[The effect of changing of conventional antihypertensive therapy to a triple fixed combination therapy with rosuvastatin in high cardiovascular risk patients].

BACKGROUND: The low efficiency of recommended therapy for reducing cardiovascular risk (CV) in patients with arterial hypertension even with an effective blood pressure decrease is often due to the persistence of high blood cholesterol and arterial stiffness. Among the effective ways to achieve the goal of therapy is considered the changing to a single-pill combinations (SPCs) of two antihypertensive drugs and statin. AIM: To assess influence of fixed combination consisted of amlodipine, lisinopril and rosuvastatin to the dynamic of lipid spectrum, blood pressure level and elastic properties of arteries in patients with arterial hypertension and high risk of cardio-vascular complications being transferred from their preceding antihypertensive therapy. MATERIALS AND METHODS: 113 patients with atherosclerosis of brachiocephalic arteries (BCA) receiving antihypertensive and partially taking statins therapy were assessed cholesterol, low-density lipoprotein cholesterol (LDL-C), peripheral and central blood pressure, carotid-femoral pulse wave velocity (PWV) initially and after 12 months of taking amlodipine + lisinopril + rosuvastatin (A+L+R) SPCs. RESULTS: The administration of A+L+R SPCs for 12 months was associated with an increasing of number of patients with the achieved target blood pressure.

Comparison of baroreflex sensitivity estimated from ECG R-R and inter-systolic intervals obtained by finger plethysmography and radial tonometry.

Spontaneous BRS estimates may considerable vary according to the technique of blood pressure and heart rate assessment. To optimise and standardise BRS estimation for clinical use we evaluated possible differences between spontaneous BRS indices estimated from either finger plethysmography or radial tonometry. Forty-five healthy volunteers underwent simultaneous recordings of electrocardiogram, finger plethysmography and radial tonometry in supine position and during 60° head-up tilt. BRS was computed by spectral analysis from either R-R time series and/or arterial pressure pulse. Radial tonometry generated higher mean BRS estimates than finger plethysmography. The difference decreased upon postural change from supine to upright. In the upright position, BRS estimates based on R-R interval proved to be generally lower compared to BRS indices estimated from arterial pressure pulse. The ratio of low-to-high-frequency power of inter-systolic interval and systolic blood pressure from tonometry was lower than that from plethysmography in supine and approximated in upright position. Spectral parameters of inter-systolic interval and R-R interval did not differ in supine but diverged in upright position. Changes of spectral parameters were most pronounced in R-R interval. Arterial pressure pulse is adequate for estimation of BRS under resting conditions but it may distort BRS estimates under physical load. We, therefore, recommend using an ECG signal for BRS estimation especially in non-stationary conditions.