Biochemical, Pharmacological, and Therapeutic Effects of Triple Antihypertensive Therapy with Amlodipine, Valsartan and Hydrochlorothiazide in Elderly Hypertensive Patients with Calcium Phosphate Nephrolithiasis

Antihypertensives are widely prescribed in the geriatric population and could influence kidney stone risk but many aspects are still unknown. Thiazides are used to control lithogenic factors and recurrences in patients with calcium lithiasis. The aim of our study was to evaluate the relationship between essential arterial hypertension and stone disease, by studying the pharmaco-therapeutic effects of a fixed-dose combination of amlodipine + valsartan + hydrochlorothiazide (Aml + Val + HCTZ) 10/320/25 mg, on the urinary stone risk in a study group of hypertensive geriatric patients. A longitudinal, randomized, three years follow-up clinical and experimental study was conducted during June 1, 2014 - July 31, 2017. A number of 60 eligible geriatric patients, treated only with a fixed-dose combination of Aml + Val + HCTZ 10/320/25 mg, as a single-tablet, were enrolled in the study. All the patients were stone formers, with more than three episodes of crystalluria in the last two years. The patient�s age ranged between 55 and 65 years. Exclusion criteria: patients with heart failure, kidney chronic diseases, use of drugs known to affect renal function, patients with multi-morbidities. All patients had similar blood pressure values, and tension was well controlled throughout the whole study period. In the elderly patients, the treatment with 25 mg/day of hydrochlorothiazide (from the combination of Aml + Val + HCTZ 10/320/25 mg) has a beneficial and prolonged efficacy in treatment of recurrences in patients with calcium oxalate and phosphate lithiasis Our study reveals that in the elderly patients with hypertension and nephrolithiasis as a comorbidity, thiazides - 25 mg/day of hydrochlorothiazide (from the combination of Aml + Val + HCTZ 10/320/25 mg) has a beneficial effect in order to control lithogenic factors and recurrences in patients with calcium phosphate lithiasis.