[Telmisartan chronotherapy and its influence on the indicators of the daily profile blood pressure.]

Arterial hypertension is one of the most common life-threatening diseases, adequate control of which is largely achieved by antihypertensive drugs, including the use of telmisartan. The aim of the study was to evaluate the effect of telmisartan chronotherapy on the parameters of daily monitoring of blood pressure during the daytime and at night in elderly patients with hypertension. The study is based on a comprehensive examination of 150 patients aged 60-74 years suffering from hypertension, who are divided into 2 groups: the main (n=76) and control (n=74). Patients with hypertension in the main group received telmisartan at a dose of 80 mg/day in the evening (20.00-22.00 hours), and in the control group - in the morning at the same dose (80 mg/day). Before treatment, after 3 months and after 6 months, patients of both groups underwent daily monitoring of blood pressure with the «BPLab monitor Mn SDP-3¼. It was found that the evening intake of telmisartan at a dose of 80 mg/day has a more significant effect than the morning intake of the same dose of telmisartan on the indicators of daily monitoring of systolic blood pressure and diastolic blood pressure in the evening, the systolic blood pressure time index in the evening. Chronotherapy with telmisartan in elderly patients with hypertension more effectively normalizes the daily blood pressure profile with the transfer of «non-dipper¼ to «dipper¼, reduces the hypertensive load and contributes to the achievement of target blood pressure levels.

Psychological Continuum of Elderly Patients Suffering from Arterial Hypertension with Metabolic Syndrome, Against the Background of Chronotherapy with a Fixed Combination of Amlodipine, Lisinopril and Rosuvastatin.

Aim        To study the psychological continuum in elderly patients with arterial hypertension associated with metabolic syndrome during the chronotherapy with a fixed combination (FC) of amlodipine, lisinopril, and rosuvastatin.Material and methods        In the inpatient conditions, 63 patients aged 60-74 years with arterial hypertension associated with metabolic syndrome were treated with chronotherapy with a FC of amlodipine, lisinopril, and rosuvastatin (5 / 10 / 10 mg/day in the evening). These patients composed the main group. The control group (58 patients aged 60-74 years with arterial hypertension associated with metabolic syndrome) was treated with the FC of amlodipine, lisinopril, and rosuvastatin at the same dose of 5 / 10 / 10 mg/day in the morning.Results   At one year, the disorders of psychological continuum were significantly decreased with the chronotherapy (evening dosing) with the antihypertensive FC of amlodipine, lisinopril, and rosuvastatin compared to the traditional treatment (morning dosing) at the same dose of 5 / 10 / 10 mg/day in both groups. With the chronotherapeutic approach, the dynamic of cognitive disorders in patients aged 60-74 years with arterial hypertension associated with metabolic syndrome was characterized by a significant increase in the Mini-Mental-State-Examination scale score from 17.8±0.3 at baseline to 23.5±0.4 with the evening dosing (р<0.001) vs. the increase from 16.9±0.3 to 20.4±0.4 (р<0.001) with the morning dosing. The situational anxiety score decreased from 40.0±2.2 to 30.6±1.8 (р<0.05) and from 40.8±2.5 to 33.5±1.9  (р<0.05), and the trait anxiety score decreased from 48.8±2.0 to 26.4±1.9 (р<0.001) and from 44.9±1.9 to 30.7±1.7  (р<0.01) with the evening and morning dosing, respectively. Depressive disorders slightly decreased with the chronotherapy by 14.1 % vs. 7.7 % with the traditional regimen; nevertheless, they were consistent with depressive spectrum disorders in both groups.Conclusion            The study results showed a higher effectiveness of the chronotherapeutic treatment compared to the traditional treatment with FC of amlodipine, lisinopril, and rosuvastatin in arterial hypertension with metabolic syndrome.

[The effect of antihypertensive chronotherapy on indicators of the daily blood pressure profile in elderly patients with arterial hypertension with a history of myocardial infarction.]

Traditional treatment regimens for patients with hypertension are not always effective and need to be improved based on the principles of chronobiology. The purpose of this work is to analyze the effect of preventive chronotherapy with amlodipine, lisinopril, and rosuvastatin on daily blood pressure monitoring. In 62 patients with a history of myocardial infarction and hypertension at the age of 60-74, a fixed combination of amlodipine, lisinopril and rosuvastatin at a dose of 5/10/10 mg 2 hours before reaching maximum systolic blood pressure (preventive chronotherapy), in 63 patients with similar diseases and age, this drug is taken at a dose of 5/10/10mg in the evening, and in 58 people - in the morning (traditional treatment). Daily monitoring of blood pressure before and 6 months after treatment was performed by the «SpacelabsMedical¼ device (USA) with the calculation of generally accepted indicators. The greatest effectiveness of preventive chronotherapy in comparison with other treatment options for achieving the target blood pressure level, reducing the time indices and the variability of systolic blood pressure has been established, which allows us to recommend this fixed combination in geriatric practice.