Experience of using vaskopina (amlodipine) in patients with hypertension

The Russian Federation has high blood pressure (BP) in adults observed in males 39.8%, women 41%, while the number of adequately treated with medical therapy, respectively, 5.7% and 17.5% of total suffering from hypertension. In the United States an adequate therapy for hypertension received 34% of patients [2].

Despite the fact that treatment of hypertension is widely covered in the medical press, some of the problems associated with the treatment of this disease remain unresolved. One of the serious complications AG is a cerebral stroke (MI), it belongs to the modifiable risk factors [3]. The positive effect of treatment of hypertension and prevention of MI was confirmed by numerous meta-analysis, which resulted in it was found that calcium antagonists (AA) of all antihypertensive drugs have a more pronounced effect, aimed at improving cerebral blood flow [6], [7]. In addition to MI, hypertension is a complex pathological processes, denoted by the term "hypertensive encephalopathy". At the "hypertensive encephalopathy" to detect changes in cerebral arteries throughout: intracerebral arteries vary by type of destructive processes in a plasma -, gemorrargy, thinning, necrosis of vessel walls, and this leads to the formation of microaneurysms and hemorrhagic strokes. Extracerebral vessels change with the development of "hypertensive stenosis," sometimes with obliteration of the lumen of the vessels, which leads to ischemia of the brain tissue and the development of ischemic stroke. When hypertension develops progressive atherosclerosis, which violates the structural and functional properties of red blood cells and platelets, leading to a deterioration of their deformation, increased hematocrit. Because of this increased blood viscosity, which promotes microcirculation disorder. As a result, all the above changes in the structure of blood vessels and function of erythrocytes and platelets growing strain of cerebral vessels in the form of twisting in the form of twisting, bending, further violates the cerebral blood flow [4]. AK has a positive effect in patients with initial manifestations of atherosclerosis. Several studies have revealed the effect of AK on the proliferation of smooth muscle cells. Influence on the AC and blood clotting, inhibits platelet aggregation.

Distinguish three main types of calcium channels: L, T, N. L - type channels located in the heart cells, skeletal muscle, vascular smooth muscle. AK has an effect, namely, this type calcium channels [5]. At the heart of the AK is noncompetitive blockade of voltage-dependent slow calcium channels in the L-type cardiomyocytes and smooth muscle cells of the vascular wall. As a result, the influence of the AK steadfastly down the tone of smooth muscle cells of large arteries and arterioles, a reduction in peripheral vascular resistance and systemic blood pressure. AK may act as neuroprotective drugs by reducing the entry of calcium ions through voltage-calcium channels [1]. Along with their extensive use in neurological practice for treatment of acute and chronic disorders of cerebral circulation, this group of drugs also has a more pronounced preventive effect on primary prevention of MI.

Recently, the prerogative of the laboratories of various pharmaceutical companies is to develop retardnyh dosage forms, one of which is vaskopin.

(амлодипин) производства компании Pharmacare Int. The aim of the study was to investigate the clinical use of the drug Vaskopin (amlodipine) manufactured by Pharmacare Int. Co., In the treatment of patients with hypertension.

Materials and Methods. The study included 34 patients with hypertension (18 women and 16 men) aged 37 to 68 years (mean age 51,3 ╠ 3,4 years). Duration of illness from 1 year to 12 years. Systolic blood pressure (SBP) was 150 - 210 mmHg and diastolic blood pressure - 90 to 110 mm Hg. of Art. The first group included 12 patients with SBP 150 -159 mm Hg. of Art., diastolic blood pressure 90 -99 Torr. of Art., the second of 14 patients with SBP 160 - 179 mm Hg and DBP 100 -109 mm Hg, a third group comprised 8 patients with SBP 180 - 210 mm Hg. of Art., diastolic blood pressure 110 - 125 mm Hg. of Art. BMI = 29,23 ╠ 2,14. Patients were excluded with severe kidney disease, decompensated liver disease who take steroids and contraceptives. In all patients within a few days prior to study entry canceled prior antihypertensive therapy. The therapeutic dose was adjusted individually vaskopina. The initial dose ranged from 2.5 mg increasing to 10 mg per day as the achievement of positive clinical outcome. 9 patients received vaskopin 2.5 mg per day, 11 patients - 5 mg per day, 14 patients - 10 mg per day. 2 patients after the first day of drug administration refused further treatment. Efficacy and tolerability of treatment was evaluated on the basis of the dynamics of clinical symptoms and hemodynamic parameters: measured blood pressure (BP) by Korotkoff, recorded heart rate (HR), recorded the electrocardiogram (ECG) in the dynamics, defined by total cholesterol and glucose in the blood before treatment and after 12 weeks of active treatment.

Results: of 34 patients completed the study 32. Hypotensive effect vaskopina evaluated on the 7th day of treatment and every 14 days for 3 months. мг/сут. In all patients after 7 days was noted a tendency towards a stable reduction of blood pressure after 14 days of blood pressure has stabilized, and 48% of patients were transferred to a maintenance dose vaskopina 5 mg / day. Dynamics of blood pressure and heart rate is presented in Table 1.

√ дневного курса лечения васкопином. Table 1. The dynamics of blood pressure and heart rate in patients on the background 7 - day course of treatment vaskopinom.

Note: * - P <0.05 compared with baseline.

The absence of sharp drops in blood pressure during treatment. Side effects such as dizziness was observed in 4 patients and were stopped after 7 days of therapy without the drug. Peripheral edema while taking vaskopina absent. The dynamics of ECG parameters did not change. There was no effect of the drug on carbohydrate and lipid metabolism. Dynamics of lipid and glucose in patients with hypertension in treatment vaskopina shown in Table 2.

Table 2. Dynamics of lipid and glucose in patients with hypertension in treatment vaskopina

является эффективным и безопасным препаратом, с наименьшими отрицательными проявлениями; не оказывает влияния на липидный спектр плазмы крови, на содержание глюкозы в крови. Conclusions: vaskopin is effective and safe drug with minimal adverse manifestations, has no effect on the lipid spectrum of blood plasma in blood glucose. At the same time has an impact on the atherosclerotic process, reducing the intima - media [5]. Considering the effect of antiplatelet and AK vaskopin improves microcirculation of cerebral vessels, thereby helping to prevent "hypertensive entseflopatii" and MI. May be appointed by AG I - II century. as monotherapy in hypertension II - III st. with prolonged duration of disease in the form of combination therapy (in combination with diuretics and ACE inhibitors). не требует длительного титрования дозы, так как 5 √ 10 мг является эффективной дозой у большинства больных с АГ. Arising during therapy vaskopinom uniform antihypertensive effect, allows you to receive it once a day. Vaskopin does not require lengthy dose titration, as 5 - 10 mg dose is effective in most patients with hypertension. Thus, a stable vaskopin drug as monotherapy or in schemes 2-3 - x component of treatment of hypertension.

References:

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2. Martsevich SJ Prevention of stroke: the possibilities of modern therapy / / Hypertension: T. 10 .- 2004 .- № 2. P.34-41.
3. Ostroumov OD Stroke Prevention. / / A manual for physicians. - M.: RCT Sauveur Press, 2004 .- p. 56.
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5. Pristrom MS, Sushinsky VE Arterial hypertension in the elderly / / Actual problems of therapy. Minsk, 2006 .- p.107.
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