Циркадный ритм артериального давления: прогностическая значимость и возможности коррекции на фоне лечения азилсартана медоксомилом
Циркадный ритм артериального давления: прогностическая значимость и возможности коррекции на фоне лечения азилсартана медоксомилом
Остроумова О.Д., Копченов И.И., Щукина Г.Н. Циркадный ритм артериального давления: прогностическая значимость и возможности коррекции на фоне лечения азилсартана медоксомилом. Consilium Medicum. 2015; 17 (5): 8–13.
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O.D.Ostroumova, I.I.Kopchenov, G.N.Shchukina.¹Circadian rhythm of blood pressure: prognostic significance and possibility to correct it during the treatment using azilsartan medoxomil. Consilium Medicum. 2015; 17 (5): 8–13.
Циркадный ритм артериального давления: прогностическая значимость и возможности коррекции на фоне лечения азилсартана медоксомилом
Остроумова О.Д., Копченов И.И., Щукина Г.Н. Циркадный ритм артериального давления: прогностическая значимость и возможности коррекции на фоне лечения азилсартана медоксомилом. Consilium Medicum. 2015; 17 (5): 8–13.
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O.D.Ostroumova, I.I.Kopchenov, G.N.Shchukina.¹Circadian rhythm of blood pressure: prognostic significance and possibility to correct it during the treatment using azilsartan medoxomil. Consilium Medicum. 2015; 17 (5): 8–13.
В статье рассмотрены место и основные показания суточного мониторирования артериального давления (АД) в свете современных рекомендаций по диагностике и лечению артериальной гипертензии (АГ). Приведены основные параметры метода суточного мониторирования АД. В настоящее время при оценке эффективности антигипертензивной терапии следует не только и даже не столько опираться на параметры офисного измерения АД, а обязательно учитывать влияние препарата на уровень средненочного и среднедневного систолического и диастолического АД. Рассмотрены литературные данные о прогностической значимости нарушений циркадных ритмов АД. Указана частота распространенности разных типов суточного профиля АД. Подчеркивается, что, учитывая прогностическую ценность такого показателя, как недостаточное снижение АД в ночное время, очень высокую распространенность данного феномена среди больных с АГ, при выборе антигипертензивного препарата следует принимать во внимание его эффекты на уровень АД у нон-дипперов. Анализируются литературные данные об эффективности нового представителя класса блокаторов рецепторов к ангиотензину II (БРА) азилсартана медоксомила, зарегистрированного к применению в Российской Федерации в 2014 г., в отношении параметров циркадного ритма АД. Установлено, что данный препарат обладает преимуществом в сравнении с другими представителями класса БРА (валсартаном, олмесартаном) в виде более мощного антигипертензивного эффекта на протяжении 24 ч по данным суточного мониторирования.
Ключевые слова: артериальная гипертензия, блокаторы рецепторов к ангиотензину II, азилсартана медоксомил, артериальное давление, суточное мониторирование артериального давления, уровень артериального давления в ночное время, суточный профиль артериального давления, циркадный ритм артериального давления.
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The article deals with the examination of the role and main indications of 24-hour blood pressure (BP) monitoring according to recommendations concerning the current diagnosis and treatment of arterial hypertension (AH). We indicate the main parameters of 24-hour blood pressure monitoring method. Currently, on the evaluating the efficacy of antihypertensive therapy one should take into account not only the measurement of office BP parameters but also the impact of the drug on the level of mean systolic and diastolic daytime and night-time BP. We study the literature data on the predictive value of circadian rhythm of BP disoders. We mark the prevalence of different types of circadian profile of BP. We underline that, according to the predictive value of lack of nocturnal BP fall, it is very important to take into account the very high prevalence of this phenomenon among patients with AH, and in case of antihypertensive drugs selection one should take into account the effect on the BP level in non-dippers. We analyze the literature data on the efficacy of new drug from angiotensin II receptor blockers (ARBs) – azilsartan medoxomil, registered in the Russian Federation in 2014, for the application in case of circadian rhythm of BP disoders. It is found that this drug has the advantage in comparison with the other members of the ARBs class (valsartan, olmesartan) in the form of strong power antihypertensive effect in a 24-h period according to the 24-hour blood pressure monitoring results.
Key words: arterial hypertension, angiotensin II receptor blockers, azilsartan medoxomil, blood pressure, 24-hour blood pressure monitoring, blood pressure at night, circadian profile of blood pressure, circadian rhythm of blood pressure.
1. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) J Hypertans 2013; 31: 1281–357.
2. Sokolow M, Werdegar D, Kain HK, Hinman AT. Relationship between level of blood pressure measured casually and by portable recorders and severity of complications in essential hypertension. Circulation 1966; 34: 279–8.
3. Perloff D, Sokolow M, Cowan R. The prognostic value of ambulatory blood pressures. JAMA 1983; 249: 2792–8.
4. National High Blood Pressure Education Coordinating Committee. National High Blood Pressure Education Program working group report on ambulatory blood pressure monitoring. Arch Intern Med 1990; 150: 2270–80.
5. Boggia J, Li Y, Thijs L et al. Prognostic accuracy of day vs. night ambulatory blood pressure: a cohort study. Lancet 2007; 370: 1219–29.
6. Fagard RH, Celis H, Thijs L et al. Daytime and night-time blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertension 2008; 51: 55–61.
7. Fagard RH, Thijs L, Staessen JA et al. Prognostic significance of ambulatory blood pressure in hypertensive patients with history of cardiovascular disease. Blood Press Monit 2008; 13: 325–32.
8. Minutolo R, Agarwal R, Borrelli S et al. Prognostic role of ambulatory blood pressure measurement in patients with nondialysis chronic kidney disease. Аrch Intern Med 2011; 171: 1090–8.
9. De la Sierra A, Banegas JR, Segura J et al. Ambulatory blood pressure monitoring and development of cardiovascular events in high-risk patients included in the Spanish ABPM registry: the CARDIORISC Event study. J Hypertens 2012; 30: 713–9.
10. Gaborieau V, Delarche N, Gosse P. Ambulatory blood pressure monitoring vs. selfmeasurement of blood pressure at home: correlation with target organ damage. J Hypertens 2008; 26: 1919–27.
11. Bliziotis IA, Destounis A, Stergiou GS. Home vs. ambulatory and office blood pressure in predicting target organ damage in hypertension: a systematic review and meta-analysis. J Hypertens 2012; 30: 1289–99.
12. Staessen JA, Thijs L, Fagard R et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA 1999; 282: 539–46.
13. Clement DL, De Buyzere ML, De Bacquer DA et al. Office vs. Ambulatory Pressure Study Investigators. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med 2003; 348: 2407–15.
14. Dolan E, Stanton A, Thijs L et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005; 46: 156–61.
15. Sega R, Facchetti R, Bombelli M et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation 2005; 111: 1777–83.
16. Conen D, Bamberg F. Noninvasive 24-h ambulatory blood pressure and cardiovascular disease: a systematic review and meta-analysis. J Hypertens 2008; 26: 1290–9.
17. Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). Системные гипертензии. 2010; 3: 5–26.
18. Ojima M, Igata H, Tanaka M et al. In vitro antagonistic properties of a new angiotensin type 1 receptor blocker, azilsartan, in receptor binding and function studies. J Pharmacol Exp Ther 2011; 336 (3): 801–8.
19. Sica D, White W, Weber M et al. Comparison of the Novel Angiotensin II Receptor Blocker Azilsartan Medoxomil vs Valsartan by Ambulatory Blood Pressure Monitoring. J Clin Hypertens (Greenwich) 2011; 13: 467–72.
20. White WB, Weber MA, Sica D et al. Effects of the angiotensin receptor blocker azilsartan medoxomil versus olmesartan and valsartan on ambulatory and clinic blood pressure in patients with stages 1 and 2 hypertension. Hypertension 2011; 57 (3): 413–20.
21. 2013 Ambulatory Blood Pressure Monitoring Recommendations for the вiagnosis of Adult Hypertension, Assessment of Cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals. Chronobiology International 2013; 30 (3): 355–410.
22. Hansen TW, Li Y, Boggia J et al. Predictive role of the night-time blood pressure. Hypertension 2011; 57: 3–10.
23. Fagard RH, Thijs L, Staessen JA et al. Night-day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension. J Hum Hypertens 2009; 23: 645–53.
24. Mancia G, Bombelli M, Facchetti R et al. Long-term prognostic value of blood pressure variability in the general population: results of the Pressioni Arteriose Monitorate e Loro Associazioni Study. Hypertension 2007; 49: 1265–70.
25. Ohkubo T, Hozawa A, Yamaguchi J et al. Prognostic significance of the nocturnal decline in blood pressure: the Ohasama study. J Hypertens 2002; 20: 2183–9.
26. Cuspidi C, Michev I, Meani S et al. Reduced nocturnal fall in blood pressure, assessed by two ambulatory blood pressure monitorings and cardiac alterations in early phases of untreated essential hypertension. J Human Hypertens 2003; 17: 245–51.
27. Pierdomenico S, Bucci A, Costantini F et al. Circadian blood pressure changes and myocardial ischemia in hypertensive patients with coronary artery disease. J Am Coll Cardiol 1998; 31 (7): 1627–34.
28. Cuspidi C, Macca G, Sampieri L et al. Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients. J Hypertens 2001; 19: 1539–45.
29. Guo H, Tabara Y, Igase M, Yamamoto M et al. Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study. Hypertens Res 2010; 33 (1): 32–6.
30. Timio M, Venanzi S, Lolli S et al."Non-dipper" hypertensive patients and progressive renal insufficiency: a 3-year longitudinal study. Clin Nephrol 1995; 43 (6): 382–7.
31. Gorostidi M, Sobrino J, Segura J et al, on behalf of the Spanish Society of Hypertension ABPM registry Investigators. Ambulatory blood pressure monitoring in hypertensive patients with high cardiovascular risk: a cross-sectional analysis of 20,000 patient data base in Spain. J Hypertens 2007; 25: 977–84.
32. Rakugi H, Enya K, Sugiura K, Ikeda Y. Comparison of the efficacy and safety of azilsartan with that of candesartan cilexetil in Japanese patients with grade I–II essential hypertension: a randomized, double-blind clinical study. Hypertens Res 2012; 35 (5): 552–8.
33. Rakugi H, Kario К, Enya К et al. Effect of azilsartan versus candesartan on nocturnal blood pressure variation in Japanese patients with essential hypertension Blood Press 2013; 22 (Suppl. 1): 22–8.
________________________________________________
1. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) J Hypertans 2013; 31: 1281–357.
2. Sokolow M, Werdegar D, Kain HK, Hinman AT. Relationship between level of blood pressure measured casually and by portable recorders and severity of complications in essential hypertension. Circulation 1966; 34: 279–8.
3. Perloff D, Sokolow M, Cowan R. The prognostic value of ambulatory blood pressures. JAMA 1983; 249: 2792–8.
4. National High Blood Pressure Education Coordinating Committee. National High Blood Pressure Education Program working group report on ambulatory blood pressure monitoring. Arch Intern Med 1990; 150: 2270–80.
5. Boggia J, Li Y, Thijs L et al. Prognostic accuracy of day vs. night ambulatory blood pressure: a cohort study. Lancet 2007; 370: 1219–29.
6. Fagard RH, Celis H, Thijs L et al. Daytime and night-time blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertension 2008; 51: 55–61.
7. Fagard RH, Thijs L, Staessen JA et al. Prognostic significance of ambulatory blood pressure in hypertensive patients with history of cardiovascular disease. Blood Press Monit 2008; 13: 325–32.
8. Minutolo R, Agarwal R, Borrelli S et al. Prognostic role of ambulatory blood pressure measurement in patients with nondialysis chronic kidney disease. Аrch Intern Med 2011; 171: 1090–8.
9. De la Sierra A, Banegas JR, Segura J et al. Ambulatory blood pressure monitoring and development of cardiovascular events in high-risk patients included in the Spanish ABPM registry: the CARDIORISC Event study. J Hypertens 2012; 30: 713–9.
10. Gaborieau V, Delarche N, Gosse P. Ambulatory blood pressure monitoring vs. selfmeasurement of blood pressure at home: correlation with target organ damage. J Hypertens 2008; 26: 1919–27.
11. Bliziotis IA, Destounis A, Stergiou GS. Home vs. ambulatory and office blood pressure in predicting target organ damage in hypertension: a systematic review and meta-analysis. J Hypertens 2012; 30: 1289–99.
12. Staessen JA, Thijs L, Fagard R et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA 1999; 282: 539–46.
13. Clement DL, De Buyzere ML, De Bacquer DA et al. Office vs. Ambulatory Pressure Study Investigators. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med 2003; 348: 2407–15.
14. Dolan E, Stanton A, Thijs L et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005; 46: 156–61.
15. Sega R, Facchetti R, Bombelli M et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation 2005; 111: 1777–83.
16. Conen D, Bamberg F. Noninvasive 24-h ambulatory blood pressure and cardiovascular disease: a systematic review and meta-analysis. J Hypertens 2008; 26: 1290–9.
17. Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). Системные гипертензии. 2010; 3: 5–26.
18. Ojima M, Igata H, Tanaka M et al. In vitro antagonistic properties of a new angiotensin type 1 receptor blocker, azilsartan, in receptor binding and function studies. J Pharmacol Exp Ther 2011; 336 (3): 801–8.
19. Sica D, White W, Weber M et al. Comparison of the Novel Angiotensin II Receptor Blocker Azilsartan Medoxomil vs Valsartan by Ambulatory Blood Pressure Monitoring. J Clin Hypertens (Greenwich) 2011; 13: 467–72.
20. White WB, Weber MA, Sica D et al. Effects of the angiotensin receptor blocker azilsartan medoxomil versus olmesartan and valsartan on ambulatory and clinic blood pressure in patients with stages 1 and 2 hypertension. Hypertension 2011; 57 (3): 413–20.
21. 2013 Ambulatory Blood Pressure Monitoring Recommendations for the вiagnosis of Adult Hypertension, Assessment of Cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals. Chronobiology International 2013; 30 (3): 355–410.
22. Hansen TW, Li Y, Boggia J et al. Predictive role of the night-time blood pressure. Hypertension 2011; 57: 3–10.
23. Fagard RH, Thijs L, Staessen JA et al. Night-day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension. J Hum Hypertens 2009; 23: 645–53.
24. Mancia G, Bombelli M, Facchetti R et al. Long-term prognostic value of blood pressure variability in the general population: results of the Pressioni Arteriose Monitorate e Loro Associazioni Study. Hypertension 2007; 49: 1265–70.
25. Ohkubo T, Hozawa A, Yamaguchi J et al. Prognostic significance of the nocturnal decline in blood pressure: the Ohasama study. J Hypertens 2002; 20: 2183–9.
26. Cuspidi C, Michev I, Meani S et al. Reduced nocturnal fall in blood pressure, assessed by two ambulatory blood pressure monitorings and cardiac alterations in early phases of untreated essential hypertension. J Human Hypertens 2003; 17: 245–51.
27. Pierdomenico S, Bucci A, Costantini F et al. Circadian blood pressure changes and myocardial ischemia in hypertensive patients with coronary artery disease. J Am Coll Cardiol 1998; 31 (7): 1627–34.
28. Cuspidi C, Macca G, Sampieri L et al. Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients. J Hypertens 2001; 19: 1539–45.
29. Guo H, Tabara Y, Igase M, Yamamoto M et al. Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study. Hypertens Res 2010; 33 (1): 32–6.
30. Timio M, Venanzi S, Lolli S et al."Non-dipper" hypertensive patients and progressive renal insufficiency: a 3-year longitudinal study. Clin Nephrol 1995; 43 (6): 382–7.
31. Gorostidi M, Sobrino J, Segura J et al, on behalf of the Spanish Society of Hypertension ABPM registry Investigators. Ambulatory blood pressure monitoring in hypertensive patients with high cardiovascular risk: a cross-sectional analysis of 20,000 patient data base in Spain. J Hypertens 2007; 25: 977–84.
32. Rakugi H, Enya K, Sugiura K, Ikeda Y. Comparison of the efficacy and safety of azilsartan with that of candesartan cilexetil in Japanese patients with grade I–II essential hypertension: a randomized, double-blind clinical study. Hypertens Res 2012; 35 (5): 552–8.
33. Rakugi H, Kario К, Enya К et al. Effect of azilsartan versus candesartan on nocturnal blood pressure variation in Japanese patients with essential hypertension Blood Press 2013; 22 (Suppl. 1): 22–8.
Авторы
О.Д.Остроумова*1,2, И.И.Копченов1, Г.Н.Щукина1
1 ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119992, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ostroumova.olga@mail.ru
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ostroumova.olga@mail.ru