В статье представлены результаты исследований по изучению эффективности и безопасности антагониста кальция III поколения лерканидипина в лечении артериальной гипертензии. Лечение лерканидипином приводит к выраженному достоверному снижению систолического и диастолического артериального давления без существенного влияния на частоту сердечных сокращений. Препарат обладает органопротективным действием, уменьшает гипертрофию левого желудочка, улучшает функцию почек и оказывает антипротеинурическое действие. Лерканидипин хорошо переносится, реже вызывает периферические отеки по сравнению с другими антагонистами кальция.
The article presents the results of studies on the effectiveness and safety of a III generation calcium antagonist lercanidipine in the treatment of hypertension. Lercanidipine treatment leads to a marked significant reduction in systolic and diastolic blood pressure without producing a significant effect on heart rate. The drug has organ-protective effect, reduces left ventricular hypertrophy, improves kidney function and has antiproteinuric action. Lercanidipine is well tolerated, less likely to cause peripheral edema compared with other calcium antagonists.
1. Рекомендации РМОАГ/ВНОК по диагностике и лечению артериальной гипертонии (четвертый пересмотр). 2010.
2. Mancia G, Fagard R, Narkiewicz K et al. Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens 2013; 31: 1925–38.
3. James PA, Oparil S, Carter BL et al. Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report Fr om the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311: 507–20.
4. Angeli F et al. Calcium channel blockade to prevent stroke in hypertension: a meta-analysis of 13 studies with 103 793 subjects. Am J Hypertens 2004; 17 (9): 817–22.
5. Angelico P, Guarneri L, Leonardi A et al. Vascular-selective effect of lercanidipine and other 1,4-dihydropyridines in isolated rabbit tissues. J Pharmacol 1999; 51: 709–14.
6. Herbette LG, Vecchiarelli M, Sartani A, Leonardi A. Lercanidipine: Short Plasma Half-Life, Long Duration of Action and High Cholesterol Tolerance. Updated Molecular Model to Rationalize its Pharmacokinetic Properties. Blood Pres Suppl 1998; 2: 10–7.
7. Barrios V, Navarro A, Esteras A et al. Antihypertensive efficacy and tolerability of lercanidipine in daily clinical practice. The ELYPSE study. Blood Press 2002; 11 (2): 95–100.
8. Fogari R, Mugellini A, Zoppi A et al. Differential effects of lercanidipine and nifedipine GITS on plasma norepinephrine in chronic treatment of hypertension. Am J Hypertens 2003; 16 (7): 596–9.
9. Bang LM, Chapman TM, Goa KL. Lercanidipine: a review of its efficacy in the management of hypertension. Drugs 2003; 63: 2449–72.
10. Policicchio D, Magliocca R, Malliani A. Efficacy and tolerability of lercanidipine in patients with mild to moderate essential hypertension: a comparative study with slow-release nifedipine. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S31–35.
11. Cavallini A. Effects of antihypertensive therapy with lercanidipine and verapamil on cardiac electrical activity in patients with hypertension: a randomized, double-blind pilot study. Curr Ther Res 2000; 61 (7): 477–87.
12. De Giorgio LA, Orlandini F, Malasoma P et al. Double-blind, crossover study of lercanidipine versus amlodipine in the treatment of mild-to-moderate essential hypertension. Curr Ther Res 1999; 60: 511–20.
13. Zanchetti A. Emerging data on calcium-channel blockers: the COHORT study. Clin Cardiol 2003; 26 (Suppl. 2): II 17–20.
14. Sironi G, Colombo D, Greto L et al. Regional vasodilating effects of lercanipine in dogs. ISHR XVI World Congress 1998.
15. Sabbatini M, Tomassoni D, Amenta F. Influence of treatment with Ca2+ antagonistis on cerebral vasculature of spontaneously hypertensive rats. Mechanisms of Ageing and Development 2001; 122: 795–809.
16. Leonetti G. The safety profile of antihypertensive drugs as the key factor for the achievement of blood pressure control: current experience with lercanidipine. High Blood Press 8; р. 92–101.
17. Barrios V, Escobar C, De la Figuera M et al. High doses of lercanidipine are better tolerated than other dihydropyridines in hypertensive patients with metabolic syndrome: results from the TOLERANCE study. Int J Clin Pract 2008; 62 (5): 723–8.
18. Cherubini A, Fabris F, Ferrari E et al. Comparative effects of lercanidipine, lacidipine and nifidepine GITS on blood pressure and heart rate in elderly hypertensive patients: the ELderly and LErcanidipine (ELLE) study. Arch Gerontol Geriatr 2003; 3: 203–12.
19. Marx A, Lichtenthal A, Milbredt C et al. Effect of anthypertensive therapy with a new third generation calcium antagonist lercanidipine on patients with concomitant diseases. J Hypertens 2004; 22 (Suppl. 2): S236.
20. Barrios V, Calderon A, Navarro A et al. Lercanidipine effectiveness and tolerability profile is not influenced by overweight or body fat increase. The LERZAMIG study. J Hypertens 2004; 17 (9): 823–7.
21. Sangiorgi BG, Putignano E, Calcara L, Barbagallo M. Efficacy and tolerability of lercanidipine vs. captopril in patients with mild to moderate hypertension in a double-blind controlled study. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S36–S39.
22. Morisco C, Trimarco B. Efficacy and tolerability of lercanidipine in comparison and in combination with atenolol in patients with mild to moderate hypertension in double-blind controlled study. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S26–S30.
23. Aranda P, Aranda FT, Bianchi JL et al. Therapeutic efficacy and tolerability of lercanidipine versus candesartan, alone or in combination, in mild-moderate essential hypertensives (abstract). J Hypertens 2000; 18 (Suppl. 2): S152.
24. Fogari R, Mugellini A, Corradi L et al. Efficacy of lercanidipinevs losartan on left ventricular hypertrophy in hypertensive type 2 diabetic patients (abstract P1.191). J Hypertens 2000; 18 (Suppl. 2): S65.
25. Sanchez A, Sayans R, Alvarez JL et al. Left ventricular hypertrophy regression after a short antihypertensive treatment with lercanidipine vs. enalapril (abstract 12). Fourth European Meeting on Calcium Antagonists Amsterdam 1999.
26. Dworkin Ld. Effects of calcium channel blockers on experimental glomerular injury. J Am Soc Nephrol 1990; 1: S21–27.
27. Viberti G. Microalbuminuria Reduction With Valsartan in Patients With Type 2 Diabetes Mellitus: A Blood Pressure – Independent Effect. Wheeldon and for the Microalbuminuria Reduction WithVALsartan (MARVAL) Study Investigators. Circulation 2002; 106: 672–8.
28. Kloke HJ et al. Meta-analysis of changes in albuminuria and arterial pressure in hypertensive patients with proteinuria in studies wh ere patients received nifedipine, any other DHP CCB, a non-DHP CCB, or an ACE inhibitor. Kidney Int 1998; 53: 1559–73.
29. Herlitz H, Harris K, Risler T et al. The effects of an ACE inhibitor and a calcium antagonist on the progression of renal disease: the Nephros Study. Nephrol Dial Transplant 2001; 16: 2158–65.
30. DallaVestra M, Pozza G, Mosca A et al. Effect of lercanidipine compared with ramipril on albumin excretion rate in hypertensive Type 2 diabetic patients with microalbuminuria: DIAL study (diabete, ipertensione, albuminuria, lercanidipina). Diabetes Nutr Metab 2004; 17 (5): 259–66.
31. Robles NR, Ocon J, Gomez CF et al. Lercanidipine in Patients with Chronic Renal Failure: The ZAFRA study. Ren Fail 2005; 27 (1): 73–80.
32. Sabbatini M, Leonardi A, Testa R et al. Effect of calcium antagonists on glomerular arteriolesin spontaneously hypertensive rats. Hypertension 2000; 35 (3): 775–9.
33. Cafiero M, Giasi M. Long-term (12-month) treatment with lercanidipine in patients with mild to moderate hypertension. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S45–49.
34. Borghi C, Prandin MG, Dormi A. The use of lercanidipine can improve the individual tolerability to dihydropyridine calcium blockers in hypertensive patients (abstract). J Hypertens 2000; 18 (Suppl. 2): S155.
35. Fogari R, Malamani GD, Zoppi A et al. Comparative effect of lercanidipine and nifedipine gastrointestinal therapeutic system on ankle volume and subcutaneous interstitial pressure in hypertensive patients: a double-blind, randomized, parallel-group study. Curr Ther Res 2000; 61 (12): 850–62.
36. Lund-Johansen P, Stranden E, Helberg S et al. Quantification of leg oedema in postmenopausal hypertensive patients treated with lercanidipine or amlodipine. J Hypertens 2003; 21: 1003–10.
37. Rengo F, Romis L. Activity of lercanidipine in double-blind comparison with nitrendipine in combination treatment of resistant essential hypertension. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S54–58.
38. Marx A, Lichtenthal A, Milbredt C et al. Effect of anthypertensive therapy with a new third generation calcium antagonist lercanidipine on patients with concomitant diseases. J Hypertens 2004; 22 (Suppl. 2): S236.
39. Sironi G, Montagna E, Greto L et al. Haemodynamic effects of lercanidipine in anaesthetized open-chest dogs. Arzneim-Forsch Drug Res 1996; 46: 256–61.
40. Specchia G, Saccaggi SP, Ghezzi C. Cardiovascular safety of lercanidipine in patients with angina pectoris: a review of six randomized clinical trials. Curr Ther Res 2001; 62: 3–15.
41. Ortiz M, Calcino G. Inferred mortality differences between dihydropyridine antihypertensives. Hypertension 2009; 53: 1116.
42. Mackenzie IS, Carmel M, McEniery CM et al. Comparison of the Effects of Antihypertension Agents on Central Blood pressure and Arterial Stiffness in Isolated Systolic Hypertension. Hypertension 2009; 54: 409–13.
________________________________________________
1. Рекомендации РМОАГ/ВНОК по диагностике и лечению артериальной гипертонии (четвертый пересмотр). 2010.
2. Mancia G, Fagard R, Narkiewicz K et al. Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens 2013; 31: 1925–38.
3. James PA, Oparil S, Carter BL et al. Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report Fr om the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311: 507–20.
4. Angeli F et al. Calcium channel blockade to prevent stroke in hypertension: a meta-analysis of 13 studies with 103 793 subjects. Am J Hypertens 2004; 17 (9): 817–22.
5. Angelico P, Guarneri L, Leonardi A et al. Vascular-selective effect of lercanidipine and other 1,4-dihydropyridines in isolated rabbit tissues. J Pharmacol 1999; 51: 709–14.
6. Herbette LG, Vecchiarelli M, Sartani A, Leonardi A. Lercanidipine: Short Plasma Half-Life, Long Duration of Action and High Cholesterol Tolerance. Updated Molecular Model to Rationalize its Pharmacokinetic Properties. Blood Pres Suppl 1998; 2: 10–7.
7. Barrios V, Navarro A, Esteras A et al. Antihypertensive efficacy and tolerability of lercanidipine in daily clinical practice. The ELYPSE study. Blood Press 2002; 11 (2): 95–100.
8. Fogari R, Mugellini A, Zoppi A et al. Differential effects of lercanidipine and nifedipine GITS on plasma norepinephrine in chronic treatment of hypertension. Am J Hypertens 2003; 16 (7): 596–9.
9. Bang LM, Chapman TM, Goa KL. Lercanidipine: a review of its efficacy in the management of hypertension. Drugs 2003; 63: 2449–72.
10. Policicchio D, Magliocca R, Malliani A. Efficacy and tolerability of lercanidipine in patients with mild to moderate essential hypertension: a comparative study with slow-release nifedipine. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S31–35.
11. Cavallini A. Effects of antihypertensive therapy with lercanidipine and verapamil on cardiac electrical activity in patients with hypertension: a randomized, double-blind pilot study. Curr Ther Res 2000; 61 (7): 477–87.
12. De Giorgio LA, Orlandini F, Malasoma P et al. Double-blind, crossover study of lercanidipine versus amlodipine in the treatment of mild-to-moderate essential hypertension. Curr Ther Res 1999; 60: 511–20.
13. Zanchetti A. Emerging data on calcium-channel blockers: the COHORT study. Clin Cardiol 2003; 26 (Suppl. 2): II 17–20.
14. Sironi G, Colombo D, Greto L et al. Regional vasodilating effects of lercanipine in dogs. ISHR XVI World Congress 1998.
15. Sabbatini M, Tomassoni D, Amenta F. Influence of treatment with Ca2+ antagonistis on cerebral vasculature of spontaneously hypertensive rats. Mechanisms of Ageing and Development 2001; 122: 795–809.
16. Leonetti G. The safety profile of antihypertensive drugs as the key factor for the achievement of blood pressure control: current experience with lercanidipine. High Blood Press 8; р. 92–101.
17. Barrios V, Escobar C, De la Figuera M et al. High doses of lercanidipine are better tolerated than other dihydropyridines in hypertensive patients with metabolic syndrome: results from the TOLERANCE study. Int J Clin Pract 2008; 62 (5): 723–8.
18. Cherubini A, Fabris F, Ferrari E et al. Comparative effects of lercanidipine, lacidipine and nifidepine GITS on blood pressure and heart rate in elderly hypertensive patients: the ELderly and LErcanidipine (ELLE) study. Arch Gerontol Geriatr 2003; 3: 203–12.
19. Marx A, Lichtenthal A, Milbredt C et al. Effect of anthypertensive therapy with a new third generation calcium antagonist lercanidipine on patients with concomitant diseases. J Hypertens 2004; 22 (Suppl. 2): S236.
20. Barrios V, Calderon A, Navarro A et al. Lercanidipine effectiveness and tolerability profile is not influenced by overweight or body fat increase. The LERZAMIG study. J Hypertens 2004; 17 (9): 823–7.
21. Sangiorgi BG, Putignano E, Calcara L, Barbagallo M. Efficacy and tolerability of lercanidipine vs. captopril in patients with mild to moderate hypertension in a double-blind controlled study. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S36–S39.
22. Morisco C, Trimarco B. Efficacy and tolerability of lercanidipine in comparison and in combination with atenolol in patients with mild to moderate hypertension in double-blind controlled study. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S26–S30.
23. Aranda P, Aranda FT, Bianchi JL et al. Therapeutic efficacy and tolerability of lercanidipine versus candesartan, alone or in combination, in mild-moderate essential hypertensives (abstract). J Hypertens 2000; 18 (Suppl. 2): S152.
24. Fogari R, Mugellini A, Corradi L et al. Efficacy of lercanidipinevs losartan on left ventricular hypertrophy in hypertensive type 2 diabetic patients (abstract P1.191). J Hypertens 2000; 18 (Suppl. 2): S65.
25. Sanchez A, Sayans R, Alvarez JL et al. Left ventricular hypertrophy regression after a short antihypertensive treatment with lercanidipine vs. enalapril (abstract 12). Fourth European Meeting on Calcium Antagonists Amsterdam 1999.
26. Dworkin Ld. Effects of calcium channel blockers on experimental glomerular injury. J Am Soc Nephrol 1990; 1: S21–27.
27. Viberti G. Microalbuminuria Reduction With Valsartan in Patients With Type 2 Diabetes Mellitus: A Blood Pressure – Independent Effect. Wheeldon and for the Microalbuminuria Reduction WithVALsartan (MARVAL) Study Investigators. Circulation 2002; 106: 672–8.
28. Kloke HJ et al. Meta-analysis of changes in albuminuria and arterial pressure in hypertensive patients with proteinuria in studies wh ere patients received nifedipine, any other DHP CCB, a non-DHP CCB, or an ACE inhibitor. Kidney Int 1998; 53: 1559–73.
29. Herlitz H, Harris K, Risler T et al. The effects of an ACE inhibitor and a calcium antagonist on the progression of renal disease: the Nephros Study. Nephrol Dial Transplant 2001; 16: 2158–65.
30. DallaVestra M, Pozza G, Mosca A et al. Effect of lercanidipine compared with ramipril on albumin excretion rate in hypertensive Type 2 diabetic patients with microalbuminuria: DIAL study (diabete, ipertensione, albuminuria, lercanidipina). Diabetes Nutr Metab 2004; 17 (5): 259–66.
31. Robles NR, Ocon J, Gomez CF et al. Lercanidipine in Patients with Chronic Renal Failure: The ZAFRA study. Ren Fail 2005; 27 (1): 73–80.
32. Sabbatini M, Leonardi A, Testa R et al. Effect of calcium antagonists on glomerular arteriolesin spontaneously hypertensive rats. Hypertension 2000; 35 (3): 775–9.
33. Cafiero M, Giasi M. Long-term (12-month) treatment with lercanidipine in patients with mild to moderate hypertension. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S45–49.
34. Borghi C, Prandin MG, Dormi A. The use of lercanidipine can improve the individual tolerability to dihydropyridine calcium blockers in hypertensive patients (abstract). J Hypertens 2000; 18 (Suppl. 2): S155.
35. Fogari R, Malamani GD, Zoppi A et al. Comparative effect of lercanidipine and nifedipine gastrointestinal therapeutic system on ankle volume and subcutaneous interstitial pressure in hypertensive patients: a double-blind, randomized, parallel-group study. Curr Ther Res 2000; 61 (12): 850–62.
36. Lund-Johansen P, Stranden E, Helberg S et al. Quantification of leg oedema in postmenopausal hypertensive patients treated with lercanidipine or amlodipine. J Hypertens 2003; 21: 1003–10.
37. Rengo F, Romis L. Activity of lercanidipine in double-blind comparison with nitrendipine in combination treatment of resistant essential hypertension. J Cardiovasc Pharmacol 1997; 29 (Suppl. 2): S54–58.
38. Marx A, Lichtenthal A, Milbredt C et al. Effect of anthypertensive therapy with a new third generation calcium antagonist lercanidipine on patients with concomitant diseases. J Hypertens 2004; 22 (Suppl. 2): S236.
39. Sironi G, Montagna E, Greto L et al. Haemodynamic effects of lercanidipine in anaesthetized open-chest dogs. Arzneim-Forsch Drug Res 1996; 46: 256–61.
40. Specchia G, Saccaggi SP, Ghezzi C. Cardiovascular safety of lercanidipine in patients with angina pectoris: a review of six randomized clinical trials. Curr Ther Res 2001; 62: 3–15.
41. Ortiz M, Calcino G. Inferred mortality differences between dihydropyridine antihypertensives. Hypertension 2009; 53: 1116.
42. Mackenzie IS, Carmel M, McEniery CM et al. Comparison of the Effects of Antihypertension Agents on Central Blood pressure and Arterial Stiffness in Isolated Systolic Hypertension. Hypertension 2009; 54: 409–13.
Авторы
Г.А.Барышникова, С.А.Чорбинская, И.И.Степанова
ФГБУ Учебно-научный медицинский центр Управления делами Президента Российской Федерации
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G.A.Baryshnikova, S.A.Chorbinskaya, I.I.Stepanova
Educational Research Medical Center, Office of the President of the Russian Federation