open access

Vol 25, No 1 (2021)
Original paper
Published online: 2021-03-23
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Therapeutic strategy in patients with long-lasting essential hypertension with comorbid type 2 diabetes mellitus and obesity

Borys O. Shelest, Olena V. Hryhorian, Vladyslava V. Sarkis-Ivanova, Yuliia O. Kovalova, Valeria V. Brek, Oleksiy M. Shelest
DOI: 10.5603/AH.a2021.0007
·
Arterial Hypertension 2021;25(1):39-46.

open access

Vol 25, No 1 (2021)
ORIGINAL PAPERS
Published online: 2021-03-23

Abstract

Background: Presently the level of blood pressure (BP) control is extremely unsatisfactory in hypertensive patients throughout the world. The aim of our study was to find the optimal drug therapy for patients with hard-to-treat essential hypertension (EH) associated with type 2 diabetes mellitus (T2DM) and obesity, namely the comparison of strategies of fixed and non-fixed combination.

Material and methods: Eighty-seven patients with EH, T2DM and obesity were enrolled into the study. Two groups were formed: the 1st group — 41 patients received antihypertensive therapy in the form of unfixed combination of drugs (“multi-pill”) perindopril, indapamide and amlodipine; the 2nd — 46 patients, who received the same drugs, but in a fixed-dose combination (“single pill”).

Results: A favorable treatment result was found for fixed-dose combination of antihypertensive drugs, with significant reduction in the frequency of visits to the doctor: relative risk (RR) — 1.27 (95% CI: 1.01‒1.61), p = 0.045, and odds ratio (OR) — 3.10 (95% CI: 1.05‒9.13), p = 0.04. That indicates that patients on fixed-dose combination were less likely to visit a doctor with complaints. Patients on single-pill therapy were less likely to get to progression (worsening) group in contrast to multi-pill non-fixed combination: RR — 1.37 (95% CI: 1.02‒1.84), p = 0.03; OR — 2.91 (95% CI: 1.12‒7.59), p = 0.03.

Conclusion: The single-pill triple combination has significant advantage compared to multi-pill regimen in hard-totreat hypertensive patients with comorbid T2DM and obesity. Fixed-dose triple combination leads to significantly faster achievement of blood pressure control.

Abstract

Background: Presently the level of blood pressure (BP) control is extremely unsatisfactory in hypertensive patients throughout the world. The aim of our study was to find the optimal drug therapy for patients with hard-to-treat essential hypertension (EH) associated with type 2 diabetes mellitus (T2DM) and obesity, namely the comparison of strategies of fixed and non-fixed combination.

Material and methods: Eighty-seven patients with EH, T2DM and obesity were enrolled into the study. Two groups were formed: the 1st group — 41 patients received antihypertensive therapy in the form of unfixed combination of drugs (“multi-pill”) perindopril, indapamide and amlodipine; the 2nd — 46 patients, who received the same drugs, but in a fixed-dose combination (“single pill”).

Results: A favorable treatment result was found for fixed-dose combination of antihypertensive drugs, with significant reduction in the frequency of visits to the doctor: relative risk (RR) — 1.27 (95% CI: 1.01‒1.61), p = 0.045, and odds ratio (OR) — 3.10 (95% CI: 1.05‒9.13), p = 0.04. That indicates that patients on fixed-dose combination were less likely to visit a doctor with complaints. Patients on single-pill therapy were less likely to get to progression (worsening) group in contrast to multi-pill non-fixed combination: RR — 1.37 (95% CI: 1.02‒1.84), p = 0.03; OR — 2.91 (95% CI: 1.12‒7.59), p = 0.03.

Conclusion: The single-pill triple combination has significant advantage compared to multi-pill regimen in hard-totreat hypertensive patients with comorbid T2DM and obesity. Fixed-dose triple combination leads to significantly faster achievement of blood pressure control.

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Keywords

single-pill; essential hypertension; comorbidity; treatment

About this article
Title

Therapeutic strategy in patients with long-lasting essential hypertension with comorbid type 2 diabetes mellitus and obesity

Journal

Arterial Hypertension

Issue

Vol 25, No 1 (2021)

Article type

Original paper

Pages

39-46

Published online

2021-03-23

DOI

10.5603/AH.a2021.0007

Bibliographic record

Arterial Hypertension 2021;25(1):39-46.

Keywords

single-pill
essential hypertension
comorbidity
treatment

Authors

Borys O. Shelest
Olena V. Hryhorian
Vladyslava V. Sarkis-Ivanova
Yuliia O. Kovalova
Valeria V. Brek
Oleksiy M. Shelest

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