[Low-dose combination of perindopril arginine with indapamide in correction of metabolic syndrome].

Aim: To study ways of realization of pleiotropic effects of treatment with low-dose combination of perindopril arginine with indapamide in hypertensive patients with metabolic syndrome (MS).
Material and Methods: Thirty hypertensive patients with MS received low-dose combined drug noliprel A (Servier, France). In weak hypotensive effect noliprel A forte was used. An antihypertensive (by the data of 24-h blood pressure monitoring), sympatholytic (by the levels of ACTH and cortisol in blood plasma, by variability of the heart rate)and metabolic effects of the drug were assessed after 3 weeks, 3 and 6 months of treatment. Carbohydrate metabolism was studied by glucose and insulin blood levels before meal and after it. Lipid and purin metabolism were assessed by enzyme method, leptin levels - by enzyme immunoassay.
Results: 24-h blood pressure monitoring registered a stable regular blood pressure lowering, target blood pressure was achieved in 78.6% patients. Blood ACTH concentration significantly reduced showing a sympatholytic action of the drug. Parameters of lipid, carbohydrate and purin metabolism changed insignificantly. Positive changes were seen in anthropometric indices, leptin tended to decrease. Changes in these parameters, sympatholytic and hypotensive effects depended on plasmic levels of leptin.
Conclusion: A fixed low-dose combination of perindopril arginine with indapamide in a stable hypotensive effect and metabolic neutrality influences some key components of MS including hyperactivity of sympathic autonomic nervous system component and hyperleptinemia.