Кандесартан является селективным блокатором рецепторов ангиотензина II 1-го типа. Отличительными особенностями его фармакокинетики и фармакодинамики являются большая продолжительность антигипертензивного действия, высокая селективность и хорошая биодоступность препарата. В лечении артериальной гипертонии кандесартан способен эффективно предотвращать утренний подъем артериального давления. Для препарата свойственны церебро-
и кардиопротективные эффекты, способность снижать риск появления новых случаев сахарного диабета. Препарат оказывается эффективным средством в лечении нефропатии разного генеза, в том числе и у больных с выраженным снижением функции почек. Метаболическая нейтральность, способность предотвращать развитие микро- и макроангиопатии позволяют рекомендовать этот блокатор рецепторов ангиотензина в лечении больных сахарным диабетом. Благоприятный профиль фармакокинетических свойств создает преимущество кандесартана в эффективности по сравнению с другими препаратами той же группы.
Candesartan is a selective angiotensin II receptor blocker type 1. The distinctive features of its pharmacokinetics and pharmacodynamics are long duration of antihypertensive action, high selectivity and good bioavailability. In the treatment of hypertension, candesartan can effectively prevent morning rise in blood pressure. For preparation peculiar cerebro-and cardioprotective effects, the ability to reduce the risk of new cases of diabetes. The drug is effective in the treatment of nephropathy different genesis, including in patients with a marked reduction in renal function. Metabolic neutrality, the ability to prevent the development of micro-and macroangiopathy can recommend this angiotensin receptor blocker in the treatment of diabetic patients. Favorable profile of the pharmacokinetic properties of an advantage in efficacy of candesartan in comparison with other drugs of the same group.
1. Gleiter CH, Mörike KE. Clinical pharmacokinetics of candesartan. Clin Pharmacokinet 2002; 41 (1): 7–17.
2. Lithell H, Hansson L, Skoog I et al. SCOPE Study Group. The Study on Cognition and Prognosis in the Elderly (SCOPE). Principal results of a randomised double-blind intervention trial. J Hypertens 2003; 21: 875–86.
3. Young JB, Dunlap ME, Pfeffer MA et al for the CHARM Investigators and Committees. Mortality and morbidity reduction with candesartan in patients with chronic heart failure and left ventricular systolic dysfunction: results of the CHARM low-left ventricular ejection fraction trials. Circulation 2004; 110 (17): 2618–26.
4. Weisser B, Gerwe M, Braun M, Funken C. Investigations of the antihypertensive long-term action of candesartan cilexetil in different dosages under the influence of therapy-free intervals Arzneimittelforschung 2005; 55 (9): 505–13.
5. Shimizu M, Ishikawa J, Yano Y et al. Association between asleep blood pressure and brain natriuretic peptide during antihypertensive treatment: the Japan Morning Surge-Target Organ Protection (J-TOP) study. J Hypertens 2012; 30 (5): 1015–21.
6. Minatoguchi S, Aoyama T, Kawai N et al. Comparative effect of candesartan and amlodipine, and effect of switching from valsartan, losartan, telmisartan and olmesartan to candesartan, on early morning hypertension and heart rate. Blood Press 2013; 22 (Suppl. 1): 29–37.
7. Kario K, Hoshide S, Shimizu M et al. Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives: the Japan Morning Surge-Target Organ Protection (J-TOP) study. J Hypertens 2010; 28 (7): 1574–83.
8. Lee HY, Hong BK, Chung WJ et al. Phase IV, 8-week, multicenter, randomized, active treatment-controlled, parallel group, efficacy, and tolerability study of high-dose candesartan cilexetil combined with hydrochlorothiazide in Korean adults with stage II hypertension. Clin Ther 2011; 33 (8): 1043–56.
9. De Rosa ML, Chiariello M. Candesartan improves maximal exercise capacity in hypertensives: results of a randomized placebo-controlled crossover trial. J Clin Hypertens (Greenwich) 2009; 11 (4): 192–200.
10. Ogihara T, Nakao K, Fukui T et al. Effects of candesartan compared with amlodipine in hypertensive patients with high cardiovascular risks: candesartan antihypertensive survival evaluation in Japan trial. Hypertension 2008; 51 (2): 393–8.
11. Ogihara T, Ueshima K, Nakao K et al. Long-term effects of candesartan and amlodipine on cardiovascular morbidity and mortality in Japanese high-risk hypertensive patients: the Candesartan Antihypertensive Survival Evaluation in Japan Extension Study (CASE-J Ex). Hypertens Res 2011; 34 (12): 1295–301.
12. Nakao K, Hirata M, Oba K et al. Role of diabetes and obesity in outcomes of the candesartan antihypertensive survival evaluation in Japan (CASE-J) trial. Hypertens Res 2010; 33 (6): 600–6.
13. Matsuno Y, Minatoguchi S, Fujiwara H et al. Effects of candesartan versus amlodipine on home-measured blood pressure, QT dispersion and left ventricular hypertrophy in high-risk hypertensive patients. Blood Press 2011; 20 (Suppl. 1): 12–9.
14. Escobar C, Barrios V, Calderón A et al. Electrocardiographic left ventricular hypertrophy regression induced by an angiotensin receptor blocker-based regimen in hypertensive patients with the metabolic syndrome: data from the SARA Study. J Clin Hypertens (Greenwich) 2008; 10 (3): 208–14.
15. Saxby BK, Harrington F, Wesnes KA et al. Candesartan and cognitive decline in older patients with hypertension: a substudy of the SCOPE trial. Neurology 2008; 70 (19 Pt 2): 1858–66.
16. Koyanagi R, Hagiwara N, Yamaguchi J et al. Efficacy of the combination of amlodipine and candesartan in hypertensive patients with coronary artery disease: a subanalysis of the HIJ-CREATE study. J Cardiol 2013; 62 (4): 217–23.
17. Bönner G. Multicentre Study Group. Antihypertensive efficacy and tolerability of candesartan-hydrochlorothiazide 32/12,5 mg and 32/25 mg in patients not optimally controlled with candesartan monotherapy. Blood Press 2008; (Suppl. 2): 22–30.
18. Bönner G, Landers B, Bramlage P. Candesartan cilexetil/hydrochlorothiazide combination treatment versus high-dose candesartan cilexetil monotherapy in patients with mild to moderate cardiovascular risk (CHILI Triple T). Vasc Health Risk Manag 2011; 7: 85–95.
19. Andersen NH, Poulsen PL, Knudsen ST et al. Long-term dual blockade with candesartan and lisinopril in hypertensive patients with diabetes: the CALM II study. Diabetes Care 2005; 28 (2): 273–7.
20. Andersen NH, Poulsen SH, Poulsen PL et al. Effects of blood pressure lowering and metabolic control on systolic left ventricular function in Type II diabetes mellitus. Clin Sci (Lond) 2006; 111 (1): 53–9.
21. Ono Y, Mizuno K, Takahashi M et al. Suppression of advanced glycation and lipoxidation end products by Angiotensin ii type-1 receptor blocker candesartan in type 2 diabetic patients with essential hypertension. Fukushima J Med Sci 2013; 59 (2): 69–75.
22. Okura T, Kojima M, Machida H et al. Effects of up-titration of candesartan versus candesartan plus amlodipine on kidney function in type 2 diabetic patients with albuminuria. J Hum Hypertens 2012; 26 (4): 214–9.
23. Sakamoto M, Suzuki H, Hayashi T et al. Effects of candesartan in hypertensive patients with type 2 diabetes mellitus on inflammatory parameters and their relationship to pulse pressure. Cardiovasc Diabetol 2012; 11: 118–23.
24. Tillin T, Orchard T, Malm A et al. The role of antihypertensive therapy in reducing vascular complications of type 2 diabetes. Findings from the DIabetic REtinopathy Candesartan Trials-Protect 2 study. J Hypertens 2011; 29 (7): 1457–62.
25. Okumi M, Kawada N, Ichimaru N et al. Safety and efficacy of administering the maximal dose of candesartan in renal transplant recipients. Clin Exp Nephrol 2011; 15 (6): 907–15.
26. Philipp T, Martinez F, Geiger H et al. Candesartan improves blood pressure control and reduces proteinuria in renal transplant recipients: results from SECRET. Nephrol Dial Transplant 2010; 25 (3): 967–76.
27. Trachtman H, Hainer JW, Sugg J et al. Efficacy, safety, and pharmacokinetics of candesartan cilexetil in hypertensive children aged 6 to 17 years. J Clin Hypertens (Greenwich) 2008; 10 (10): 743–50.
28. Franks AM, O'Brien CE, Stowe CD et al. Candesartan cilexetil effectively reduces blood pressure in hypertensive children. Ann Pharmacother 2008; 42 (10): 1388–95.
29. Simonetti GD, von Vigier RO, Konrad M et al. Candesartan cilexetil in children with hypertension or proteinuria: preliminary data. Pediatr Nephrol 2006; 21 (10): 1480–2.
30. Bakris G, Gradman A, Reif M et al and the CLAIM Study Investigators. Antihypertensive efficacy of candesartan in comparison to losartan: the CLAIM study. J Clin Hypertens 2001; 3: 16–21.
31. Vidt DG, White WB, Ridley E et al and the CLAIM Study investigators. A forced titration study of antihypertensive efficacy of candesartan cilexetil in comparison to losartan: CLAIM Study II. J Hum Hypertens 2001; 15: 475–80.
32. Granström O, Levin LÅ, Henriksson M. Cost-effectiveness of candesartan versus losartan in the primary preventive treatment of hypertension. Clinicoecon Outcomes Res 2012; 4: 313–22.
33. Zhenfeng Zheng, Huilan Shi, Junya Jia et al. A systematic review and meta-analysis of candesartan and losartan in the management of essential hypertension. J Renin Angiotensin Aldosterone Syst 2011; 12 (3): 365–74.
34. Russell D, Stålhammar J, Bodegard J et al. Cardiovascular events in subgroups of patients during primary treatment of hypertension with candesartan or losartan. J Clin Hypertens (Greenwich) 2011; 13 (3): 189–97.
35. Hasegawa H, Takano H, Kameda Y et al. Effect of switching from telmisartan, valsartan, olmesartan, or losartan to candesartan on morning hypertension. Clin Exp Hypertens 2012; 34 (2): 86–91.
36. Lin JW, Chang CH, Caffrey JL et al. Examining the Association of Olmesartan and Other Angiotensin Receptor Blockers With Overall and Cause-Specific Mortality. Hypertension 2014.
________________________________________________
1. Gleiter CH, Mörike KE. Clinical pharmacokinetics of candesartan. Clin Pharmacokinet 2002; 41 (1): 7–17.
2. Lithell H, Hansson L, Skoog I et al. SCOPE Study Group. The Study on Cognition and Prognosis in the Elderly (SCOPE). Principal results of a randomised double-blind intervention trial. J Hypertens 2003; 21: 875–86.
3. Young JB, Dunlap ME, Pfeffer MA et al for the CHARM Investigators and Committees. Mortality and morbidity reduction with candesartan in patients with chronic heart failure and left ventricular systolic dysfunction: results of the CHARM low-left ventricular ejection fraction trials. Circulation 2004; 110 (17): 2618–26.
4. Weisser B, Gerwe M, Braun M, Funken C. Investigations of the antihypertensive long-term action of candesartan cilexetil in different dosages under the influence of therapy-free intervals Arzneimittelforschung 2005; 55 (9): 505–13.
5. Shimizu M, Ishikawa J, Yano Y et al. Association between asleep blood pressure and brain natriuretic peptide during antihypertensive treatment: the Japan Morning Surge-Target Organ Protection (J-TOP) study. J Hypertens 2012; 30 (5): 1015–21.
6. Minatoguchi S, Aoyama T, Kawai N et al. Comparative effect of candesartan and amlodipine, and effect of switching from valsartan, losartan, telmisartan and olmesartan to candesartan, on early morning hypertension and heart rate. Blood Press 2013; 22 (Suppl. 1): 29–37.
7. Kario K, Hoshide S, Shimizu M et al. Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives: the Japan Morning Surge-Target Organ Protection (J-TOP) study. J Hypertens 2010; 28 (7): 1574–83.
8. Lee HY, Hong BK, Chung WJ et al. Phase IV, 8-week, multicenter, randomized, active treatment-controlled, parallel group, efficacy, and tolerability study of high-dose candesartan cilexetil combined with hydrochlorothiazide in Korean adults with stage II hypertension. Clin Ther 2011; 33 (8): 1043–56.
9. De Rosa ML, Chiariello M. Candesartan improves maximal exercise capacity in hypertensives: results of a randomized placebo-controlled crossover trial. J Clin Hypertens (Greenwich) 2009; 11 (4): 192–200.
10. Ogihara T, Nakao K, Fukui T et al. Effects of candesartan compared with amlodipine in hypertensive patients with high cardiovascular risks: candesartan antihypertensive survival evaluation in Japan trial. Hypertension 2008; 51 (2): 393–8.
11. Ogihara T, Ueshima K, Nakao K et al. Long-term effects of candesartan and amlodipine on cardiovascular morbidity and mortality in Japanese high-risk hypertensive patients: the Candesartan Antihypertensive Survival Evaluation in Japan Extension Study (CASE-J Ex). Hypertens Res 2011; 34 (12): 1295–301.
12. Nakao K, Hirata M, Oba K et al. Role of diabetes and obesity in outcomes of the candesartan antihypertensive survival evaluation in Japan (CASE-J) trial. Hypertens Res 2010; 33 (6): 600–6.
13. Matsuno Y, Minatoguchi S, Fujiwara H et al. Effects of candesartan versus amlodipine on home-measured blood pressure, QT dispersion and left ventricular hypertrophy in high-risk hypertensive patients. Blood Press 2011; 20 (Suppl. 1): 12–9.
14. Escobar C, Barrios V, Calderón A et al. Electrocardiographic left ventricular hypertrophy regression induced by an angiotensin receptor blocker-based regimen in hypertensive patients with the metabolic syndrome: data from the SARA Study. J Clin Hypertens (Greenwich) 2008; 10 (3): 208–14.
15. Saxby BK, Harrington F, Wesnes KA et al. Candesartan and cognitive decline in older patients with hypertension: a substudy of the SCOPE trial. Neurology 2008; 70 (19 Pt 2): 1858–66.
16. Koyanagi R, Hagiwara N, Yamaguchi J et al. Efficacy of the combination of amlodipine and candesartan in hypertensive patients with coronary artery disease: a subanalysis of the HIJ-CREATE study. J Cardiol 2013; 62 (4): 217–23.
17. Bönner G. Multicentre Study Group. Antihypertensive efficacy and tolerability of candesartan-hydrochlorothiazide 32/12,5 mg and 32/25 mg in patients not optimally controlled with candesartan monotherapy. Blood Press 2008; (Suppl. 2): 22–30.
18. Bönner G, Landers B, Bramlage P. Candesartan cilexetil/hydrochlorothiazide combination treatment versus high-dose candesartan cilexetil monotherapy in patients with mild to moderate cardiovascular risk (CHILI Triple T). Vasc Health Risk Manag 2011; 7: 85–95.
19. Andersen NH, Poulsen PL, Knudsen ST et al. Long-term dual blockade with candesartan and lisinopril in hypertensive patients with diabetes: the CALM II study. Diabetes Care 2005; 28 (2): 273–7.
20. Andersen NH, Poulsen SH, Poulsen PL et al. Effects of blood pressure lowering and metabolic control on systolic left ventricular function in Type II diabetes mellitus. Clin Sci (Lond) 2006; 111 (1): 53–9.
21. Ono Y, Mizuno K, Takahashi M et al. Suppression of advanced glycation and lipoxidation end products by Angiotensin ii type-1 receptor blocker candesartan in type 2 diabetic patients with essential hypertension. Fukushima J Med Sci 2013; 59 (2): 69–75.
22. Okura T, Kojima M, Machida H et al. Effects of up-titration of candesartan versus candesartan plus amlodipine on kidney function in type 2 diabetic patients with albuminuria. J Hum Hypertens 2012; 26 (4): 214–9.
23. Sakamoto M, Suzuki H, Hayashi T et al. Effects of candesartan in hypertensive patients with type 2 diabetes mellitus on inflammatory parameters and their relationship to pulse pressure. Cardiovasc Diabetol 2012; 11: 118–23.
24. Tillin T, Orchard T, Malm A et al. The role of antihypertensive therapy in reducing vascular complications of type 2 diabetes. Findings from the DIabetic REtinopathy Candesartan Trials-Protect 2 study. J Hypertens 2011; 29 (7): 1457–62.
25. Okumi M, Kawada N, Ichimaru N et al. Safety and efficacy of administering the maximal dose of candesartan in renal transplant recipients. Clin Exp Nephrol 2011; 15 (6): 907–15.
26. Philipp T, Martinez F, Geiger H et al. Candesartan improves blood pressure control and reduces proteinuria in renal transplant recipients: results from SECRET. Nephrol Dial Transplant 2010; 25 (3): 967–76.
27. Trachtman H, Hainer JW, Sugg J et al. Efficacy, safety, and pharmacokinetics of candesartan cilexetil in hypertensive children aged 6 to 17 years. J Clin Hypertens (Greenwich) 2008; 10 (10): 743–50.
28. Franks AM, O'Brien CE, Stowe CD et al. Candesartan cilexetil effectively reduces blood pressure in hypertensive children. Ann Pharmacother 2008; 42 (10): 1388–95.
29. Simonetti GD, von Vigier RO, Konrad M et al. Candesartan cilexetil in children with hypertension or proteinuria: preliminary data. Pediatr Nephrol 2006; 21 (10): 1480–2.
30. Bakris G, Gradman A, Reif M et al and the CLAIM Study Investigators. Antihypertensive efficacy of candesartan in comparison to losartan: the CLAIM study. J Clin Hypertens 2001; 3: 16–21.
31. Vidt DG, White WB, Ridley E et al and the CLAIM Study investigators. A forced titration study of antihypertensive efficacy of candesartan cilexetil in comparison to losartan: CLAIM Study II. J Hum Hypertens 2001; 15: 475–80.
32. Granström O, Levin LÅ, Henriksson M. Cost-effectiveness of candesartan versus losartan in the primary preventive treatment of hypertension. Clinicoecon Outcomes Res 2012; 4: 313–22.
33. Zhenfeng Zheng, Huilan Shi, Junya Jia et al. A systematic review and meta-analysis of candesartan and losartan in the management of essential hypertension. J Renin Angiotensin Aldosterone Syst 2011; 12 (3): 365–74.
34. Russell D, Stålhammar J, Bodegard J et al. Cardiovascular events in subgroups of patients during primary treatment of hypertension with candesartan or losartan. J Clin Hypertens (Greenwich) 2011; 13 (3): 189–97.
35. Hasegawa H, Takano H, Kameda Y et al. Effect of switching from telmisartan, valsartan, olmesartan, or losartan to candesartan on morning hypertension. Clin Exp Hypertens 2012; 34 (2): 86–91.
36. Lin JW, Chang CH, Caffrey JL et al. Examining the Association of Olmesartan and Other Angiotensin Receptor Blockers With Overall and Cause-Specific Mortality. Hypertension 2014.
Авторы
Л.О.Минушкина
ФГБУ Учебно-научный медицинский центр Управления делами Президента РФ, Москва minushkina@mail.ru