To access this material please log in or register

Register Authorize

Comparative evaluation of compliance with therapy with fixed and non-fixed combinations of drugs for arterial hypertension

Grigorjeva N. Yu., Kuznetsov A. N., Koroleva M. E.
State Budgetary Educational Institution of Higher Professional Education, "Nizhny Novgorod State Medical Academy" of the RF Ministry of Healthcare, Minin and Pozharsky Square 10/1, Nizhny Novgorod 603005

Keywords: hyperpiesis, treatment compliance, bisoprolol, amlodipine, fixed combinations

DOI: 10.18087/rhj.2015.4.2111

Background. Most patients require two antihypertensive medicines to achieve their BP goal. One of rational combinations of antihypertensive drugs is a combination of β-blocker and dihydropyridine Ca2+ antagonist. Aim. To compare efficacies of and patient compliance with the AH treatment with fixed-dose and free combinations of bisoprolol and amlodipine. Materials and methods. 64 patients with stage 2 essential AH were evaluated. The patients were divided into two groups using the closed envelope method. The first group consisted of 34 patients, including 22 (64.7 %) women and 12 (35.3 %) men (mean age, 64.5±15.3), who received a fixed-dose combination of bisoprolol and amlodipine in the form of Concor AM. The second group consisted of 30 patients, including 18 (60 %) women and 12 (40 %) men (mean age, 65.8±11.5) who received a free combination of bisoprolol and amlodipine. Results. The Concor AM treatment (group 1) resulted in a smooth decrease of systolic and diastolic BP, which reached normal values at 14 days of treatment and remained at this level during the follow-up period (21 days). In group 2, these parameters reached normal values at 21 days of treatment. In two months, all patients of group 1 (34 patients) followed physician’s recommendations and took Concor AM as prescribed. In group 2, 28 of 30 patients (93 %) continued the treatment, and 20 (71 %) of them strictly adhered to the prescribed dosing while 8 (29 %) of them stopped taking one of the two drugs without permission. Conclusion. Administration of a fixed-dose combination of bisoprolol and amlodipine provides faster and optimum control of BP and enhances compliance with the treatment.
  1. Wald DS, Law M, Morris JK, Bestwick JP, Wald NJ. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 1,000 participants from 42 trials. Am J Med. 2009 Mar;122(3):290-300.
  2. Persistence of reduction in blood pressure and mortality of participants in the Hypertension Detection and Follow-up Program. Hypertension Detection and Follow-up Program Cooperative Group. JAMA. 1988 Apr 8;259(14):2113-22.
  3. Архипов М.В., Арутюнов Г.П., Бойцов С.А., Галявич А.С., Карпов Ю.А., Кобалава Ж.Д. и др. Новые Российские рекомендации по АГ – приоритет комбинированной терапии. Информационное письмо. Системные гипертензии. 2011;3:58-61.
  4. Chrysant SG1. Fixed low-dose drug combination for the treatment of hypertension. Arch Fam Med. 1998 Jul-Aug;7(4):370-6.
  5. Morgado MP, Morgado SR, Mendes LC, Pereira LJ, Castelo-Branco M. Pharmacist interventions to enhance blood pressure control and adherence to antihypertensive therapy: Review and meta-analysis. Am J Health Syst Pharm. 2011 Feb 1;68(3):241-53.
  6. Ho PM, Magid DJ, Shetterly SM, Olson KL, Peterson PN, Masoudi FA, Rumsfeld JS. Importance of therapy intensification and medication nonadherence for blood pressure control in patients with coronary disease. Arch Intern Med. 2008 Feb 11;168(3):271-6.
  7. Затейщикова А.А. Комбинированная терапия артериальной гипертензии. Комбинация лизиноприла и амлодипина. Русский медицинский журнал. 2011;32:2080-2085.
  8. Рекомендации экспертов ВНОК по диагностике и лечению артериальной гипертензии (4-й пересмотр). Журнал Системные гипертензии. 2010;3:5-26.
  9. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007 Jun;25(6):1105-87.
Grigorjeva N. Yu., Kuznetsov A. N., Koroleva M. E. Comparative evaluation of compliance with therapy with fixed and non-fixed combinations of drugs for arterial hypertension. Russian Heart Journal. 2015;14 (4):231–234

To access this material please log in or register

Register Authorize
Ru En