Background Cardiovascular disease is the main cause of death among postmenopausal women and arterial hypertension, apart from diabetes and smoking, is a major risk factor of its development. The pathogenetic mechanisms of arterial hypertension among postmenopausal women suggest that angiotensin converting enzyme inhibitors (ACEI) posses several favorable effects, which are desirable in this population. Therefore, the aim of our study was to evaluate the efficacy and tolerability of long acting, tissue ACEI - perindopril, in the treatment of hypertension in postmenopausal women.
Material and methods We studied 667 postmenopausal women (54.9 ± 5.4 years) with mild and moderate hypertension. The treatment period lasted 12 weeks. At the first visit, all the patients started receiving perindopril at the dose of 4 mg per day. After 4 and 8 weeks of treatment, in those subjects where diastolic blood pressure was still ≥ 90 mm Hg and did not decrease by ≥ 10 mm Hg in comparison with the last visit, the dose of perindopril was increased to 8 mg per day. If, after 8 weeks, the patient still had elevated blood pressure values, slow release indapamid at the dose of 1.5 mg per day was added.
Results After 4, 8 and 12 weeks of treatment, the normalization of diastolic blood pressure (< 90 mm Hg) was achieved in 42.4%, 67.6% and 84.3% of cases respectively. 74.2% of treated women responded well to the monotherapy with perindopril. In 8.7% cases indapamid at a dose of 1.5 mg had to be added to 8 mg of perindopril. No serious adverse events were noted during the study. The most frequent adverse event was cough, present in 5.1% of patients. Other adverse events were: headache (1.5%), nausea (1%), fatigue (0.9%) and vertigo (0.7%). Only 2.7% of women discontinued the study due to adverse events. 94.5% of women rated their life comfort during this therapy regimen as good or excellent.
Conclusion Our results show that perindopril - long acting, tissue ACEI, is a very effective and a well tolerated drug in the therapy of hypertension in postmenopausal women.