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Возможности дигидропиридинового блокатора кальциевых каналов фелодипина в обеспечении органопротекции и снижении риска сердечно-сосудистых осложнений у больных артериальной гипертензией
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Аннотация
Фелодипин – представитель дигидропиридиновых блокаторов кальциевых каналов длительного действия, обладающий высокой сосудистой селективностью, имеет обширную доказательную базу (исследования HOT, FEVER, NEPHROS). Обоснованы антигипертензивные эффекты фелодипина как в виде монотерапии, так и в составе рациональной комбинированной терапии. Имеет хорошую переносимость, что способствует повышению приверженности лечению больных артериальной гипертензией (АГ). Продемонстрированная способность фелодипина в обеспечении органопротекции и снижении риска сердечно-сосудистых осложнений позволяет успешно применять его у разных категорий больных АГ, включая пациентов высокого риска сердечно-сосудистых осложнений.
Ключевые слова: артериальная гипертензия, дигидропиридиновые блокаторы кальциевых каналов, фелодипин, органопротекция.
Ключевые слова: артериальная гипертензия, дигидропиридиновые блокаторы кальциевых каналов, фелодипин, органопротекция.
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Felodipine is a long-acting representative of the dihydropyridine calcium channel blockers, which has a high vascular selectivity and an extensive evidence base (HOT, FEVER, NEPHROS studies). There is evidence for the antihypertensive effects of felodipine as monotherapy and as part of rational combination therapy.
The drug is well tolerated, which promotes higher treatment adherence in patients with EH. The demonstrated capacity of felodipine to protect organs and to reduce a cardiovascular risk permits its successful use in different categories of patients with EH, including those at high risk for cardiovascular events.
Key words: essential hypertension, dihydropyridine calcium channel blockers, felodipine, organ protection.
Полный текст
Список литературы
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14. Zanchetti A, Bold G, Hennig M et al. Calcium antagonist lacidipin slows down progression of asymptomatic carotid atherosclerosis. Principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double-blind, long-term trial. Circulation 2002; 106: 2422–7.
15. Nissen SE, Tuzcu EM, Libby P et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. J A M A 2004; 292 (18): 2217–25.
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23. Lehri S, Grässel E, Eicke C. Effectiveness of felodipine in hypertensive patients with mild cerebral cognition disorders in a randomized double-blind study. Dtsch Med Wochenschr 2000; 125 (45): 1350–5.
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26. Dworkin LD, Benstein JA, Parker M et al. Calcium antagonists and converting enzyme inhibitors reduce renal injury by different mechanisms. Kidney Int 1993; 43: 808–14.
27. Harris DCH, Hammond WS, Burke TJ. Verapamil protects against progression of experimental chronic renal failure. Kidney Int 1987; 31: 41–6.
28. Dworkin LD, Tolbert E, Recht PA. Effects of amlodipine on glomerular filtration, growth and injury in experimental hypertension. Hypertension 1996; 27: 245–50.
29. Brunner FP, Bock HA, Hermle M. Control of hypertension by verapamil enhances renal damage in a rat remnant kidney model. Nephrol Dial Transplant 1991; 6: 420–7.
30. Tarif N, Bakris GL. Preservation of renal function: the spectrum of effects by сalcium‐channel blockers. Nephrol Dial Transplant 1997; 12: 2244–50.
31. Weidmann P, Schneider M, Bohlen L. Therapeutic efficacy of different antihypertensive drugs in human diabetic nephropathy:an updated meta-analysis. Nephrol Dial Transplant 1995; (Suppl. 10): 39–45.
32. Zucchelli P, Zuccala A, Borghi M et al. Long-term comparison between captopril and nifedipine in the progression of renal insufficiency. Kidney Int 1992; 42: 452–8.
33. Gansevoort RT, Sluiter WJ, Hemmelder MH et al. Antiproteinuric effect of blood‐pressure‐lowering agents: a meta‐analysis of comparative trials. Nephrol Dial Transplant 1995; 10: 1963–74.
34. Mene P. Calcium channel blockers: what they can and what they can't do. Nephrol Dial Transplant 1997; 12 (1): 25–8.
35. 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 (11): 2158–65.
36. Callera GE, Montezano AC, Yogi A et al. c-Src-dependent nongenomic signaling responses to aldosterone are increased in vascular myocytes from spontaneously hypertensive rats. Hypertension 2005; 46: 1032–8.
37. Stier CT Jr, Chander PN, Rocha R. Aldosterone as a mediator in cardiovascular injury. Cardiol Rev 2002; 10 (2): 97–107.
38. Fritsch Neves M, Schiffrin EL. Aldosterone: a risk factor for vascular disease. Curr Hypertens Rep 2003; 5 (1): 59–65.
39. Dietz JD, Du S, Bolten CW et al. A number of marketed dihydropyridine calcium channel blockers have mineralocorticoid receptor antagonist activity. Hypertension 2008; 51: 742–8.
40. Matsubara BB, Franco M, Janicki JS et al. Effect of felodipine on myocardial and renal injury induced by aldosterone-high salt hypertension in uninephrectomized rats. Braz J Med Biol Res 2010; 43 (5): 506–14.
41. Schaefer RM, Aldons PM, Burgess ED et al. Improved tolerability of felodipine compared with amlodipine in elderly hypertensives: a randomized, double-blind study in 535 patients, focusing on vasodilatory adverse events. The International Study Group. Int J Clin Pract 1998; 52 (6): 381–6.
42. Bicchi M, Vedovini G, Cappelli R et al. Effect of felodipine on arterial blood flow and venous function at rest in patients with mild essential hypertension. Angiology 1998; 49 (5): 373–80.
43. Агеев Ф.Т., Фофанова Т.В., Деев А.Д. Применение фелодипина в амбулаторной практике: оценка клинической эффективности и приверженности к лечению у больных с артериальной гипертонией. Кардиология. 2009; 1: 30–3.
2. O’Leary DH, Polak JF, Kronmal RA. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999; 340: 14–22.
3. Bots ML, Hoes AW, Koudstaal PJ et al. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 1997; 96 (5): 1432–7.
4. Диагностика и лечение артериальной гипертензии. Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов (4-й пересмотр). Системные гипертензии 2010; 3: 5–26.
5. ESH-ESC Guidelines Committee. 2007 guidelines for the management of arterial hypertension. J Hypertension 2007; 25: 1105–87.
6. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351 (9118): 1755–62.
7. Liu L, Zhang Y, Liu G et al. The Felodipine Event Reduction (FEVER) Study: a randomized long-term placebo-controlled trial in Chinese hypertensive patients. J Hypertens 2005; 23 (12): 2157–72.
8. Zhang Y, Zhang X, Liu L et al. Is a systolic blood pressure target <140 mmHg indicated in all hypertensives? Subgroup analyses of findings from the randomized FEVER trial. Eur Heart J 2011; 32 (12): 1500–8.
9. Mancia G, Laurent S, Agabiti-Rosei E et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 2009; 27.
10. Ibsen H, Olsen MH, Wachtell K et al. Reduction in albuminuria translates to reduction in cardiovascular events in hypertensive patients: Losartan Intervention For Endpoint reduction in hypertension study. Hypertension 2005; 45: 198–202.
11. De Zeeuw D, Parving HH, Henning RH. Microalbuminuria as an early marker for cardiovascular disease. J Am Soc Nephrol 2006; 17: 2100–5.
12. Nalbantgil I, Onder R, Killiçcioglu B et al. The efficacy of felodipine ER on regression of left ventricular hypertrophy in patients with primary hypertension. Blood Press 1996; 5 (5): 285–91.
13. Wetzchewald D, Klaus D, Garanin G et al. Regression of left ventricular hypertrophy during long-term antihypertensive treatment--a comparison between felodipine and the combination of felodipine and metoprolol. J Intern Med 1992; 231 (3): 303–8.
14. Zanchetti A, Bold G, Hennig M et al. Calcium antagonist lacidipin slows down progression of asymptomatic carotid atherosclerosis. Principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double-blind, long-term trial. Circulation 2002; 106: 2422–7.
15. Nissen SE, Tuzcu EM, Libby P et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. J A M A 2004; 292 (18): 2217–25.
16. Godfraind T. Antioxidant effects and the therapeutic mode of action of calcium channel blockers in hypertension and atherosclerosis. Philos Trans R Soc Lond B Biol Sci 2005; 360 (1464): 2259–72.
17. Song H, Bao W, Wang H et al. Effects of extended-release felodipine on endothelial vasoactive substances in patients with essential hypertension. Clin Chem Lab Med 2008; 46 (3): 393–5.
18. Xing SS, Tan HW, Bi XP et al. Felodipine reduces cardiac expression of IL-18 and perivascular fibrosis in fructose-fed rats. Mol Med 2008; 14 (7–8): 395–402.
19. Bi XP, Tan HW, Xing SS et al. Felodipine downregulates srum interleukin-18 levels in rats with fructose-induced metabolic syndrome. J Endocrinol Invest 2009; 32 (4): 303–7.
20. Amenta F, Lanari A, Mignini F et al. Nicardipine use in cerebrovascular disease: a review of controlled clinical studies. J Neurol Sci 2009; 283 (1–2): 219–23.
21. Kimura Y, Kitagawa K, Oku N et al. Hemodynamic influences of azelnidipine, a novel calcium channel blocker, on cerebral circulation in hypertensive patients with ischemic white matter lesions. Hypertens Res 2008; 31 (12): 2147–54.
22. Русина А.М., Мордовин В.Ф., Федоренко Е.В. и др. Сравнительный анализ гипотензивной и церебропротективной эффективности антагонистов кальция и b-блокаторов у пациентов с гипертонической болезнью и хронической гипертензивной энцефалопатией. РМЖ. 2009; 17 (1): 1–5.
23. Lehri S, Grässel E, Eicke C. Effectiveness of felodipine in hypertensive patients with mild cerebral cognition disorders in a randomized double-blind study. Dtsch Med Wochenschr 2000; 125 (45): 1350–5.
24. Смоленская О.Г., Клейнер С.Л., Ставрова Н.Ю. Терапия гипертонической болезни блокаторами кальциевых каналов пролонгированного действия. Кардиология. 2004; 5: 59–62.
25. Inzitari D, Poggesi A. Calcium channel blockers and stroke. Aging Clin Exp Res. 2005; 17 (Suppl. 4): 16–30.
26. Dworkin LD, Benstein JA, Parker M et al. Calcium antagonists and converting enzyme inhibitors reduce renal injury by different mechanisms. Kidney Int 1993; 43: 808–14.
27. Harris DCH, Hammond WS, Burke TJ. Verapamil protects against progression of experimental chronic renal failure. Kidney Int 1987; 31: 41–6.
28. Dworkin LD, Tolbert E, Recht PA. Effects of amlodipine on glomerular filtration, growth and injury in experimental hypertension. Hypertension 1996; 27: 245–50.
29. Brunner FP, Bock HA, Hermle M. Control of hypertension by verapamil enhances renal damage in a rat remnant kidney model. Nephrol Dial Transplant 1991; 6: 420–7.
30. Tarif N, Bakris GL. Preservation of renal function: the spectrum of effects by сalcium‐channel blockers. Nephrol Dial Transplant 1997; 12: 2244–50.
31. Weidmann P, Schneider M, Bohlen L. Therapeutic efficacy of different antihypertensive drugs in human diabetic nephropathy:an updated meta-analysis. Nephrol Dial Transplant 1995; (Suppl. 10): 39–45.
32. Zucchelli P, Zuccala A, Borghi M et al. Long-term comparison between captopril and nifedipine in the progression of renal insufficiency. Kidney Int 1992; 42: 452–8.
33. Gansevoort RT, Sluiter WJ, Hemmelder MH et al. Antiproteinuric effect of blood‐pressure‐lowering agents: a meta‐analysis of comparative trials. Nephrol Dial Transplant 1995; 10: 1963–74.
34. Mene P. Calcium channel blockers: what they can and what they can't do. Nephrol Dial Transplant 1997; 12 (1): 25–8.
35. 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 (11): 2158–65.
36. Callera GE, Montezano AC, Yogi A et al. c-Src-dependent nongenomic signaling responses to aldosterone are increased in vascular myocytes from spontaneously hypertensive rats. Hypertension 2005; 46: 1032–8.
37. Stier CT Jr, Chander PN, Rocha R. Aldosterone as a mediator in cardiovascular injury. Cardiol Rev 2002; 10 (2): 97–107.
38. Fritsch Neves M, Schiffrin EL. Aldosterone: a risk factor for vascular disease. Curr Hypertens Rep 2003; 5 (1): 59–65.
39. Dietz JD, Du S, Bolten CW et al. A number of marketed dihydropyridine calcium channel blockers have mineralocorticoid receptor antagonist activity. Hypertension 2008; 51: 742–8.
40. Matsubara BB, Franco M, Janicki JS et al. Effect of felodipine on myocardial and renal injury induced by aldosterone-high salt hypertension in uninephrectomized rats. Braz J Med Biol Res 2010; 43 (5): 506–14.
41. Schaefer RM, Aldons PM, Burgess ED et al. Improved tolerability of felodipine compared with amlodipine in elderly hypertensives: a randomized, double-blind study in 535 patients, focusing on vasodilatory adverse events. The International Study Group. Int J Clin Pract 1998; 52 (6): 381–6.
42. Bicchi M, Vedovini G, Cappelli R et al. Effect of felodipine on arterial blood flow and venous function at rest in patients with mild essential hypertension. Angiology 1998; 49 (5): 373–80.
43. Агеев Ф.Т., Фофанова Т.В., Деев А.Д. Применение фелодипина в амбулаторной практике: оценка клинической эффективности и приверженности к лечению у больных с артериальной гипертонией. Кардиология. 2009; 1: 30–3.
Авторы
Н.М.Чихладзе
ИКК им. А.Л.Мясникова ФГБУ РКНПК Минздрава РФ, Москва
ИКК им. А.Л.Мясникова ФГБУ РКНПК Минздрава РФ, Москва
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N.M.Chikhladze
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