Prediction of the Individual Efficacy of Fixed Triple-Component Therapy in the Management of Severe Hypertension

Abstract

Summary. This study evaluated the effects of fixed triple-component antihypertensive therapy on clinical and hemodynamic parameters in patients with Grade 3 arterial hypertension and identified predictors of individual treatment efficacy.
Materials and methods. A total of 50 patients underwent comprehensive clinical, laboratory, and instrumental examinations, including ambulatory blood pressure monitoring, echocardiography, Doppler echocardiography, and carotid Doppler ultrasound at baseline and after six months of therapy. Treatment efficacy was defined as a reduction of at least 10% in left ventricular myocardial mass, and multivariable logistic regression and ROC analyses were used to determine prognostic factors.
Results. Higher baseline left ventricular myocardial mass and left ventricular diastolic dimension significantly decreased the likelihood of treatment efficacy, whereas a higher baseline ejection fraction increased the probability of achieving the therapeutic target. Carotid intima-media thickness was identified as the strongest independent vascular predictor of an unfavorable individual response to therapy. The combined cardiac and vascular prognostic model demonstrated high predictive performance, with an AUC of 0.892, sensitivity of 86.7%, and specificity of 82.4%.
Conclusion. Fixed triple-component therapy efficacy in severe arterial hypertension can be predicted using baseline echocardiographic and carotid vascular parameters. The developed mathematical model may support personalized treatment planning and the early identification of patients at risk of poor therapeutic response.