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COMBINED THERAPY WITH TELMISARTAN AND AMLODIPINE ON BLOOD PRESSURE, ECHOCARDIOGRAPHIC PARAMETERS AND MICROALBUMINURIA IN PATIENTS WITH METABOLIC SYNDROME

Objective: Patients with hypertension (H) with metabolic syndrome (MS) have a high risk of cardiovascular events. The aim of the study was to assess the effects of combination therapy with Telmisartan (L) and Amlodipine (A) on BP, left ventricular (LV) hypertrophy, LV diastolic function, and microalbuminuria in patients with hypertension and MS. Design and method: Sixty four patients with moderate to severe hypertension and metabolic syndrome were provided to T (80 mg) + A (5 mg) in combination once a day (31 males and 33 females). The presence of metabolic syndrome was diagnosed by “Harmonized” Metabolic Syndrome definition. Anthropometric, laboratory and instrumental measures was performed at baseline and after 12 weeks of therapy. Statistical comparisons were performed by 2 tailed Student's t test for quantitative parameters. Results: All patients completed the study without showing intolerance or side effects to the drugs. At the end of the study therapy normalized BP (from 178.26 ± 9.1/109.3 ± 7.2 mmHg to 127.8 ± 6.2/80.2 ± 4.8 mmHg, p < 0.01) in 95.3 % of patients. LV mass index reduced from 162.0 ± 9.4 to 137.8 ± 5.0 g/m2, (p < 0.01) in 79.7 % of patients. At the end of the study E/A ratio increased from 0.87 ± 0.04 to 1.42 ± 0.05 (p < 0.01) in 82.8 % of patients. IVRT has been decreased from 108.4 ± 8.5 to 77.3 ± 5.2 msec (p < 0.01) in 81.2% of patients. Deceleration time passed from 170.6 ± 7.2 to 134.1 ± 4.0 msec (p < 0.05) in 78.1% of patients. Microalbuminuria decreased from 56.6 ± 12.5 to 35.4 ± 10.6 mg/l (P < 0.05) in 84.3 % of patients. Conclusions: These data suggest significant antihypertensive and nephroprotective efficacy of the combination of T 80 mg + A 5 mg. Combination therapy with T + A has been demonstrated positive effect on the echocardiographic indexes of the heart by reducing LV hypertrophy and improving LV diastolic function, and renal function by reducing albuminuria in patients with moderate to severe hypertension and metabolic syndrome.