| Abstract: | Hypertrophy of left ventricular myocardium observed in 15-20% of patients with arterial hypertension is an independent factor which elevates considerably risk of complications of hypertension (ischemic heart disease, chronic heart failure, ventricular arrhythmias). Regression of left ventricular hypertrophy (LVH) at the background of hypotensive therapy is associated with additional lowering of cardiovascular risk. This should be taken into consideration in selection of a hypotensive preparation. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are believed to have most pronounced ability to cause reverse development of LVH. It has been shown in recently finished PIXEL trial that administration of fixed combination of ACEI perindopril and diuretic indapamide reduced LVH more effectively than monotherapy with high doses of ACEI enalapril and provided better blood pressure control. Therefore in a patient with hypertension and LVH it is expedient to consider combined therapy with ACEI and diuretic including use of their fixed combinations as treatment of choice. |
