Pharmacoepidemiologic and clinical rationale for the inclusion of L-arginine and dihydroquercetin in the combined pharmacotherapy of hypertensive patients with COVID-19

Introduction: The article presents information on the dynamics of office blood pressure in patients with arterial hypertension stage II who have had COVID-19 during antihypertensive pharmacotherapy (AHPT), including the L-arginine complex (500 mg tablets once a day) + dihydroquercetin (25 mg tablets twice a day). The aim was to improve the effectiveness of treatment of COVID-19-treated HD patients by pharmacoepidemiologic and clinical substantiation of inclusion of L-arginine + dihydroquercetin complex in the composition of combined AHPT. Materials and Methods: In order to achieve the goal, we developed a research design, which involved two stages. During the 1st stage, we designed a questionnaire for pharmacy visitors, which in agreement with the management of pharmacies, pharmacists offered visitors to fill out when the latter buy antihypertensive officinal drugs (AHOD). The questionnaire survey of pharmacy visitors in Donetsk was conducted from December 2021 till February 2023. A total of 1118 pharmacy visitors with HD participated in the questionnaire survey. The 2nd stage of the study included HD patients who had undergone COVID-19. Patients who met the inclusion criteria and had no exclusion criteria were included in the study. Results and Discussion. The proposed treatment has been shown to be more effective than standard antihypertensive pharmacotherapy. This is manifested by the achievement of normotonic values of office systolic and diastolic blood pressure by the end of the 2nd week of treatment (<140/90 mmHg) compared to standard antihypertensive pharmacotherapy, in which this result was achieved only by the end of the 4th week of treatment. A decrease in systolic blood pressure levels to <130 mm Hg and diastolic blood pressure to <80 mm Hg was achieved starting from the 4th week of treatment only when the L-arginine + dihydroquercetin complex was included in the combined antihypertensive pharmacotherapy. Conclusion: Inclusion of L-arginine complex (500 mg tablets once a day, for 12 weeks according to the 2 weeks-on/1 week-off regimen) + dihydroquercetin (25 mg tablets twice a day, for 12 weeks according to the 4 weeks-on/1 week-off regimen) as a part of combined AHPT (including statins) in patients with stage II HD, who underwent COVID-19, increased its efficacy, which was manifested by achievement of normotonic values of office SAP and DAP (<140/90 mm Hg) by the end of the 2nd week of treatment compared to combined AHPT (including statins) in comparison with combined AHPT (by the end of the 4th week of treatment).