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Effect of indapamide/perindopril fixed-dose combination on 24-hour blood pressure and cognitive functions in treatment-naive middle-aged patients with essential arterial hypertension

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Objective: to investigate the effect of indapamide/perindopril fixed-dose combination (FC) on 24-hour blood pressure (BP) and cognitive functions in antihypertensive treatment-naive middle-aged patients with uncomplicated grade 1–2 essential arterial hypertension (EAH) . Patients and methods. The open prospective study enrolled 25 patients (9 men and 16 women) aged 40–59 years with a diastolic BP of 90–109 mm Hg and/or a systolic BP of 140–179 mm Hg, as evidenced by routine measurements. As starting antihypertensive therapy, the patients received indapamide 1.25/perindopril 5 mg FC once daily in the morning; if necessary, after 2 weeks (if the routine blood pressure was ≥140/90 mm Hg) they took indapamide 2.5/perindopril 10 mg once daily in the morning. The follow-up period was 14–16 weeks. Before and at the end of the follow-up, the patients underwent 24-hour ambulatory BP monitoring (ABPM) and evaluation of cognitive functions using the Montreal Cognitive Assessment (MoCA), ten-words test (immediate and delayed word recall), verbal association test (literal and categorical associations), number connecting test (Trail making test (TMT), part A and numbers and letters connecting test (TMT) part B), and Stroop test. Results. At the end of the follow-up period, treatment with indapamide/perindopril fixed-dose combination showed a statistically significant reduction in BPs, as evidenced by routine measurements and ABPM (during 24-hour, and awake and sleep periods); a statistically significant cognitive improvement: an increase in the number of the so-called words in the ten-words test during both immediate (from 5.5±1.6 6.5±1.5 words; p=0.02 vs baseline) and delayed (from 6.2±1.7 to 7.4±1.4 words; p=vs baseline) recalls, a decrease in the performance time of TMTB (from 112.6±42.5 to 90.4±28.4 sec; p=0.02) and Stroop test Part 3 (from 135.5±50.1 to 112.6±19.6 sec; p=0.02), and a larger number of called words in the categorical associations test (from 6.5±2.4 to 8.1±2.9 words; p=0.02). Conclusion. The results obtained indicate that in treatment-naive middle-aged patients with EAH, indapamide/perindopril fixed-dose combination assures an effective reduction in BPs, as evidenced by routine measurements and ABPM, also improves cognitive functions, particularly attention, information processing speed, semantic memory, cognitive flexibility, and short-term and long-term memory.

About the Authors

T. M. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
Russian Federation

V. A. Parfenov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
Russian Federation

O. D. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow
Russian Federation

E. V. Borisova
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow; E.O. Mukhin City Clinical Hospital, Moscow Healthcare Department, Moscow
Russian Federation


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For citations:

Ostroumova T.M., Parfenov V.A., Ostroumova O.D., Borisova E.V. Effect of indapamide/perindopril fixed-dose combination on 24-hour blood pressure and cognitive functions in treatment-naive middle-aged patients with essential arterial hypertension. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):19-28. (In Russ.)

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