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Новые широко обсуждаемые клинически значимые аспекты влияния b-блокаторов
Новые широко обсуждаемые клинически значимые аспекты влияния b-блокаторов
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Назначение β-блокаторов в настоящее время представляет особый интерес. Существуют доводы за и против назначения этих препаратов. Так, с 2006-2008 гг. было опубликовано значительное количество работ, поставивших под сомнение роль β-блокаторов у пожилых больных артериальной гипертензией (АГ), в предотвращении развития хронической сердечной недостатончости (ХСН) у больных АГ, в повышении переносимости физических нагрузок у больных АГ. Однако в российских рекомендациях β-блокаторы сохранили свои показания и являются обязательными препаратами в лечении пациентов, страдающих АГ с высокой коморбидностью.
В статье приводится анализ наиболее изученных β-блокаторов.
Ключевые слова: β-блокаторы, метопролола сукцинат.
The paper analyzes the most studied b-blockers.
Key words: b-blockers, metoprolol succinate.
В статье приводится анализ наиболее изученных β-блокаторов.
Ключевые слова: β-блокаторы, метопролола сукцинат.
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The paper analyzes the most studied b-blockers.
Key words: b-blockers, metoprolol succinate.
Полный текст
Список литературы
1. Bangalore S, Sawhney S, Messerli FH. Relation of beta-blocker-induced heart rate lowering and cardioprotection in hypertension. Cardiology 2008; 52 (18): 1482–9.
2. Bangalore S, Steg G, Deedwania P et al. b-Blocker use and clinical outcomes in stable outpatients with and without coronary artery disease JAMA 2012; 308 (13): 1340–9.
3. Nakamura M, Sato K, Nagano M. Estimation of aortic systolic blood pressure in community-based screening: the relationship between clinical characteristics and peripheral to central blood pressure differences. J Hum Hypertens 2005; 19: 251–3.
4. Roman MJ, Devereux RB, Kizer JR. High Central Pulse Pressure Is Independently Associated With Adverse Cardiovascular Outcome: The Strong Heart Study J Am Coll Cardiol 2009; 54 (18): 1730–4.
5. Rashmer R. Functional anatomy and control of the heart. Cardiovascular Dynamics 4th ed. Philadelphia: WB Saunders; 1975.
6. Фолков Б., Нил Э. Кровообращение. М.: Медицина, 1976.
7. Manisty CH, Hughes AD, Meta-analysis of the comparative effects of different classes of antihypertensive agents on brachial and central systolic blood pressure, and augmentation index. Br J Clin Pharmacol 2013; 75 (1): 79–92.
8. Williams B, Lacy P for the CAFE and the ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) Investigators Impact of Heart Rate on Central Aortic Pressures and Hemodynamics Analysis From the CAFE (Conduit Artery Function Evaluation) Study: CAFE-Heart Rate. J Am Coll Cardiol 2009; 54: 705–13.
9. Williams B, Lacy PS, Thom SM et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213–25.
10. Kolloch R, Legler UF, Champion A et al. Impact of resting heart rate on outcomes in hypertensive patients with coronary artery disease: findings from the INternational VErapamil-SR/trandolapril STudy (INVEST) Eur Heart J 2008; 29 (10): 1327–34.
11. Poole-Wilson PA, Swedberg K, Cleland JGF for the COMET investigators. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial. Lancet 2003; 362: 7–13.
12. Ong K, Delerme S, Pannier B et al on behalf of the investigators. Аоtic stiffness is reduced beyond blood pressure lowering by short-term and long-term antihypertensive treatment: a meta-analysis of individual data in 294 patients. J Hypertension 2011; 29: 1034–42.
13. Грибкова И.В., Шуберт Р., Серебряков В.П. NO активизирует Ca2+-активизируемый К+ ток гладкомышечных клеток хвостовой артерии крысы через GMP-зависимый механизм. Кардиология. 2002; 40 (8): 65–70.
14. Mongrain R, Cabau JR. Role of Shear Stress in Atherosclerosis and Restenosis After Coronary Stent Implantation Revista Espanola de Card 2006; 59 (1): 1–4.
15. Lee CS, Tarbell JM. Influence of vasoactive drugs on wall shear stress distribution in the abdominal aortic bifurcation: an in vitro study. Ann Biomed Eng 1998; 26 (2): 200–12.
16. Gnasso A, Carallo C, Irace C. Association Between Intima–Media Thickness and Wall Shear Stress in Common Carotid Arteries in Healthy Male Subjects Circulation 1996; 94: 2–1489, 3257–62.
17. Kveiborg В, Hermann T, Atheline Major-Pedersen A et al. Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes – a randomized study. Cardiovasc Diabetology 2010; 9: 21–30.
18. Falkner B, Kushner H. Treatment With Metoprolol Succinate, a Selective Beta Adrenergic Blocker, Lowers Blood Pressure Without Altering Insulin Sensitivity in Diabetic Patients The J Clin Hypertension 2008; 10 (1): 51–7.
19. Bakris G, Fonseca V, Katholi R et al. Metabolic Effects of Carvedilol vs Metoprolol in Patients With Type 2 Diabetes Mellitus and Hypertension: A Randomized Controlled Trial. JAMA 2004; 292: 2227–36.
20. Janka HU, Ziegler AG, Disselhoff G, Mehnert H. Influence of bisoprolol on blood glucose, glucosuria, and haemoglobin A1 in noninsulin-dependent diabetics. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S96–9.
21. Hansson L, Lindholm L, Niskanen L et al. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity in hypertension: the Captopril Preventional Project (CAPP) randomised trial. Lancet 1999; 353: 611–6.
22. Adler AI, Stratton IM, Neil H et al on behalf of the UK Prospective Study group. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000; 321: 412–9.
23. Agarval A, Haddad N, Hebert LA. Progression of kidney disease: Diagnosis and management. In: Moloni D, Craig J eds. Evidence-Based Nephrology. Hoboken, NJ: Wiley 2003; 5 (2): 159–67; 2008; p. 311–22.
24. Sica DA.The African American Study of Kidney Disease and Hypertension (AASK) trial: what more have we learned? J Clin Hypert 2003; 5 (2): 159–6723.
25. Messerli FH, Grossman E, Goldbourt U . Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 1998; 279: 1903–7.
26. Dahlöf B, Devereux RB, Kjeldsen SE et al for the LIFE study group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint Reduction in Hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.
27. Carlberg B, Samuelsson O, Lindholm LH. Atenolol in hypertension: is it a wise choice? Lancet 2004; 364: 1684–9.
28. Dahlöf B, Sever PS, Poulter NR et al. 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-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895–906.
29. Lindholm LH, Carlberg B, Samuelsson O. Should beta-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 366:1545–53.
30. Neutel JM, Schnaper H, Cheung DG et al. Antihypertensive effects of beta-blockers administered once daily: 24-hour measurements. Am Heart J 1990; 120: 166–71.
31. Khan N, McAlister FA. Re-examining the efficacy of beta-blockers for the treatment of hypertension: a meta-analysis. CMAJ 2006; 174: 1737–42.
32. Hjalmarson Å. Heart rate: An independent risk factor in cardiovascular disease. Eur Heart J 2007; 9 (Suppl. F): F3–7.
33. Jouven X, Empana JP, Schwartz PJ et al. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005; 352: 1951–8.
34. Palatini P, Dorigatti F, Zaetta V et al. Heart rate as a predictor of development of sustained hypertension in subjects screened for stage 1 hypertension: The HARVEST Study. J Hypertens 2006; 24: 1873–80.
35. Aboyans V, Criqui M. Can we improve cardiovascular risk prediction beyond risk equations in the physician’s office? J Clin Epidemiol 2006; 59: 547–58.
36. Diaz A, Bourassa MG, Guertin MC, Tardif JC. Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. Eur Heart J 2005; 26: 967–74.
37. Wieselgren I, Lundborg P, Sandberg A et al. Pharmacokinetic and pharmacodynamic evaluation of metoprolol controlled release (CR/ZOK) 50 mg in young subjects J Clin Pharmacol 1990; 1 (30): S28–S32.
38. Schmieder RE, Martus P, Klingbeil A. Reversal of left ventricular hypertrophy in essential hypertension. A meta-analysis of randomized double-blind studies. JAMA 1996; 275: 1507–13.
39. Klingbeil A, Schneider M, Martus P et al. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med 2003; 115: 41–6.
40. Verza M, Ammendola S, Cambardella A et al. Regression of left ventricular hypertrophy in hypertensive elderly patients with carvedilol. Arch Gerontol Geriatr 1996; 22 (Suppl. 1): 143–7.
41. Hedblad B, Wikstrand J, Janzon L et al. Low dose metoprolol CR/XL and fluvastatin slow progression of carotid intima-media thickness: main results from the Beta-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS). Circulation 2001; 103: 1721–6.
42. Marfella R, Siniscalchi M, Nappo F et al. Regression of carotid atherosclerosis by control of morning blood pressure peak in newly diagnosed hypertensive patients. Am J Hypertens 2005; 18: 308–31.
2. Bangalore S, Steg G, Deedwania P et al. b-Blocker use and clinical outcomes in stable outpatients with and without coronary artery disease JAMA 2012; 308 (13): 1340–9.
3. Nakamura M, Sato K, Nagano M. Estimation of aortic systolic blood pressure in community-based screening: the relationship between clinical characteristics and peripheral to central blood pressure differences. J Hum Hypertens 2005; 19: 251–3.
4. Roman MJ, Devereux RB, Kizer JR. High Central Pulse Pressure Is Independently Associated With Adverse Cardiovascular Outcome: The Strong Heart Study J Am Coll Cardiol 2009; 54 (18): 1730–4.
5. Rashmer R. Functional anatomy and control of the heart. Cardiovascular Dynamics 4th ed. Philadelphia: WB Saunders; 1975.
6. Фолков Б., Нил Э. Кровообращение. М.: Медицина, 1976.
7. Manisty CH, Hughes AD, Meta-analysis of the comparative effects of different classes of antihypertensive agents on brachial and central systolic blood pressure, and augmentation index. Br J Clin Pharmacol 2013; 75 (1): 79–92.
8. Williams B, Lacy P for the CAFE and the ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) Investigators Impact of Heart Rate on Central Aortic Pressures and Hemodynamics Analysis From the CAFE (Conduit Artery Function Evaluation) Study: CAFE-Heart Rate. J Am Coll Cardiol 2009; 54: 705–13.
9. Williams B, Lacy PS, Thom SM et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213–25.
10. Kolloch R, Legler UF, Champion A et al. Impact of resting heart rate on outcomes in hypertensive patients with coronary artery disease: findings from the INternational VErapamil-SR/trandolapril STudy (INVEST) Eur Heart J 2008; 29 (10): 1327–34.
11. Poole-Wilson PA, Swedberg K, Cleland JGF for the COMET investigators. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial. Lancet 2003; 362: 7–13.
12. Ong K, Delerme S, Pannier B et al on behalf of the investigators. Аоtic stiffness is reduced beyond blood pressure lowering by short-term and long-term antihypertensive treatment: a meta-analysis of individual data in 294 patients. J Hypertension 2011; 29: 1034–42.
13. Грибкова И.В., Шуберт Р., Серебряков В.П. NO активизирует Ca2+-активизируемый К+ ток гладкомышечных клеток хвостовой артерии крысы через GMP-зависимый механизм. Кардиология. 2002; 40 (8): 65–70.
14. Mongrain R, Cabau JR. Role of Shear Stress in Atherosclerosis and Restenosis After Coronary Stent Implantation Revista Espanola de Card 2006; 59 (1): 1–4.
15. Lee CS, Tarbell JM. Influence of vasoactive drugs on wall shear stress distribution in the abdominal aortic bifurcation: an in vitro study. Ann Biomed Eng 1998; 26 (2): 200–12.
16. Gnasso A, Carallo C, Irace C. Association Between Intima–Media Thickness and Wall Shear Stress in Common Carotid Arteries in Healthy Male Subjects Circulation 1996; 94: 2–1489, 3257–62.
17. Kveiborg В, Hermann T, Atheline Major-Pedersen A et al. Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes – a randomized study. Cardiovasc Diabetology 2010; 9: 21–30.
18. Falkner B, Kushner H. Treatment With Metoprolol Succinate, a Selective Beta Adrenergic Blocker, Lowers Blood Pressure Without Altering Insulin Sensitivity in Diabetic Patients The J Clin Hypertension 2008; 10 (1): 51–7.
19. Bakris G, Fonseca V, Katholi R et al. Metabolic Effects of Carvedilol vs Metoprolol in Patients With Type 2 Diabetes Mellitus and Hypertension: A Randomized Controlled Trial. JAMA 2004; 292: 2227–36.
20. Janka HU, Ziegler AG, Disselhoff G, Mehnert H. Influence of bisoprolol on blood glucose, glucosuria, and haemoglobin A1 in noninsulin-dependent diabetics. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S96–9.
21. Hansson L, Lindholm L, Niskanen L et al. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity in hypertension: the Captopril Preventional Project (CAPP) randomised trial. Lancet 1999; 353: 611–6.
22. Adler AI, Stratton IM, Neil H et al on behalf of the UK Prospective Study group. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000; 321: 412–9.
23. Agarval A, Haddad N, Hebert LA. Progression of kidney disease: Diagnosis and management. In: Moloni D, Craig J eds. Evidence-Based Nephrology. Hoboken, NJ: Wiley 2003; 5 (2): 159–67; 2008; p. 311–22.
24. Sica DA.The African American Study of Kidney Disease and Hypertension (AASK) trial: what more have we learned? J Clin Hypert 2003; 5 (2): 159–6723.
25. Messerli FH, Grossman E, Goldbourt U . Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 1998; 279: 1903–7.
26. Dahlöf B, Devereux RB, Kjeldsen SE et al for the LIFE study group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint Reduction in Hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.
27. Carlberg B, Samuelsson O, Lindholm LH. Atenolol in hypertension: is it a wise choice? Lancet 2004; 364: 1684–9.
28. Dahlöf B, Sever PS, Poulter NR et al. 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-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895–906.
29. Lindholm LH, Carlberg B, Samuelsson O. Should beta-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 366:1545–53.
30. Neutel JM, Schnaper H, Cheung DG et al. Antihypertensive effects of beta-blockers administered once daily: 24-hour measurements. Am Heart J 1990; 120: 166–71.
31. Khan N, McAlister FA. Re-examining the efficacy of beta-blockers for the treatment of hypertension: a meta-analysis. CMAJ 2006; 174: 1737–42.
32. Hjalmarson Å. Heart rate: An independent risk factor in cardiovascular disease. Eur Heart J 2007; 9 (Suppl. F): F3–7.
33. Jouven X, Empana JP, Schwartz PJ et al. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005; 352: 1951–8.
34. Palatini P, Dorigatti F, Zaetta V et al. Heart rate as a predictor of development of sustained hypertension in subjects screened for stage 1 hypertension: The HARVEST Study. J Hypertens 2006; 24: 1873–80.
35. Aboyans V, Criqui M. Can we improve cardiovascular risk prediction beyond risk equations in the physician’s office? J Clin Epidemiol 2006; 59: 547–58.
36. Diaz A, Bourassa MG, Guertin MC, Tardif JC. Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. Eur Heart J 2005; 26: 967–74.
37. Wieselgren I, Lundborg P, Sandberg A et al. Pharmacokinetic and pharmacodynamic evaluation of metoprolol controlled release (CR/ZOK) 50 mg in young subjects J Clin Pharmacol 1990; 1 (30): S28–S32.
38. Schmieder RE, Martus P, Klingbeil A. Reversal of left ventricular hypertrophy in essential hypertension. A meta-analysis of randomized double-blind studies. JAMA 1996; 275: 1507–13.
39. Klingbeil A, Schneider M, Martus P et al. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med 2003; 115: 41–6.
40. Verza M, Ammendola S, Cambardella A et al. Regression of left ventricular hypertrophy in hypertensive elderly patients with carvedilol. Arch Gerontol Geriatr 1996; 22 (Suppl. 1): 143–7.
41. Hedblad B, Wikstrand J, Janzon L et al. Low dose metoprolol CR/XL and fluvastatin slow progression of carotid intima-media thickness: main results from the Beta-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS). Circulation 2001; 103: 1721–6.
42. Marfella R, Siniscalchi M, Nappo F et al. Regression of carotid atherosclerosis by control of morning blood pressure peak in newly diagnosed hypertensive patients. Am J Hypertens 2005; 18: 308–31.
Авторы
Г.П.Арутюнов
ГБОУ ВПО РНИМУ им. Н.И.Пирогова Минздрава РФ
ГБОУ ВПО РНИМУ им. Н.И.Пирогова Минздрава РФ
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