OBJECTIVE

Comparison of the effectiveness of the effect of two variants of combination therapy: “angiotensin-converting enzyme (ACE) inhibitor + thiazide-like diuretic + metformin” and “ACE inhibitor + moxonidine + metformin” on indicators of the daily blood pressure profile (DBPP), vascular wall stiffness, central aortic pressure (CAP) and metabolic indicators in patients with hypertension and prediabetes.

MATERIAL AND METHODS

The study involved 80 patients with arterial hypertension and prediabetes, who were randomized by the envelope method into two groups: the 1st group (n=40) — received ACE inhibitor perindopril, thiazide-like diuretic indapamide, and biguanide metformin; the 2nd group (n=40) — received ACE inhibitor perindopril, imidazoline receptor agonist moxonidine, and biguanide metformin. At baseline and after 24 weeks, all patients underwent 24-hour blood pressure monitoring with determination of the main indicators of vascular wall stiffness and CAP, as well as analysis of metabolic parameters.

RESULTS

The use of a combination of perindopril, moxonidine and metformin compared with therapy in the comparison group was accompanied by a more significant improvement in the daily blood pressure profile, a decrease in arterial stiffness and CAP in people with hypertension and prediabetes, as well as positive changes in metabolic parameters and more frequent registration of the normalization of carbohydrate metabolism parameters.

CONCLUSION

The combination of ACE inhibitor, imidazoline receptor agonist and biguanide may be the preferred options for pharmacotherapy in patients with hypertension and early disorders of carbohydrate metabolism, since it provides not only blood pressure control, normalization of DBPP, but also has significant vasoprotective and positive metabolic effects.