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Beneficial effects of triple antihypertensive therapy with amlodipine, valsartan and hydrochlorothiazide on copper status in a trial of geriatric patients in Southwestern Romania

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ABSTRACT
Background. Inadequate mineral status involving the biometals copper and zinc is linked to cardiovascular homeostasis, anemia and arterial hypertension. In our previous studies, we revealed that long-time therapy with angiotensin-converting enzyme (ACE) inhibitors causes excessive zinc deficiency in comparison with the triple fixed-dose combination antihypertensive therapy, which is safer for the elderly hypertensive patient.
Objectives. The aim of our study was to evaluate the pharmaco-therapeutic effects of a fixed-dose combination of Amlodipine + Valsartan + Hydrochlorothiazide (Aml + Val + HCTZ) 10/320/25 mg on the copper status, in a clinical setting of geriatric patients from Southwestern Romania. Methods. We performed a randomized longitudinal, retrospective and comparative survey on 115 hypertensive elderly patients (65 to 80 years, 40 males and 75 females), during April 2013-May 2016. The patients received fixed-dose combination of Aml + Val + HCTZ 10/320/25 mg, as a single-tablet, for a study period of three years. Plasma copper concentrations and Copper/ Zinc ratio (CZr) were measured comparatively, by atomic absorption spectrophotometry (AAS), at baseline and at the end of the study.
Results. The copper serum levels and plasma CZr ratio of the study group were significantly higher at the end of the study in comparison with baseline values (P < 0.01).
Conclusions. Our study reveals beneficial pharmacological and therapeutic activities of triple fixed-dose combination of Aml + Val + HCTZ 10/320/25 mg on copper mineral status in the elderly hypertensive patient with comorbidities (coronary heart disease, anemia and systemic inflammatory diseases).
Key words: copper serum levels, Copper/Zinc ratio, fixed-dose combination Amlodipine + Valsartan + Hydrochlorothiazide 10/320/25 mg, geriatric patient.
Abbreviations list
Aml + Val + HCTZ = amlodipine + valsartan + hydrochlorothiazide
ACE = angiotensin converting enzyme
AAS = atomic absorption spectrometry

CZr = Cu/Zn ratio

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Dan Simion Cipu, Daniela Cipu, Adina Bucur, Anca-Alexandra Matusz and Victor Dumitrascu

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