Vasoprotective Possibilities of Combinations of Modern Antihypertensive Drugs in Patients With Arterial Hypertension, Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease

The aim of the study was to compare the effectiveness of the effect of combinations of azilsartan medoxomil (Az-M) with amlodipine (Aml) and olmesartan medoxomil (Ol-M) with Aml on achieving target blood pressure levels (CPP), parameters of vascular wall stiffness and central aortic pressure (CAP) in patients with arterial hypertension (AH), combined with type 2 diabetes mellitus (DM2) and non-alcoholic fatty liver disease (NAFLD). Materials and methods: 137 patients with uncontrolled hypertension combined with DM2 and NAFLD were examined. Patients were randomized into 2 groups: group 1 (n=68) was assigned a combination of Az-M with Aml at an initial dosage of 40/5 mg/day, in group 2 (n=69) patients received a fixed combination of Ol-M/Aml 20/5 mg/day. In addition to the general clinical examination, initially, after 4, 8, 12 and 24 weeks, they measured office blood pressure. Determination of the parameters of vascular wall stiffness and CAP was performed initially and after 24 weeks of the study. Taking into account the persons who did not reach the blood pressure target and dropped out of the study after 12 weeks, the evaluation of the studied parameters was carried out in 59 and 58 patients for groups 1 and 2, respectively. Results: the study demonstrated high antihypertensive efficacy of both combinations of antihypertensive drugs: the frequency of achievement of blood pressure control by patients of the 1st and 2nd groups after 12 weeks of treatment was 86.8% and 84.1% of cases, respectively. However, a more pronounced vasoprotective efficacy was characteristic of the combination of Az-M with Aml: in the 1st group of patients, there was a more pronounced positive dynamics of vascular wall stiffness and CAP.