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Вопросы эффективности и безопасности терапии артериальной гипертонии. Диуретики и β-адреноблокаторы: за и против
Вопросы эффективности и безопасности терапии артериальной гипертонии. Диуретики и β-адреноблокаторы: за и против
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Аннотация
Для эффективной антигипертензивной терапии, согласно национальным и европейским рекомендациям, возможно применение 5 классов лекарственных препаратов, которые подходят для инициации и продолжения лечения артериальной гипертонии как в виде монотерапии, так и в составе комбинированной терапии. Нет доказательств, что основные антигипертензивные препараты имеют различия по их способности воздействовать на общий сердечно-сосудистый риск или сердечно-сосудистые события. Однако каждое вмешательство может обладать преимуществом при том или ином специфическом состоянии, т.е. обосновывается индивидуальный подбор антигипертензивных препаратов. В статье представлен материал об эволюции представлений использования диуретиков и β-адреноблокаторов при лечении артериальной гипертонии. Одним из представителей комбинации – тиазидовый диуретик и β-адреноблокатор – является препарат Лодоз. Статья содержит обзор фармакологических свойств, антигипертензивной эффективности и безопасности применения Лодоза.
Ключевые слова: артериальная гипертония, тиазидовые диуретики, β-адреноблокаторы, Лодоз.
Keywords: arterial hypertension, thiazide diuretics, β-adrenoblockers, Lodoz.
Ключевые слова: артериальная гипертония, тиазидовые диуретики, β-адреноблокаторы, Лодоз.
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Keywords: arterial hypertension, thiazide diuretics, β-adrenoblockers, Lodoz.
Полный текст
Список литературы
1. Guidelines for the management of arterial hypertension. Guidelines Committee 2007. European Society of Hypertension/European Society of Cardiology J Hypertens 2007; 25: 1105–87.
2. Диагностика и лечение артериальной гипертонии. Национальные клинические рекомендации. М., 2008: 20–56.
3. Lindholm LH, Ibsen H, Dahlot B et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 1004–10.
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7. Blackburn DF, Lamb DA, Eurich DT et al. Atenolol as initial antihypertensive therapy: an observational study comparing first-line agents. J Hypertens 2007; 25: 1499–505.
8. Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122: 290–300.
9. Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007; 369: 201–7.
10. Mancia G, Grassi G, Zanchetti A. New-onset diabetes and antihypertensive drugs. J Hypertens 2006; 24: 3–10.
11. Zanchetti A, HennigM, Baurecht H et al. Prevalence and incidence of the metabolic syndrome in the European Lacidipine Study on Atherosclerosis (ELSA) and its relation with carotid intima-media thickness. J Hypertens 2007; 25: 2463–70.
12. Cutler JA, Davis BR. Thiazide-type diuretics and beta-adrenergic blockers as first-line drug treatments for hypertension. Circulation 2008; 117: 2691–704.
13. Kostis JB, Wilson AC, Freudenberger RS et al. SHEP Collaborative Research Group. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes. Am J Cardiol 2005; 95: 29–35.
14. Messerli FH, Bangalore S, Julius S. Risk/benefit assessment of betablockers and diuretics precludes their use for first-line therapy in hypertension. Circulation 2008; 117: 2706–15.
15. Barr EL, Zimmet PZ, Welborn TA et al. Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation 2007; 116: 151–7.
16. Mule G, Nardi E, Cottone S et al. Influence of metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503–13.
17. Zillich AJ, Garg J, Basu S et al. Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension 2006; 48: 219–24.
18. Bakris G, Molitch M, Hewkin A et al. STAR Investigators. Differences in glucose tolerance between fixed-dose antihypertensive drug combinations in people with metabolic syndrome. Diabetes Care 2006; 29: 2592–7.
19. Helderman JH, Elahi D, Andersen DK et al. Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes 1983; 32: 106–11.
20. Wright GM, Musini VM. First-line drugs for hypertension. Cochrane Library 2009; CD001841: e1–e59.
21. Reappraisal of European guidelines on hypertension management: a Eupopean Society of Hypertention Task Force document. J Hypertention 2009; 27: 2121–58.
22. Frishman WH, Bryzinski BS, Coulson LR et al. A multifactorial trial design to assess combination therapy in hypertension. Treatment with bisoprolol and hydrochlorothiazide. Arch Intern Med 1994; 154 (13): 1461–8.
23. Prisant LM, Neutel JM, Papademetriou V et al. Low-dose combination treatment for hypertension versus single-drug treatment-bisoprolol/hydrochlorothiazide versus amlodipine, enalapril, and placebo: combined analysis of comparative studies. Am J Ther 1998; 5: 313–21.
24. Lewin AJ, Leug MC, Targum S et al. A clinical trial evaluating the 24-hour effects of bisoprolol/hydrochlorothiazide 5 mg/6,25 mg combination in patients with mild to moderate hypertension. Clin Cardiol 1993; 16: 732–6.
25. Benetos A, Adamopoulos C, Argyriadis P et al. Clinical results with bisoprolol 2.5 mg/hydrochlorothiazide 6.25 mg combination in systolic hypertension in the elderly. Hypertens Suppl 2002; 20 (1): 21–5.
2. Диагностика и лечение артериальной гипертонии. Национальные клинические рекомендации. М., 2008: 20–56.
3. Lindholm LH, Ibsen H, Dahlot B et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 1004–10.
4. Sever PS, Dahlof B, Poulter NR et al. For the ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo–Scandinavian Cardiac Outcomes Trial (ASCOT–BPLA): a multicentre randomized controlled trial. Lancet 2005; 366: 895–906.
5. Smith C, Teitler M. Beta-blocker selectivity at cloned human beta1- and beta2- adrenergic receptors. J Cardiovasc Ther 1999; 13: 123–6.
6. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of the 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 2009; 338: 1665–83.
7. Blackburn DF, Lamb DA, Eurich DT et al. Atenolol as initial antihypertensive therapy: an observational study comparing first-line agents. J Hypertens 2007; 25: 1499–505.
8. Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122: 290–300.
9. Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007; 369: 201–7.
10. Mancia G, Grassi G, Zanchetti A. New-onset diabetes and antihypertensive drugs. J Hypertens 2006; 24: 3–10.
11. Zanchetti A, HennigM, Baurecht H et al. Prevalence and incidence of the metabolic syndrome in the European Lacidipine Study on Atherosclerosis (ELSA) and its relation with carotid intima-media thickness. J Hypertens 2007; 25: 2463–70.
12. Cutler JA, Davis BR. Thiazide-type diuretics and beta-adrenergic blockers as first-line drug treatments for hypertension. Circulation 2008; 117: 2691–704.
13. Kostis JB, Wilson AC, Freudenberger RS et al. SHEP Collaborative Research Group. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes. Am J Cardiol 2005; 95: 29–35.
14. Messerli FH, Bangalore S, Julius S. Risk/benefit assessment of betablockers and diuretics precludes their use for first-line therapy in hypertension. Circulation 2008; 117: 2706–15.
15. Barr EL, Zimmet PZ, Welborn TA et al. Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation 2007; 116: 151–7.
16. Mule G, Nardi E, Cottone S et al. Influence of metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503–13.
17. Zillich AJ, Garg J, Basu S et al. Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension 2006; 48: 219–24.
18. Bakris G, Molitch M, Hewkin A et al. STAR Investigators. Differences in glucose tolerance between fixed-dose antihypertensive drug combinations in people with metabolic syndrome. Diabetes Care 2006; 29: 2592–7.
19. Helderman JH, Elahi D, Andersen DK et al. Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes 1983; 32: 106–11.
20. Wright GM, Musini VM. First-line drugs for hypertension. Cochrane Library 2009; CD001841: e1–e59.
21. Reappraisal of European guidelines on hypertension management: a Eupopean Society of Hypertention Task Force document. J Hypertention 2009; 27: 2121–58.
22. Frishman WH, Bryzinski BS, Coulson LR et al. A multifactorial trial design to assess combination therapy in hypertension. Treatment with bisoprolol and hydrochlorothiazide. Arch Intern Med 1994; 154 (13): 1461–8.
23. Prisant LM, Neutel JM, Papademetriou V et al. Low-dose combination treatment for hypertension versus single-drug treatment-bisoprolol/hydrochlorothiazide versus amlodipine, enalapril, and placebo: combined analysis of comparative studies. Am J Ther 1998; 5: 313–21.
24. Lewin AJ, Leug MC, Targum S et al. A clinical trial evaluating the 24-hour effects of bisoprolol/hydrochlorothiazide 5 mg/6,25 mg combination in patients with mild to moderate hypertension. Clin Cardiol 1993; 16: 732–6.
25. Benetos A, Adamopoulos C, Argyriadis P et al. Clinical results with bisoprolol 2.5 mg/hydrochlorothiazide 6.25 mg combination in systolic hypertension in the elderly. Hypertens Suppl 2002; 20 (1): 21–5.
Авторы
Т.В.Адашева, В.С.Задионченко, З.О.Гринева, М.А.Миронова
ГОУ ВПО Московский государственный медико-стоматологический университет Росздрава
Moscow State University of Medicine and Dentistry, Russian Agency for Health Care
ГОУ ВПО Московский государственный медико-стоматологический университет Росздрава
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Moscow State University of Medicine and Dentistry, Russian Agency for Health Care
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