40 patients with diabetes mellitus type 2 (avg. age 63.2±1.2) with diabetic nephropathy and hypertension were examined. The patients were randomized into 2 groups (20 patients in each group). The patients of the first group were treated a fixed combination of 2 drags: the Perindopril 5 mg and the Indapamide 1,25 mg (Noliprel A Forte). The patients of the second group were treated a free combination of the Valsartan 160 mg and the Indapamide SR 1,5 mg for 2 months. 24-hours arterial pressure monitoring was conducted in patients twice using the device AVRM - 04 (Hungary) according to the conventional method. Saltsensitivity of BP was evaluated by the method (Weinberger MN, 1986). After 2 months of therapy, avg. SBP in the patients of the first group decreased from 152,75±1,5 to 128,4±0,9 mmHg (pO.01), avg. DBP - from 88.95±1.9 to 75.45±0.7 mmHg (p<0,05); in the patients of group 2 from 153,2±1,3 mmHg to 133,7±0,9 (p<0.05) and from 89,15±1,9 to 77,85±0,9 mmHg (p<0,05), respectively. Both combinations of drags were most effective in the patients with saltsensitivity of hypertension: administration of the Noliprel in saltsensitive patients resulted in absolute reduction of avg. SAD by 27,8±0,7 mm Hg vs 18,3±0,4 mm Hg in saltresistant ones, p<0,01, avg. DAD decreased by 13,7±1,5 mm Hg vs 9,0±1,08 mm Hg, p<0,05, respectively; administration of the Valsartan and the Indapamide in saltsensitive patients resulted in avg. SAD decrease by 18,4±0,7 mm Hg vs 12,2±0,5 mm Hg in saltresistant ones, p <0.01, avg. DAD - by 10,3±1,2 mm Hg vs 6,7±0,9 mm Hg p<0,05, respectively. Both combinations of drags showed a comparable antihypertensive effect, which was significantly more pronounced in the saltsensitive patients.
diabetic nephropathy, hypertension, therapy, saltsensitivity of hypertension
Артериальная гипертензия (AT) является одним из самых распространенных заболеваний сердечнососудистой системы. Среди симптоматических гипертоний основное место занимает нефрогенная АГ. Частота АГ при диабетической нефропатии наблюдается в 30-64% случаев [5, 12-14]. Коррекция артериального
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