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Abstracts e553

Methods: In hypertensive patients (n ¼ 122, mean ages; 67 years) who Objective: The aim was to evaluate the antihypertensive treatment admin-
treated and not well-controlled using standard dose of ARB, CCB, diuretic istration with observed drug classes, and its pharmaceutical substance and
or these combinations at least for 3 months were enrolled. They were divided dosage in patients with hypertension and diabetes mellitus type II in routine
with/without CKD or Mets according to the new diagnostic criteria in Japan, general practice.
respectively. At 6 month after the switching to high-dose ARB (valsartan;
160 mg/day), blood pressure, some of hypertensive organ damage markers, Design and Methods: Clinical data, evaluation of medications and target
renal function, and metabolic syndrome related factors were evaluated. drug dosage, risk factors controls were recorded from 288 hypertensive type
II diabetes patients attended Moscow city cardiologic outpatient clinic in
Results: Systolic (p < 0.01) and diastolic BP (P < 0.01) have been signifi- 2005–2006 years.
cantly decreased already at 1 month after the switching and these effects
were kept to 6 months. Hs-CRP and serum BNP revealed no significant Results: The study included patients of mean age 59.6  9.6 years, females
differences, however, urinary albumin index (p < 0.05) could be significantly was 66.7%. Medical history of diabetes was 4.1  0.1 years, arterial hyper-
reduced and this was more effective in Mets (p < 0.05 vs non-Mets). There tension duration was 10.2  0.1 years. Mean SBP was 145.9  31.4 mmHg
was no significant changes in fasting blood glucose, however, HOMA-IR and DBP 86.6  17.4mmHg. The treatment management included antihy-
(p < 0.05), fasting-IRI (p < 0.05) and triglyceride (p < 0.05) were significantly pertensive drugs used in 94.4% patients, hypolipidemic therapy was given
decreased and these were more significantly reduced in Mets (p < 0.05 vs for 28.8% of patients, administration of hypoglycemic drugs were registered
non-Mets). On the other hand, eGFR was significantly decreased at 6 month, in 59.4% of attendees, 55.9% of group had antithrombotic treatment. The
however it was significantly maintained in CKD (p < 0.05 vs non-CKD). No antihypertensive drugs prescribed were ACE inhibitors used in 80,2%, beta
severe adverse effect was observed during treatment. blockers in 61.1%, calcium antagonist in 30.9%, diuretics 47.6% of all
Conclusion: Switching for high-dose valsartan indicated not only blood patients accordingly. The structure of the hypertensive drug was modified
pressure lowering effect but also improving for organ damage markers, by the specialized cardiology clinic in comparison with general outpatients
especially renal function in CKD and insulin resistance in Mets complicated practice for wide usage of ACE inhibitors and calcium channel blockers with
with hypertension. Severer control of blood pressure using high-dose ARB prolonged action and selective beta-blockers. Regarding ACE-inhibitors:
was consequent strategy to reduce cardiovascular complications in hyper- perindopril was recommended in 26.3%, fosinopril in 28.1% and intake
tensive subjects with CKD or Mets. captopril 0.4%. The administered dosage was for fosinopril 18.1  2.6 and
perindopril 4.0  0.1. The structure of the beta-blockers changed from
decreased atenolol administration in 11.5%, increased metoprolol intake
PP.33.343 THERAPEUTIC DECISION FOR UNCONTROLLED in 32.3%. The administered used dosage for atenolol was 56.0  5.2 and
AND UNTREATED HYPERTENSIVE PATIENTS: metoprolol 51.4  6.7. On the therapy only 4.4% of patients have reach the
Conclusion: In hypertensive type II diabetes patient’s ACE inhibitors were
B. Fiquet1, S. Quere1, A. Francillon1, M. Galinier2. 1Novartis Pharma SAS, the most widely used antihypertensive drugs as recommended in current
Clinical Research and Development, Rueil Malmaison, France, 2CHU Rangueil, guidelines. The target dosage has greater impact on the efficient BP control
Cardiology Department, Toulouse, France than the class of antihypertensive drug. The dosage of the administered
The study aim was to observe the therapeutic decision made by GPs or antihypertensive drug should be tightly controlled in order to reach the
cardiologists for uncontrolled and untreated hypertensive patients (pts) target BP levels.
(BP> ¼ 140/90 for non diabetic (DB) and BP>¼130/80mmHg for DB pts).
Three treatment approaches were assessed: lifestyle and diet recommen-
dations without treatment (LD), implementation of a single drug antihyper-
tensive treatment (SD) or prescription of two antihypertensive agents (TD). PP.33.345 THE EFFECT OF IRBESARTAN AND LOSARTAN ON
French cross sectional study conducted with 1048 GPs and 155 cardiologists HYPERTENSIVE PATIENTS
in 2008. Each physician included the first 5 consecutive hypertensive pts
according to above inclusion criteria. Cardiovascular (CV) risk factors (RF) N. Afanasyeva, V. Mordovin. Research Institute of Cardiology of Siberian Branch
and associated diseases were collected to compare pts characteristics in the of Russian Academy of Medical Sciences, Tomsk, Russia
3 groups.
Background and Purpose: Cognitive impairment also arises at early stages of
5201 pts were included by GPs and 764 pts by cardiologists (see table below). hypertension. Angiotensin receptor blocker (ARB) suppress activity of
sympathetic nervous system and are capable to eliminate factors which raise
vascular risk in hypertensive patients. The aim of the present study was to
study hypotensive and ñerebroprotective efficacy of ARB irbesartan and
losartan in hypertensive patients.

Methods: Forty five hypertensive patients (21 women and 24 men), aged
between 28–56 years, were randomized to treatment with either blockers
irbesartan 150–300 mg or losartan 50–100 mg during 6 month. 24-hours
ambulatory blood pressure monitoring and neurocognitive assessment by
Wechsler Memory Scale (WMS) were performed in all patients at baseline
and in course of the treatment.
Overall physicians mostly chose to start an antihypertensive treatment: only
7.9% of pts followed by GPs remained without treatment versus 10.6% of pts Results: Irbesartan reduced significantly 24-h SBP (with 156.8 mm Hg up
managed by cardiologists. to 134.0 mm Hg; P ¼ 0.009), 24-h DBP (with 96 mm Hg up to 88 mm Hg;
Cardiologists were more disposed to immediately prescribe a two-drug P ¼ 0.012), time-index 24-h SBP (with 72% up to 44%; P ¼ 0.014) and
regimen than GPs, respectively 32.7 and 22.9%, even though their patients time-index 24-h DBP (with 64% up to 42%; P ¼ 0.018). Losartan reduced
didn’t have more severe HTN or more associated cardiovascular risk factors significantly 24-h SBP (with 148.8 mm Hg up to 132.0 mm Hg; P ¼ 0.008),
or diseases. 24-h DBP (with 98 mm Hg up to 89 mm Hg; P ¼ 0.024), time-index 24-h
SBP (with 58% up to 42%; P ¼ 0.028) and time-index 24-h DBP (with 46%
Therapeutic management for uncontrolled and untreated hypertensive up to 38%; P ¼ 0.034). Later 6 months hypotensive therapies by results of
patients differ between cardiologist and GPs, with cardiologists adopting proof test were marked statistically significant reduction the quantity of
a more aggressive approach despite the same cardiovascular risk of their pts. errors (irbesartan with 6 up to 1.8; P ¼ 0.003, losartan with 5 up to 4.2;
P ¼ 0.062). By results of tables of Shulte psychomotor speed has increased
The more frequent ambulatory BP measurement prescribed by cardiologists (irbesartan with 48 sec up to 36 sec; P ¼ 0.026, losartan with 48 sec up to
could explain partly the differences observed in therapeutic decision. 44 sec; P ¼ 0.242), indicators of long-term memory have increased (irbe-
sartan with 68.5 word up to 52.6 word; P ¼ 0.005, losartan with 60.4 word
up to 56.2 word; P ¼ 0.084).
Conclusions: Our study demonstrates, that long controllable treatment of
hypertension with irbesartan and losartan reduces blood pressure and
M. Barabanschikova, L.S. Pak, E.A. Prochorovich. Moscow Medical Stomato- improves cognitive function. The most expressed positive effect on cogni-
logical State University, Moscow, Russia tion rendered irbesartan.