Pleiotropic effect of chronotherapy with a fixed combination of amlodipine, lisinopril and rosuvastatin on the psychological state in elderly hypertensive patients with metabolic syndrome

Background . Hypertension (HTN) in metabolic syndrome (MS) in the elderly contributes to the formation of cognitive disorders and anxiety-depressive disorders. Objective. To study the psychological state of elderly patients with HTN and MS treated by evening versus morning dosing of a fixed combination (FC) of amlodipine, lisinopril and rosuvastatin. Design and methods. In a randomized, double-blind, controlled trial 63 patients aged 60–74 years with HTN and MS received a FC of amlodipine, liiznopril and rosuvastatin at a dose of 5/10/10 mg in the evening (after 20:00 hours) (study group) And 58 patients aged 60–74 years with HTN and MS took the drug in the morning (control group). Cognitive dysfunction was assessed by Mini-Mental State Examination (MMSE), anxiety and depressive disorders were assessed by State-Trait Anxiety Inventory adapted by Yu. Khanin and scale of the Center for Epidemiologic Studies-Depression (CES-D). Results . In evening dosing group, MMSE result increased from 17,8 ± of 0,3 to 23,5 ± 0,4 points (р = 0,13) vs. 16,9 ± of 0,3 to 20,4 ± 0,4 points (р = 0,148) in morning dosing. Situational anxiety score decreased from 40,0 ± 2,2 to 30,6 ± 1,8 points (р = 0,009) vs. from 40,8 ± of 2,5 to 33,5 ± 1,9 points (р = 0,011), and personal anxiety score from 48,8 ± 2,0 to 26,4 ± of 1,9 points (р = 0,003) and from 44,9 ± of 1,9 to 30,7 ± of 1,7 points (р = 0,008) in evening and morning dosing, respectively. Depressive disorders decreased similarly and slightly in both groups (14,1% versus 7,7% in evening and morning dosing, respectibely, p = 0,214). Conclusions. The results indicate that chronotherapy is more effective than the traditional use of a FC of amlodipine, lisinopril and rosuvastatin in HTN associated with MS.