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«Рожденный» ASCOT
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Аннотация
В статье приведены данные исследования ASCOT. Рассмотрены преимущества комбинации амлодипин/периндоприл в плане снижения артериального давления и сердечно-сосудистого риска. Обсуждаются важность центрального давления как прогностического фактора и результаты субисследования ASCOT-CAFE, в котором выявлены преимущества комбинации амлодипина и периндоприла в отношении его снижения. Особое внимание уделено уровням артериального давления в течение суток, определяемым при помощи суточного мониторирования, как прогностически независимых факторов риска развития сердечно-сосудистых осложнений. Приведены результаты субисследования ASCOT-ABPM, где определена важность ночного систолического артериального давления как независимого предиктора риска развития инфаркта миокарда и инсульта, а также преимущества комбинации амлодипина с периндоприлом в снижении ночного систолического артериального давления.
Ключевые слова: артериальная гипертензия, амлодипин, периндоприл, суточное мониторирование артериального давления, фиксированные комбинации антигипертензивных препаратов.
Ключевые слова: артериальная гипертензия, амлодипин, периндоприл, суточное мониторирование артериального давления, фиксированные комбинации антигипертензивных препаратов.
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The paper presents data from an Anglo-Scandinavian Outcome Trial (ASCOT). It considers the benefits of amlodipine/perindopril in lowering blood pressure and a cardiovascular risk. It discusses the importance of central pressure as a prognostic factor and the results of a Conduit Artery Function Evaluation (CAFE), an ASCOT substudy, which has revealed the benefits of a combination of amlodipine and perindopril in its reduction. Particular attention is given to 24-hour monitoring-measured blood pressure levels as prognostically independent risk factors for cardiovascular events. The authors provide the results of the ASCOT-ABPM substudy that has defined the importance of nocturnal systolic blood pressure as an independent predictor of the development of myocardial infarction and stroke, as well as the benefit of a combination of amlodipine and perindopril in lowering nocturnal systolic blood pressure.
Key words: arterial hypertension, amlodipine, perindopril, 24-hour blood pressure monitoring, fixed-dose combinations of antihypertensive agents.
Полный текст
Список литературы
1. Dahlof B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in Anglo-Scandinavian Cardiac Outcomes Trial – Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentral randomized controlled trial. Lancet 2005; 366: 895–906.
2. Диагностика и лечение артериальной гипертензии. Российский рекомендации (четвертый пересмотр). Системные гипертензии. 2010; 3: 5–26.
3. Sever PS, Dahlof B, Poulter NR et al. Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial J Hypertens 2001; 6: 1139–47.
4. Kjeldsen SE, Dahlof B, Devereux RB et al. Losartan Intervention for Endpoint Reduction (LIFE) Study Group: Effect of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy: Losartan Intervention for Endpoint Reduction (LIFE) substudy. J Am Med Assoc 2002; 288: 1491–8.
5. London GM, Asmar RG, Rourke MF, Safar ME. REASON Project Investigators: Mechanism(s) of selective systolic blood pressure reduction after a low dose combination of perindopril/indapamide in hypertensive subjects: comparison with atenolol. J Am Coll Cardiol 2004; 43: 92–9.
6. Williams B, Lacy PS, Thom SM et al. The CAFÉ Investigators, for the Anglo-Scandinavian Cardiac Outcomes Trial – Blood Pressure Lowering Arm (ASCOT) Investigators, CAFÉ Steering Committee and Writing Committee. Circulation 2006; 113: 1213–25.
7. Бойцов С.А. Исследование ASCOT как аргумент в борьбе «нового» со «старым» и шаг к переоценке «системы ценностей». Cons. Med. 2006; 8 (8).
8. Tropeano A, Boutouyrie P, Pannier B et al. Brachial pressure-independent reduction in carotid stiffnes after long-term angiotensin-convertinge enzyme inhibition in diabetic hypertensives. Hypertension 2006; 48 (1): 80–6.
9. O’Brien E. Is the case for ABP as a routine investigation in clinical practice not overwhelming? Hypertension 2007; 50: 284–6.
10. Dolan E, Stanton A, Thijs L, Hinedi K et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005; 46: 156–61.
11. Perloff D, Sokolow M, Cowan R. The prognostic value of ABP blood pressure. JAMA 1983; 249: 2792–8.
12. Redon J, Campos C, Narciso ML, Rodicio JL et al. Prognostic value of ABP blood pressure monitoring in refractory hypertension: a prospective study. Hypertension 1998; 31: 712–8.
13. Staessen J, Thijs L, Fagard R, O’Brien E et al. for the systolic hypertension in Europe Trial Investigators. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. JAMA 1999; 282: 539–46.
14. Ohkubo T, Imai Y, Tsuji I, Nagai K et al. Prediction of mortality by ABP blood pressure monitoring versus screening blood pressure measurements: a pilot study in Ohasama. J Hypertens 1997; 15: 357–64.
15. D Ohkubo T, Hozawa A, Nagai K, Kikuya M et al. Prediction of stroke by mortality by ambulatory blood pressure monitoring versus screening blood pressure measurements in a general population: the Ohasama study. J Hypertens 2000; 18: 847–54.
16. Clement DL, De Buyzere M, De Bacquer DA, de Leeuw PW et al. for the Office versus Ambulatory Blood Pressure (OvA) Study Investigators. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med 2003; 348: 207–15.
17. Verdecchia P, Reboldi G, Porcellati C, Schillaci G et al. Risk of cardiovascular disease in relation to achieved office and ambulatory blood pressure control in treated hypertensive subjects. J Am Coll Cardiol 2002; 39: 878–85.
18. Verdecchia P, Angeli F, Cavallini C. Ambulatory blood pressure for cardiovascular risk stratification. Circulation 2007; 115: 2091–3.
19. Svensson P, de Faire U, Sleight P, Yusuf S. Comparative effects of ramipril on ambulatory and office blood pressures. A HOPE sub-study. Hypertens 2001; 38: e28–e32.
20. Dolana E, Stantonb AV, Thomc S, Caulfieldd M et al on behalf of the ASCOT Investigators. Ambulatory blood pressure monitoring predicts cardiovascular events in treated hypertensive patients – an Anglo-Scandinavian cardiac outcomes trial substudy. J Hypertens 2009; 27 (4): 876–85.
21. O’Brien E, Asmar R, Beilin L, Imai Y et al. on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens 2003; 21: 821–48.
22. O’Brien E, Mee F, Atkins N, O’Malley K. Accuracy of the SpaceLabs 90207 determined by the British Hypertension Society protocol. J Hypertens 1991; 9: 573–4.
23. Physicians Desk Reference. NJ: Medical Economics Company; 2008.
2. Диагностика и лечение артериальной гипертензии. Российский рекомендации (четвертый пересмотр). Системные гипертензии. 2010; 3: 5–26.
3. Sever PS, Dahlof B, Poulter NR et al. Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial J Hypertens 2001; 6: 1139–47.
4. Kjeldsen SE, Dahlof B, Devereux RB et al. Losartan Intervention for Endpoint Reduction (LIFE) Study Group: Effect of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy: Losartan Intervention for Endpoint Reduction (LIFE) substudy. J Am Med Assoc 2002; 288: 1491–8.
5. London GM, Asmar RG, Rourke MF, Safar ME. REASON Project Investigators: Mechanism(s) of selective systolic blood pressure reduction after a low dose combination of perindopril/indapamide in hypertensive subjects: comparison with atenolol. J Am Coll Cardiol 2004; 43: 92–9.
6. Williams B, Lacy PS, Thom SM et al. The CAFÉ Investigators, for the Anglo-Scandinavian Cardiac Outcomes Trial – Blood Pressure Lowering Arm (ASCOT) Investigators, CAFÉ Steering Committee and Writing Committee. Circulation 2006; 113: 1213–25.
7. Бойцов С.А. Исследование ASCOT как аргумент в борьбе «нового» со «старым» и шаг к переоценке «системы ценностей». Cons. Med. 2006; 8 (8).
8. Tropeano A, Boutouyrie P, Pannier B et al. Brachial pressure-independent reduction in carotid stiffnes after long-term angiotensin-convertinge enzyme inhibition in diabetic hypertensives. Hypertension 2006; 48 (1): 80–6.
9. O’Brien E. Is the case for ABP as a routine investigation in clinical practice not overwhelming? Hypertension 2007; 50: 284–6.
10. Dolan E, Stanton A, Thijs L, Hinedi K et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005; 46: 156–61.
11. Perloff D, Sokolow M, Cowan R. The prognostic value of ABP blood pressure. JAMA 1983; 249: 2792–8.
12. Redon J, Campos C, Narciso ML, Rodicio JL et al. Prognostic value of ABP blood pressure monitoring in refractory hypertension: a prospective study. Hypertension 1998; 31: 712–8.
13. Staessen J, Thijs L, Fagard R, O’Brien E et al. for the systolic hypertension in Europe Trial Investigators. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. JAMA 1999; 282: 539–46.
14. Ohkubo T, Imai Y, Tsuji I, Nagai K et al. Prediction of mortality by ABP blood pressure monitoring versus screening blood pressure measurements: a pilot study in Ohasama. J Hypertens 1997; 15: 357–64.
15. D Ohkubo T, Hozawa A, Nagai K, Kikuya M et al. Prediction of stroke by mortality by ambulatory blood pressure monitoring versus screening blood pressure measurements in a general population: the Ohasama study. J Hypertens 2000; 18: 847–54.
16. Clement DL, De Buyzere M, De Bacquer DA, de Leeuw PW et al. for the Office versus Ambulatory Blood Pressure (OvA) Study Investigators. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med 2003; 348: 207–15.
17. Verdecchia P, Reboldi G, Porcellati C, Schillaci G et al. Risk of cardiovascular disease in relation to achieved office and ambulatory blood pressure control in treated hypertensive subjects. J Am Coll Cardiol 2002; 39: 878–85.
18. Verdecchia P, Angeli F, Cavallini C. Ambulatory blood pressure for cardiovascular risk stratification. Circulation 2007; 115: 2091–3.
19. Svensson P, de Faire U, Sleight P, Yusuf S. Comparative effects of ramipril on ambulatory and office blood pressures. A HOPE sub-study. Hypertens 2001; 38: e28–e32.
20. Dolana E, Stantonb AV, Thomc S, Caulfieldd M et al on behalf of the ASCOT Investigators. Ambulatory blood pressure monitoring predicts cardiovascular events in treated hypertensive patients – an Anglo-Scandinavian cardiac outcomes trial substudy. J Hypertens 2009; 27 (4): 876–85.
21. O’Brien E, Asmar R, Beilin L, Imai Y et al. on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens 2003; 21: 821–48.
22. O’Brien E, Mee F, Atkins N, O’Malley K. Accuracy of the SpaceLabs 90207 determined by the British Hypertension Society protocol. J Hypertens 1991; 9: 573–4.
23. Physicians Desk Reference. NJ: Medical Economics Company; 2008.
Авторы
О.Д.Остроумова*, О.В.Бондарец
ГОУ ВПО Московский государственный медико-стоматологический университет Минздравсоцразвития РФ
*ostroumova.olga@mail.ru
ГОУ ВПО Московский государственный медико-стоматологический университет Минздравсоцразвития РФ
*ostroumova.olga@mail.ru
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O.D.Ostroumova*, O.V.Bondarets
Moscow State University of Medicine and Dentistry
*ostroumova.olga@mail.ru
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