two antihypertensive drugs is recommended for >70% of patients, with ramipril and amlodipine highlighted as an effective choice for arterial hypertension.
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