Profiles of patients in whom it is worth using perindopril with indapamide to treat hypertension – case reports Case report series
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Abstract
Hypotensive therapy consists of many elements. Apart from drug therapy, one of the most important ones are lifestyle changes. Every patient with recognized hypertension should aim to reach target values of blood pressure through regular exercise, proper diet, weight reduction and other. If those methods are insufficient, we implement pharmacotherapy. Optimal antihypertensive treatment relies on adjusting drug scheme to patients’ profiles. While taking into consideration various aspects, including comorbidities and patient’s age, we should chose drugs to minimalize side effects and properly regulate blood pressure. In practice, hypotensive therapy is often based on polytherapy. To reach target blood pressure, we frequently use two or more antihypertensive medecines. Combination drugs have been on the market for several years now. They have positive influence on compliance and they improve treatment effects. Using two or more drugs helps exploit different active mechanisms, maximizing treatment tolerance, reducing doses and, what is most important, it enables the patients to take only one tablet. One of this types of combination is perindopril with indapamide, which has multiple applications. Elderly patients usually suffer from isolated systolic hypertension and chronic kidney disease, so the most favoured drug combination is ACEI with thiazide and thiazide-like diuretics. This therapy is also recommended in patients with diabetes, especially with concomitant microalbuminuria, because of its nephroprotective effect and in patients with recognized chronic kidney disease. Furthermore, combination of those two substances can be advantageous in patients after stroke due to proved positive action in prevention of stroke and in reaching optimal blood pressure. The treatment methods proposed show many problems and challenges of general practitioners. Family doctors choosing antihypertensive therapy have to take under consideration a number of aspects, such as patients’ general condition, drug tolerance and comorbidities.
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