Influence fixed combination therapy on arterial stiffness and erectile function in patients with arterial hypertension

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Yu. M. Sirenko
O. L. Rekovets
G. D. Radchenko
O. O. Torbas
S. M. Kushnir
G. F. Prymak
V. M. Granich
I. O. Zhyvylo
P. I. Sidorenko
S. A. Polishchuk


The aim – to evaluate the therapeutic efficacy and dynamics of arterial stiffness using сardio-ankle vascular index (CAVI), as well as the dynamics of erectile function in men of the generic fixed triple combination of valsartan/amlodipine/hydrochlorothiazide and a double fixed combination of valsartan/amlodipine in the treatment of patients with arterial hypertension II–III degree.
Materials and methods. The study included patients with moderate and severe arterial hypertension without diabetes. Patients were divided into 2 groups by the method of envelopes of 25 each. The first group (n=25) was assigned a fixed triple combination of tablets valsartan/amlodipine/hydrochlorothiazide. The drug was administered 1 tablet (160 mg of valsartan/5 mg of amlodipine/12.5 mg of hydrochlorothiazide) once a day in the morning for 1 month. Patients in the second group (n=25) received a similar scheme of a double fixed combination of the drug valsartan/amlodipine. The drug was administered 1 tablet (160 mg of valsartan/5 mg of amlodipine) once a day in the morning for 1 month. If necessary, the target level of office blood pressure was less than 140/90 mm Hg, the dose was titrated to a daily dose of 320/10/12.5 mg (valsartan/amlodipine/hydrochlorothiazide) on a fixed triple combination and up to 320/10 mg
(valsartan/amlodipine) on a fixed double combination. After 3 months of treatment there was control of therapy.
Results and discussion. The study included 50 patients with moderate and severe hypertension. The average age of patients was 54.9±1.8 (25–75) years. The average BMI is 31.2±0.7 kg/m2. The average of the office of SBP and DBP at the beginning of the study were 161.7±1.8 mm Hg and 98.5±1.4 mm Hg in accordance. The office heart rate is 70.7±1.4 bpm. The decrease in the office blood pressure (SBP/DBP) was 35/19 mm Hg (p<0.05) on the double combination and 42/26 mm Hg (p<0.05) on the triple combination. Achieving target BP measurement in the office was 90.9 % – in the double combination and 95.7 % – in triple combination. In the dual combination group, withdrawal was observed in
3 (6 %) patients, in the triple combination group, withdrawal was observed in 4 (8 %) patients. There was a tendency to decrease the stiffness of the arterial wall in terms of cardio-vascular index CAVI, but there was no significant difference. CAVI right on dual therapy up to 8.68±0.57 units and after treatment 8.30±0.55 units. CAVI on the left on double therapy to 8.49±1.49 units and after treatment 8.17±1.49 units. CAVI right on triple therapy up to 8.86±0.39 units and after treatment 8.50±0.40 units from CAVI on the left in a triple combination up to 8.09±0.53 units and after treatment 8.27±0.36 units (p>0.05 for all values). No significant change in erectile function in men was detected during treatment.
Conclusion. The dual (valsartan/amlodipine) and triple (valsartan/amlodipine/hydrochlorothiazide) fixed combination showed high antihypertensive efficacy, did not adversely affect metabolic disorders and erectile function in men, and inhibited the progression of stiffness.

Article Details


fixed combination, arterial hypertension, valsartan, amlodipine, hydrochlorothiazide, сardio-ankle vascular index, erectile function


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