«Новейшая история» лекарственной терапии больных артериальной гипертонией: только ли антигипертензивная терапия?
«Новейшая история» лекарственной терапии больных артериальной гипертонией: только ли антигипертензивная терапия?
Гиляревский С.Р., Голшмид М.В., Кузьмина И.М. и др. «Новейшая история» лекарственной терапии больных артериальной гипертонией: только ли антигипертензивная терапия? Consilium Medicum. 2016; 18 (5): 36–42. DOI: 10.26442/2075-1753_2016.5.36-42
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Giliarevskii S.R., Golshmid M.V., Kuzmina I.M. et al. The “Contemporary History” of the drug therapy in patients with arterial hypertension: is antihypertensive therapy only one way of treating? Consilium Medicum. 2016; 18 (5): 36–42. DOI: 10.26442/2075-1753_2016.5.36-42
«Новейшая история» лекарственной терапии больных артериальной гипертонией: только ли антигипертензивная терапия?
Гиляревский С.Р., Голшмид М.В., Кузьмина И.М. и др. «Новейшая история» лекарственной терапии больных артериальной гипертонией: только ли антигипертензивная терапия? Consilium Medicum. 2016; 18 (5): 36–42. DOI: 10.26442/2075-1753_2016.5.36-42
________________________________________________
Giliarevskii S.R., Golshmid M.V., Kuzmina I.M. et al. The “Contemporary History” of the drug therapy in patients with arterial hypertension: is antihypertensive therapy only one way of treating? Consilium Medicum. 2016; 18 (5): 36–42. DOI: 10.26442/2075-1753_2016.5.36-42
В статье обсуждаются результаты недавно завершившихся рандомизированных и обсервационных исследований, которые могут существенно повлиять на тактику применения антигипертензивных и гиполипидемических средств, а также тактику применения комбинированных препаратов, содержащих постоянные дозы препаратов, влияющих на уровень артериального давления и концентрацию липидов в крови. Приводятся современные данные об оптимальных подходах к применению статинов с целью первичной профилактики. Рассматриваются возможные изменения в целевом, а возможно, и пороговом уровне артериального давления у широкого круга больных артериальной гипертонией. Обсуждается роль нового комбинированного препарата Эквамер, содержащего постоянные дозы амлодипина, лизиноприла и розувастатина, в обеспечении максимального снижения риска развития осложнений сердечно-сосудистых заболеваний, обусловленных атеросклерозом.
This article discusses the results of the recently concluded randomized and observational studies, which may significantly affect application of antihypertensive and lipid-lowering agents as well as may affect application of combined agents containing constant doses of drugs having an effect on blood pressure and blood lipid concentrations. We showed new data concerning the best approaches to use statins for the purpose of primary prevention. We discussed the possible changes for target arterial pressure and probably for threshold level of arterial pressure in a wide range of patients suffering from arterial hypertension. We discussed the role of new combined drug called Ekvamer, containing constant doses of amlodipine, lisinopril and rosuvastatin, to reduce the risk of cardiovascular disease complications associated with atherosclerosis.
1. Roth GA, Forouzanfar MH, Moran AE et al. Demographic and epidemiologic drivers of global cardiovascular mortality. N Engl J Med 2015; 372: 1333–41.
2. Lewington S, Clarke R, Qizilbash N et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–13.
3. Yusuf S, Hawken S, Ounpuu S et al. Effect of potentially modifiable risk factors associated with myocardial infarc- tion in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 937–52.
4. Rose G. Strategy of prevention: lessons from cardiovascular disease. Br Med J (Clin Res Ed) 1981; 282: 1847–51.
5. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003; 326: 1419.
6. Yusuf S, Lonn E, Pais P et al. Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease. NEJM 2016, April 2.
7. The SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373: 2103–16.
8. Lonn EM, Bosch J, López-Jaramillo P et al. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med. DOI: 10.1056/ NEJMoa1600175
9. Emdin CA, Rahimi K, Neal B et al. Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. JAMA 2015; 313: 603–15.
10. Brunström M, Carlberg B. Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses. BMJ 2016; 352: i717.
11. Stone NJ, Robinson JG, Lichtenstein AH et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation 2014; 129 (25, Suppl. 2): S1–S45.
12. Perk J, De Backer G, Gohlke H et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012; 33: 1635–701.
13. Goff DC Jr, Lloyd-Jones DM, Bennett G et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: 2935–59.
14. National Institute for Health and Care Excellence (NICE). Clinical Guideline CG181: lipid modification – cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. http://www.nice.org.uk/Guidance/cg181
15. JBS3 Board. Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3). Heart 2014; 100: ii1–67.
16. Lloyd-Jones DM. Cardiovascular risk prediction: basic concepts, current status, and future directions. Circulation 2010; 121: 1768–77.
17. Cooney MT, Dudina AL, Graham IM. Value and limitations of existing scores for the assessment of cardiovascular risk: a review for clinicians. J Am Coll Cardiol 2009; 54: 1209–27.
18. Ridker PM, Wilson PW. A trial-based approach to statin guidelines. JAMA 2013; 310: 1123–4.
19. Ridker PM, Rose L, Cook NR. A Proposal to incorporate trial data into a hybrid ACC/AHA algorithm for the allocation of statin therapy in primary prevention. J Am Coll Cardiol 2015; 65: 942–8.
20. Mortensen MB, Afzal S, Nordestgaard BG, Falk E. Primary Prevention With Statins: ACC/AHA Risk-Based Approach Versus Trial-Based Approaches to Guide Statin Therapy. J Am Coll Cardiol 2015; 66: 2699–709.
21. Jones PH, Davidson MH, Stein EA et al. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR Trial). Am J Cardiol 2003; 92: 152–60.
22. McKenney JM, Jones PH, Adamczyk MA et al. Comparison of the efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals: results from the STELLAR trial. Curr Med Res Opin 2003; 19: 689–98.
23. Nicholls SJ, Ballantyne CM, Barter PJ et al. Effect of two intensive statin regimens on progression of coronary disease. N Engl J Med 2011; 365: 2078–87.
24. Cannon CP, Blazing MA, Giugliano RP et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015; 372: 2387–97.
25. Jaffe MG, Lee GA, Young JD et al. Improved blood pressure control associated with a large-scale hypertension program. JAMA 2013; 310: 699–705.
26. Kotchen TA. Expanding role for combination drug therapy in the initial treatment of hypertension? Hypertension 2011; 58: 550–1.
27. Tomaszewski M, White C, Patel P et al. High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis. Heart 2014; 100 (11): 855–61.
28. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981–97.
________________________________________________
1. Roth GA, Forouzanfar MH, Moran AE et al. Demographic and epidemiologic drivers of global cardiovascular mortality. N Engl J Med 2015; 372: 1333–41.
2. Lewington S, Clarke R, Qizilbash N et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–13.
3. Yusuf S, Hawken S, Ounpuu S et al. Effect of potentially modifiable risk factors associated with myocardial infarc- tion in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 937–52.
4. Rose G. Strategy of prevention: lessons from cardiovascular disease. Br Med J (Clin Res Ed) 1981; 282: 1847–51.
5. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003; 326: 1419.
6. Yusuf S, Lonn E, Pais P et al. Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease. NEJM 2016, April 2.
7. The SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373: 2103–16.
8. Lonn EM, Bosch J, López-Jaramillo P et al. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med. DOI: 10.1056/ NEJMoa1600175
9. Emdin CA, Rahimi K, Neal B et al. Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. JAMA 2015; 313: 603–15.
10. Brunström M, Carlberg B. Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses. BMJ 2016; 352: i717.
11. Stone NJ, Robinson JG, Lichtenstein AH et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation 2014; 129 (25, Suppl. 2): S1–S45.
12. Perk J, De Backer G, Gohlke H et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012; 33: 1635–701.
13. Goff DC Jr, Lloyd-Jones DM, Bennett G et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: 2935–59.
14. National Institute for Health and Care Excellence (NICE). Clinical Guideline CG181: lipid modification – cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. http://www.nice.org.uk/Guidance/cg181
15. JBS3 Board. Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3). Heart 2014; 100: ii1–67.
16. Lloyd-Jones DM. Cardiovascular risk prediction: basic concepts, current status, and future directions. Circulation 2010; 121: 1768–77.
17. Cooney MT, Dudina AL, Graham IM. Value and limitations of existing scores for the assessment of cardiovascular risk: a review for clinicians. J Am Coll Cardiol 2009; 54: 1209–27.
18. Ridker PM, Wilson PW. A trial-based approach to statin guidelines. JAMA 2013; 310: 1123–4.
19. Ridker PM, Rose L, Cook NR. A Proposal to incorporate trial data into a hybrid ACC/AHA algorithm for the allocation of statin therapy in primary prevention. J Am Coll Cardiol 2015; 65: 942–8.
20. Mortensen MB, Afzal S, Nordestgaard BG, Falk E. Primary Prevention With Statins: ACC/AHA Risk-Based Approach Versus Trial-Based Approaches to Guide Statin Therapy. J Am Coll Cardiol 2015; 66: 2699–709.
21. Jones PH, Davidson MH, Stein EA et al. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR Trial). Am J Cardiol 2003; 92: 152–60.
22. McKenney JM, Jones PH, Adamczyk MA et al. Comparison of the efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals: results from the STELLAR trial. Curr Med Res Opin 2003; 19: 689–98.
23. Nicholls SJ, Ballantyne CM, Barter PJ et al. Effect of two intensive statin regimens on progression of coronary disease. N Engl J Med 2011; 365: 2078–87.
24. Cannon CP, Blazing MA, Giugliano RP et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015; 372: 2387–97.
25. Jaffe MG, Lee GA, Young JD et al. Improved blood pressure control associated with a large-scale hypertension program. JAMA 2013; 310: 699–705.
26. Kotchen TA. Expanding role for combination drug therapy in the initial treatment of hypertension? Hypertension 2011; 58: 550–1.
27. Tomaszewski M, White C, Patel P et al. High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis. Heart 2014; 100 (11): 855–61.
28. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981–97.
1 ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1;
2 ГБУЗ НИИ скорой помощи им. Н.В.Склифосовского Департамента здравоохранения г. Москвы. 129090, Москва, Большая Сухаревская пл., д. 3
*sgilarevsky@rambler.ru
1 Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1;
2 N.V.Sklifosovsky Research Institute of Emergency Medicine of the Department of Health of Moscow. 129090, Russian Federation, Mosсow, Bol’shaya Sukharevskaya pl., d. 3
*sgilarevsky@rambler.ru