В представленном обзоре дана оценка социально значимого заболевания – артериальной гипертонии (АГ) – и проблемы поиска эффективной антигипертензивной терапии.
Препарат Твинста® – современный комбинированный антигипертензивный препарат, который обеспечивает не только эффективный контроль артериального давления.
В клинических исследованиях показано, что каждый из компонентов препарата Твинста® (телмисартан и амлодипин) обеспечивает дополнительные преимущества при лечении пациентов с метаболическим синдромом (улучшает параметры углеводного и липидного обмена), больных с нарушением функции почек (вызывает регрессию протеинурии), а также с гипертрофией левого желудочка (вызывает регрессию последнего).
В представленом обзоре показано, что Твинста® является представителем современных комбинированных антигипертензивных препаратов, имеет доказанный крупными клиническими исследованиями благоприятный профиль эффективности и безопасности.
The following review assesses socially significant disease – hypertension (AH) – and the problem of finding an effective antihypertensive therapy.
Twynsta® drug – modern combined antihypertensive drug, which not only provides effective blood pressure control.
The clinical studies show that components of Twynsta® (telmisartan and amlodipine) provides additional benefits in the treatment of patients with metabolic syndrome (by improving the carbohydrate and lipid metabolism), patients with impaired renal function (by inducing the regression of proteinuria), as well as left ventricular hypertrophy (by causing regression of the latter).
In the present review it is shown that Twynsta® represents modern combined antihypertensive drugs and has a clinically proven favorable efficacy and safety profile.
1. Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). Системные гипертензии 2010; 3: 5–26.
2. Амосова Е.Н. Блокада рецепторов ангиотензина – новое направление в лечении артериальной гипертензии. Укр. кардіол. журн. 1999; 4: 87–91.
3. Задионченко В.С., Шехян Г.Г., Щикота А.М. и др. Особенности комбинированной антигипертензивной терапии в современном лечении артериальной гипертензии. Рус. мед. журн. 2011; 19 (26): 1630–9.
4. Кобалава Ж.Д. Место комбинированной антигипертензивной терапии в современном лечении артериальной гипертонии. Клиническая фармакология и терапия 2001; 10 (3).
5. Лукина Ю.В. Препарат амлодипина – новый старый знакомый. Русский медицинский журнал 2011; 5: 343–347.
6. Чазова И.Е. Новые Европейские рекомендации по ведению пациентов с артериальной гипертонией: место сартанов. Системные гипертензии 2008; 2: 4–7.
7. Чазова И.Е., Карпов Ю.А., Остроумова О.Д. Заседание совета экспертов «Новое в комбинированной терапии артериальной гипертензии». Системные гипертензии 2012; 3: 66–8.
8. Ялымов А.А., Шехян Г.Г., Щикота А.М. и др. Антагонисты кальция в терапии сердечно-сосудистых заболеваний. Участковый терапевт. 2012; 5: 7.
9. Alizade IG, Karayeva NT. The effects of amlodipine on cerebral circulatory values in patients with essential hypertension. Anadolu Kardiyol Derg 2001; 1 (1): 14–6.
10. ALLHAT officers and co-ordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981–97.
11. Battershill AJ, Scott LJ. Telmisartan: preparation application in treatment of arterial hypertension. Drugs 2006; 66 (1): 51–83.
12. Detry JM. Amlodipine and the total ischemic burden: Circadian Anti–Ischemia Program in Europe (CAPE) trial. Methodology, safety and toleration. Cardiology 1994; 85 (Suppl. 2): 24–30.
13. Elmer PJ, Grimm RJr, Laing B et al. Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS). Prev Med 1995; 24 (4): 378–88.
14. Julius S, Kjeldsen SE, Weber M et al. Outcomes in hypertensive patients at high cardiovascular risk treated with valsartan or amlodipine-based regimens: VALUE, a randomised trial. Lancet 2004; 363: 2022–31.
15. Mancia G, De Backer G, Dominiczak A et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–87.
16. Mancia G, Parati G, Bilo G et al. Ambulatory Blood Pressure Values in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET). Hypertension 2012; 60: 1400–6.
17. Muller J.E. Circadian variation and triggering of acute coronary events. Amer. Heart J. 1999; 137: 1–8.
18. Neldam S, Edwards C, Jones R. Switching patients with uncontrolled hypertension on amlodipine 10 mg to single-pill combinations of telmisartan and amlodipine: results of the TEAMSTA-10 study. Curr Med Res Opin 2011; 27: 2145–53.
19. Neldam S, Edwards C, Lang M, Jones R for The TEAMSTA-5 and TEAMSTA-10 Investigators. Long-Term Tolerability and Efficacy of Single-Pill Combinations of Telmisartan 40–80 mg Plus Amlodipine 5 or 10 mg in Patients Whose Blood Pressure Was Not Initially Controlled by Amlodipine 5–10 mg: Open-Label, Long-Term Follow-Ups of the TEAMSTA-5 and TEAMSTA-10 Studies. Current Ther Res, Clin Exp 2012; 73 (1/2): 65–84.
20. Neutel JM, Klein C, Meinicke TW. Long-term efficacy and tolerability of telmisartan as monotherapy and in combination with other antihypertensive medications. Blood Press 2002; 11: 302–9.
21. Neutel J, Mancia G, Black H et al. Single-Pill Combination of Telmisartan/Amlodipine in Patients With Severe Hypertension: Results From the TEAMSTA Severe HTN Study. J Clin Hypertens (Greenwich) 2012; 14 (4): 206–15 (ERRATUM J Clin Hypertens doi: 10.1111/jch.12025).
22. Neutel J.M., Smith D.H. Dose response and antihypertensive efficacy of the AT1 receptor antagonist telmisartam in patients with mild to moderate hypertension. Adv. Ther.1998; 15: 206–217.
23. Nicholls MG, Charles CJ, Crozier IG et al. Blockade of the renin-angiotensin system. J Hypertension 1994; 10 (Suppl.): 95–103.
24. Nissen S.E., Tuzcu E.M., Libby P et al. CAMELOT Investigators. Effect of antihypertensive agents on cardiorprovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA 2004; 292: 2217–25.
25. Pitt B et al. Effect of amlodipine on progression of atherosclerosis and the occurrence of clinical events. PREVENT investigators. Circulation 2000; 102 (13): 1503–10.
26. Ragot S, Ezzaher A, Meunier A. Comparison of trough effect of telmisartan vs perindopril using self blood pressure measurement: EVEREST study. J Hum Hypertension 2002; 16: 865–73.
27. Rippin J, Bain SC, Barnett AH. Rationale and design of diabetics exposed to telmisartan and enalapril (DETAIL) study. J Diabetes Complications 2002; 16 (3): 195–200.
28. Rossi A, Dikareva A, Bacon SL, Daskalopoulou SS. The impact of physical activity on mortality in patients with high blood pressure: a systematic review. J Hypertens 2012; 30: 1277–88.
29. Schmerbach K, Unger T. Pharmacoeconomics and quality of life analysis of telmisartan in hypertension treatment. Expert Review of Pharmacoeconomics and Outcome Research 2007; 7(5): 435–444.
30. Sharma AM, Bakris G, Neutel JM et al. Single-pill combination of telmisartan/amlodipine versus amlodipine monotherapy in diabetic hypertensive patients: an 8-week randomized, parallel-group, double-blind trial. Clin Ther 2012; 34: 537–51.
31. Smith DH, Matzek KM, Kempthorne-Rawson J. Dose response and safety of telmisartan in patients with mild to moderate hypertension. J Clin Pharmacology 2000; 40; 1380–90.
32. Smith DH. Treatment of hypertension with an angiotensin II-receptor antagonist compared with an angiotensin-converting enzyme inhibitor: a review of clinical studies of telmisartan and enalapril. Clin Ther 2002; 24: 1484–501.
33. Telmisartan Randomized Assessment Study in ACE intolerant subjects with cardiovascular disease (TRANSCEND) Investigators. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet 2008; 372: 1174–83.
34. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. Brit Med J 1998; 317: 703–13.
35. Инструкция по медицинскому применению препарата Твинста®.
36. Инструкция по медицинскому применению препарата Микардис®.
________________________________________________
1. Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). Системные гипертензии 2010; 3: 5–26.
2. Амосова Е.Н. Блокада рецепторов ангиотензина – новое направление в лечении артериальной гипертензии. Укр. кардіол. журн. 1999; 4: 87–91.
3. Задионченко В.С., Шехян Г.Г., Щикота А.М. и др. Особенности комбинированной антигипертензивной терапии в современном лечении артериальной гипертензии. Рус. мед. журн. 2011; 19 (26): 1630–9.
4. Кобалава Ж.Д. Место комбинированной антигипертензивной терапии в современном лечении артериальной гипертонии. Клиническая фармакология и терапия 2001; 10 (3).
5. Лукина Ю.В. Препарат амлодипина – новый старый знакомый. Русский медицинский журнал 2011; 5: 343–347.
6. Чазова И.Е. Новые Европейские рекомендации по ведению пациентов с артериальной гипертонией: место сартанов. Системные гипертензии 2008; 2: 4–7.
7. Чазова И.Е., Карпов Ю.А., Остроумова О.Д. Заседание совета экспертов «Новое в комбинированной терапии артериальной гипертензии». Системные гипертензии 2012; 3: 66–8.
8. Ялымов А.А., Шехян Г.Г., Щикота А.М. и др. Антагонисты кальция в терапии сердечно-сосудистых заболеваний. Участковый терапевт. 2012; 5: 7.
9. Alizade IG, Karayeva NT. The effects of amlodipine on cerebral circulatory values in patients with essential hypertension. Anadolu Kardiyol Derg 2001; 1 (1): 14–6.
10. ALLHAT officers and co-ordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981–97.
11. Battershill AJ, Scott LJ. Telmisartan: preparation application in treatment of arterial hypertension. Drugs 2006; 66 (1): 51–83.
12. Detry JM. Amlodipine and the total ischemic burden: Circadian Anti–Ischemia Program in Europe (CAPE) trial. Methodology, safety and toleration. Cardiology 1994; 85 (Suppl. 2): 24–30.
13. Elmer PJ, Grimm RJr, Laing B et al. Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS). Prev Med 1995; 24 (4): 378–88.
14. Julius S, Kjeldsen SE, Weber M et al. Outcomes in hypertensive patients at high cardiovascular risk treated with valsartan or amlodipine-based regimens: VALUE, a randomised trial. Lancet 2004; 363: 2022–31.
15. Mancia G, De Backer G, Dominiczak A et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–87.
16. Mancia G, Parati G, Bilo G et al. Ambulatory Blood Pressure Values in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET). Hypertension 2012; 60: 1400–6.
17. Muller J.E. Circadian variation and triggering of acute coronary events. Amer. Heart J. 1999; 137: 1–8.
18. Neldam S, Edwards C, Jones R. Switching patients with uncontrolled hypertension on amlodipine 10 mg to single-pill combinations of telmisartan and amlodipine: results of the TEAMSTA-10 study. Curr Med Res Opin 2011; 27: 2145–53.
19. Neldam S, Edwards C, Lang M, Jones R for The TEAMSTA-5 and TEAMSTA-10 Investigators. Long-Term Tolerability and Efficacy of Single-Pill Combinations of Telmisartan 40–80 mg Plus Amlodipine 5 or 10 mg in Patients Whose Blood Pressure Was Not Initially Controlled by Amlodipine 5–10 mg: Open-Label, Long-Term Follow-Ups of the TEAMSTA-5 and TEAMSTA-10 Studies. Current Ther Res, Clin Exp 2012; 73 (1/2): 65–84.
20. Neutel JM, Klein C, Meinicke TW. Long-term efficacy and tolerability of telmisartan as monotherapy and in combination with other antihypertensive medications. Blood Press 2002; 11: 302–9.
21. Neutel J, Mancia G, Black H et al. Single-Pill Combination of Telmisartan/Amlodipine in Patients With Severe Hypertension: Results From the TEAMSTA Severe HTN Study. J Clin Hypertens (Greenwich) 2012; 14 (4): 206–15 (ERRATUM J Clin Hypertens doi: 10.1111/jch.12025).
22. Neutel J.M., Smith D.H. Dose response and antihypertensive efficacy of the AT1 receptor antagonist telmisartam in patients with mild to moderate hypertension. Adv. Ther.1998; 15: 206–217.
23. Nicholls MG, Charles CJ, Crozier IG et al. Blockade of the renin-angiotensin system. J Hypertension 1994; 10 (Suppl.): 95–103.
24. Nissen S.E., Tuzcu E.M., Libby P et al. CAMELOT Investigators. Effect of antihypertensive agents on cardiorprovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA 2004; 292: 2217–25.
25. Pitt B et al. Effect of amlodipine on progression of atherosclerosis and the occurrence of clinical events. PREVENT investigators. Circulation 2000; 102 (13): 1503–10.
26. Ragot S, Ezzaher A, Meunier A. Comparison of trough effect of telmisartan vs perindopril using self blood pressure measurement: EVEREST study. J Hum Hypertension 2002; 16: 865–73.
27. Rippin J, Bain SC, Barnett AH. Rationale and design of diabetics exposed to telmisartan and enalapril (DETAIL) study. J Diabetes Complications 2002; 16 (3): 195–200.
28. Rossi A, Dikareva A, Bacon SL, Daskalopoulou SS. The impact of physical activity on mortality in patients with high blood pressure: a systematic review. J Hypertens 2012; 30: 1277–88.
29. Schmerbach K, Unger T. Pharmacoeconomics and quality of life analysis of telmisartan in hypertension treatment. Expert Review of Pharmacoeconomics and Outcome Research 2007; 7(5): 435–444.
30. Sharma AM, Bakris G, Neutel JM et al. Single-pill combination of telmisartan/amlodipine versus amlodipine monotherapy in diabetic hypertensive patients: an 8-week randomized, parallel-group, double-blind trial. Clin Ther 2012; 34: 537–51.
31. Smith DH, Matzek KM, Kempthorne-Rawson J. Dose response and safety of telmisartan in patients with mild to moderate hypertension. J Clin Pharmacology 2000; 40; 1380–90.
32. Smith DH. Treatment of hypertension with an angiotensin II-receptor antagonist compared with an angiotensin-converting enzyme inhibitor: a review of clinical studies of telmisartan and enalapril. Clin Ther 2002; 24: 1484–501.
33. Telmisartan Randomized Assessment Study in ACE intolerant subjects with cardiovascular disease (TRANSCEND) Investigators. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet 2008; 372: 1174–83.
34. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. Brit Med J 1998; 317: 703–13.
35. Инструкция по медицинскому применению препарата Твинста®.
36. Инструкция по медицинскому применению препарата Микардис®.
1 ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России;
2 ГБУЗ ГКБ №24, филиал №1 Департамента здравоохранения г. Москвы