Possibilities of modern combined pharmacotherapy in patients with combined cardiovascular pathology under conditions of outpatient practice

Objective: to conduct a comprehensive comparative assessment of the effectiveness of typical outpatient practice and active combined pharmacotherapy in patients with combined cardiovascular pathology. 

Materials and methods. The study included 100 patients with combined cardiovascular pathology: arterial hypertension, stable angina, chronic heart failure (CHF). The examination was carried out in 2 stages: 1) monitoring the effectiveness of pharmacotherapy carried out in a standard outpatient facility; 2) a change in the pharmacotherapy regimen in patients and, if needed, dose correction of the newly prescribed treatment regimen. Evaluation of the results was carried out on the basis of clinical, biochemical, and instrumental methods of examination, statistical analysis. 

Results. During the period of active intervention, in comparison with standard outpatient practice, a statistically significant improvement in the main clinical indicators was found, a significant decrease in the level of blood pressure(BP) (systolic (SBP) - 136.36 ± 9.23, diastolic (DBP) - 82.34 ± 6.95) and heart rate (66.42 ± 5.26). No negative changes in the biochemical analysis of blood were detected, and positive changes in the parameters of the daily BP and electrocardiography (ECG) monitoring were recorded. A more pronounced (p <0.05) positive effect of active intervention on the structural parameters of the left ventricle was established (left ventricular myocardial mass index (∆%) - 8.12 ± 0.96), parameters of life quality, level of anxiety and depression. 

Conclusion. The results of the study demonstrate the superiority of active management of patients with combined cardiac pathology, which is expressed in considerably more significant positive dynamics of hemodynamic parameters, regression of clinical indicators of the severity of heart failure and stable angina, structural characteristics of the left ventricle, parameters of arrhythmic activity of the heart, indicators of life quality, level of anxiety and depression.