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Диуретики при артериальной гипертонии: фокус на торасемид
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Аннотация
Диуретики давно применяются для лечения артериальной гипертензии, однако применение петлевых диуретиков ограничивалось случаями с хронической почечной и сердечной недостаточностью. Петлевой диуретик торасемид в субдиуретических дозах (2,5–5 мг) в настоящее время применяется для лечения артериальной гипертензии, хорошо переносится, метаболически нейтрален; благодаря антиальдостероновому эффекту не вызывает гипокалиемию.
Ключевые слова: петлевой диуретик, торасемид, Диувер, артериальная гипертензия.
Ключевые слова: петлевой диуретик, торасемид, Диувер, артериальная гипертензия.
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Diuretics have been long used to treat arterial hypertension; however, the use of loop diuretics has been limited by cases of chronic kidney and heart failure. The loop diuretic torasemide is now administered in subdiuretic doses (2,5–5 mg) to treat arterial hypertension; it is well tolerated, metabolically neutral, and, due to its antialdosterone effect, fails to cause hypokalemia.
Key words: loop diuretic, torasemide, Diuver, arterial hypertension.
Полный текст
Список литературы
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2. Hebert P, Moser M, Mayer J, Hennekens C. Recent evidence on drug therapy of mild to moderate hypertension and decreased risk of coronary heart disease. Arch Intern Med 1993; 153: 578–81.
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4. Lewington S 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.
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6. Raid IR, Ames RW, Orr-Walker BJ et al. Hydrochlorothiazide reduces loss of cortical bone in normal postmenopausal women: a randomized controlled trial. Am J Med 2000; 109: 362–70.
7. Conn JW. Primary aldosteronism, а new clinical syndrome. J Lab Clin Med 1955; 45: 3–17.
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9. Brunner G, von Bergmann K, Hacker W et al. Comparison of diuretic effects and pharmacokinetics of torasemid and furosemid after a single oral dose in patients with hydropically decompensated cirrhosis of the liver. Arzt-Forsch/Drug Res 1998; 38: 176–9.
10. Barr WH, Smith HL, Karnes HAT et al. Torasemide dose-proportionality of pharmacokinetics and pharmacodynamics. Prog Pharmacol Clinl Pharmacol, Gustav-Fischer-Verlag: Stuttgart, New York 1990; 8 (1): 29–37.
11. Bolke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of Today 1994; 30 (8): 1–28.
12. Reyes A. Effects of diuretics on outputs and flows or urine and urinary solutes in healthy subjects. Drugs 1991; 41 (Suppl. 3): 35–59.
13. Baumgart P, Walger P, von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 169–81.
14. Achhammer I, Metz P. Low dose loop diuretics in essential hypertension. Experience with torasemide. Drugs 1991; 41 (Suppl. 3): 80–91.
15. Baumgart P, Walger P, von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 169–81.
16. Baumgart P. Torasemide in comparison with thiazides in the treatment of hypertension. Cardiovasc. Drugs Ther 1993; 7 (Suppl. 1): 63–8.
17. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res 1988; 38 (1): 190–3.
18. Dupont AG, Schoors D, Six RO, Vanhaelst L. Antihypertensive efficacy of low dose torasemide in essential hypertension: a placebo-controlled study. J Hum Hypertens 1988; 2: 265–8.
19. Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmacotherapy in elderly patients; randomized and double-blind study. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 183–209.
20. Achhammer I, Eberhard R. Comparison of serum potassium levels during long-term treatment of hypertension patients with 2,5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothiazide o.d. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 211–20.
21. Bolke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of Today 1994; 30 (8): 1–28.
22. Lopez B, Querejeta R, Gonzales A et al. Effects of loop diuretics on myocardial fibrosis and collage type I turnover in chronic heart failure. J Am Coll Cardiol 2004; 43 (11): 2028–35.
23. Brown NJ. Aldosterone and end-organ damage. Curr Opin Nephrol Hypertens 2005; 14 (3): 235–41.
24. Ткачева О.Н., Шарашкина Н.В., Новикова И.М. и др. Применение петлевого диуретика торасемида в комбинированном лечении гипертонической болезни у женщин в период постменопаузы. Cons. Med. 2011; 13 (10): 54–9.
25. Reyes A et al. Prog Pharmacol Clinl Pharmacol, Gustav-Fischer-Verlag: Stuttgart, New York 1992; 9: 219–62.
26. Uchida T, Ohtaki Y, Kido H, Watanabe M. Diuretic profile of a novel loop diuretic torasemide in rats and dogs. Drugs Exp Clin Res 1991; 17: 293–8.
27. Liguori A, Casini A, Di Loreto M et al. Loop diuretics enhance the secretion of prostacyclin in vitro, in healthy persons, and in patients with chronic heart failure. Eur J Clin Pharmacol 1999; 55: 117–24.
28. Spieker C, Zidek W, Häcker W et al. Assessment of intracellular sodium and calcium in essential hypertension during diuretic treatment. Arzneimittelforschung 1988; 38: 1188–90.
29. Boesken WN, Eberwein B, Pieschke L. Efficacy and safety of torasemide (10, 20, 50, 100 and 200 mg/d p.o.) in the reatment of oedema in patients with nephrotic syndrome. Diuretics IV, Proceedings of the 4th. Conference on Diuretics. Elsevier New York, Amsterdam, London 1993.
30. Andreucci UE, Russo D, Memoli B et al. Efficacy of i.v. torasemide in the treatment of acute and chronic high grade renal failure. Prog Pharmacol Clinl Pharmacol, Gustav-Fischer-Verlag: Stuttgart, New York 1990; 8 (1).
31. Fassbinder W, Achhammer I, Ziegler J. Improved prognosis of patients with chronic heart failure by an optimized diuretic therapy with the new loop diuretic torasemide. J Am Coll Cardiol 1998; 31 (Suppl C).
32. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the antihypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Arzneimittelforschung 1988; 38 (1A): 190–3.
2. Hebert P, Moser M, Mayer J, Hennekens C. Recent evidence on drug therapy of mild to moderate hypertension and decreased risk of coronary heart disease. Arch Intern Med 1993; 153: 578–81.
3. Collins R, Peto R, MacMahon S et al. Blood pressure, stroke and coronary heart disease, II. Short-term reductions in blood pressure: overview of randomized drug trials in their epidemiological context. Lancet 1990; 335: 827–38.
4. Lewington S 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.
5. Рекомендации РМОАГ/ВНОК по диагностике и лечению артериальной гипертонии (IV пересмотр), 2010.
6. Raid IR, Ames RW, Orr-Walker BJ et al. Hydrochlorothiazide reduces loss of cortical bone in normal postmenopausal women: a randomized controlled trial. Am J Med 2000; 109: 362–70.
7. Conn JW. Primary aldosteronism, а new clinical syndrome. J Lab Clin Med 1955; 45: 3–17.
8. Friedel H, Buckley M. Torasemide A review of its pharmacological properties and therapeutic potential. Drugs 1991; 41 (1): 81–103.
9. Brunner G, von Bergmann K, Hacker W et al. Comparison of diuretic effects and pharmacokinetics of torasemid and furosemid after a single oral dose in patients with hydropically decompensated cirrhosis of the liver. Arzt-Forsch/Drug Res 1998; 38: 176–9.
10. Barr WH, Smith HL, Karnes HAT et al. Torasemide dose-proportionality of pharmacokinetics and pharmacodynamics. Prog Pharmacol Clinl Pharmacol, Gustav-Fischer-Verlag: Stuttgart, New York 1990; 8 (1): 29–37.
11. Bolke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of Today 1994; 30 (8): 1–28.
12. Reyes A. Effects of diuretics on outputs and flows or urine and urinary solutes in healthy subjects. Drugs 1991; 41 (Suppl. 3): 35–59.
13. Baumgart P, Walger P, von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 169–81.
14. Achhammer I, Metz P. Low dose loop diuretics in essential hypertension. Experience with torasemide. Drugs 1991; 41 (Suppl. 3): 80–91.
15. Baumgart P, Walger P, von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 169–81.
16. Baumgart P. Torasemide in comparison with thiazides in the treatment of hypertension. Cardiovasc. Drugs Ther 1993; 7 (Suppl. 1): 63–8.
17. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res 1988; 38 (1): 190–3.
18. Dupont AG, Schoors D, Six RO, Vanhaelst L. Antihypertensive efficacy of low dose torasemide in essential hypertension: a placebo-controlled study. J Hum Hypertens 1988; 2: 265–8.
19. Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmacotherapy in elderly patients; randomized and double-blind study. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 183–209.
20. Achhammer I, Eberhard R. Comparison of serum potassium levels during long-term treatment of hypertension patients with 2,5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothiazide o.d. Prog Pharmacol Clinl Pharmacol. Gustav-Fischer-Verlag: Stuttgart 1990; 8: 211–20.
21. Bolke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of Today 1994; 30 (8): 1–28.
22. Lopez B, Querejeta R, Gonzales A et al. Effects of loop diuretics on myocardial fibrosis and collage type I turnover in chronic heart failure. J Am Coll Cardiol 2004; 43 (11): 2028–35.
23. Brown NJ. Aldosterone and end-organ damage. Curr Opin Nephrol Hypertens 2005; 14 (3): 235–41.
24. Ткачева О.Н., Шарашкина Н.В., Новикова И.М. и др. Применение петлевого диуретика торасемида в комбинированном лечении гипертонической болезни у женщин в период постменопаузы. Cons. Med. 2011; 13 (10): 54–9.
25. Reyes A et al. Prog Pharmacol Clinl Pharmacol, Gustav-Fischer-Verlag: Stuttgart, New York 1992; 9: 219–62.
26. Uchida T, Ohtaki Y, Kido H, Watanabe M. Diuretic profile of a novel loop diuretic torasemide in rats and dogs. Drugs Exp Clin Res 1991; 17: 293–8.
27. Liguori A, Casini A, Di Loreto M et al. Loop diuretics enhance the secretion of prostacyclin in vitro, in healthy persons, and in patients with chronic heart failure. Eur J Clin Pharmacol 1999; 55: 117–24.
28. Spieker C, Zidek W, Häcker W et al. Assessment of intracellular sodium and calcium in essential hypertension during diuretic treatment. Arzneimittelforschung 1988; 38: 1188–90.
29. Boesken WN, Eberwein B, Pieschke L. Efficacy and safety of torasemide (10, 20, 50, 100 and 200 mg/d p.o.) in the reatment of oedema in patients with nephrotic syndrome. Diuretics IV, Proceedings of the 4th. Conference on Diuretics. Elsevier New York, Amsterdam, London 1993.
30. Andreucci UE, Russo D, Memoli B et al. Efficacy of i.v. torasemide in the treatment of acute and chronic high grade renal failure. Prog Pharmacol Clinl Pharmacol, Gustav-Fischer-Verlag: Stuttgart, New York 1990; 8 (1).
31. Fassbinder W, Achhammer I, Ziegler J. Improved prognosis of patients with chronic heart failure by an optimized diuretic therapy with the new loop diuretic torasemide. J Am Coll Cardiol 1998; 31 (Suppl C).
32. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the antihypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Arzneimittelforschung 1988; 38 (1A): 190–3.
Авторы
Г.А.Барышникова, И.И.Степанова
Кафедра семейной медицины ФГБУ Учебно-научный медицинский центр Управления делами Президента РФ
Кафедра семейной медицины ФГБУ Учебно-научный медицинский центр Управления делами Президента РФ
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G.A.Baryshnikova, I.I.Stepanova
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