Aim . The study was aimed to assess the prevalence and risk factors of hypertension in cardiac recipients. Materials and methods . End-stage heart failure patients who received cardiac transplant between 01.01.2013 and 31.12.2016 in V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Moscow) and survived 3 months after surgery were included and followed up for 999.4 ± 774.3 (108–1587) days. Young patients (<18 y/o) and patients after repeated (n = 18) or multi-organ transplantation (n = 3) were excluded. Results. 353 cardiac recipients aged 45.6 ± 1.6 years (18.1% females and 81.9% males) were enrolled into the study. Hypertension was prevalent in 17.6, 42.8, 62.3 and 71.4%, respectively, before, in 3 months, in 1 year, and 3+ years after the transplantation. The study revealed significant relationship between post-transplant hypertension incidence and pre-op body mass index (р = 0.026), serum creatinine (р < 0.001), preexisting hypertension (RR = 1.36, р = 0.022) and renal failure, as well as donor heart posterior wall thickness (р = 0.034), post-transplant dialysis (RR = 1.85, р < 0.001), and antibody mediated rejection episodes (RR = 1.7, р = 0.001). Uncontrolled hypertension in cardiac recipients was related to poor compliance and new-onset post-transplant renal failure. Conclusion . Hypertension is highly prevalent among our population of cardiac recipients. The combination of various etiologic mechanisms, multiplex therapy and subjective factors calls for the careful individual patient management.

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Распространенность и предикторы артериальной гипертонии у реципиентов сердца

Peculiarities of the mode of action and clinical use of fixed low-dose combination of lisinopril and hydrochlorothiazide are discussed. Reasonability of ACE inhibitor and thiazide diuretic combination is supported due to more effective blood pressure control, organoprotection improvement and side events risk reduction. Results of the clinical studies on efficacy and safety of this combination in hypertensive patients with different concomitant diseases are presented.

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A. O. Shevchenko

Papers

Fixed low-dose combination of lisinopril and hydrochlorothiazide in the prevention of cardiovascular events in hypertensive patients