В статье представлен обзор литературы по выбору фармакотерапии артериальной гипертензии (АГ). Среди антигипертензивных препаратов важное место занимают блокаторы рецепторов ангиотензина II (БРА), неоднородная группа препаратов, представители которой имеют существенные внутригрупповые различия. В данной статье сделан акцент на свойствах и эффектах олмесартана, которые выделяют его среди прочих БРА. Наряду с выраженным долгосрочным антигипертензивным действием олмесартан обладает органопротективными свойствами (вызывает обратное развитие гипертрофии левого желудочка, оказывает нефропротекцию и пр.). Опыт клинического применения олмесартана свидетельствует о высокой эффективности и хорошем спектре безопасности у разных категорий больных АГ.
The article presents an overview of the literature on the choice of pharmacotherapy of arterial hypertension (AH). Among antihypertensive drugs occupy an important place ARBs II (BRA), a heterogeneous group of drugs whose representatives have significant intercompany differences. This article focuses on the properties and effects of olmesartan, that distinguish it from other ARBs. Along with a strong long-term antihypertensive effect of olmesartan has organoprotective (regression of LVH, nephroprotection etc.). Olmesartan clinical experience indicates a high efficiency and a good range of security among different categories of patients with hypertension.
Key words: cardiovascular disease, hypertension, pharmacotherapy of hypertension, antihypertensive therapy, the renin-angiotensin-aldosterone system, RAAS, angiotensin receptor II, ARBs, olmesartan, сardosal, clinical studies, review.
1. Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens 2009; 27: 963–75.
2. Britton KA, Gaziano JM, Djousse L. Normal systolic blood pressure and risk of heart failure in US male physicians. Eur J Heart Fail 2009; 11: 1129–34.
3. Redon J, Olsen MH, Cooper RS et al. Stroke mortality trends from 1990 to 2006 in 39 countries from Europe and Central Asia: implications for control of high blood pressure. Eur Heart J 2011; 32: 1424–31.
4. 2013 ESH/ESC 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 2013; 31 (7): 1281–357.
5. Диагностика и лечение артериальной гипертонии. Клин. рекомендации Минздрава РФ, 2013; http://cardioweb.ru/klinicheskie-rekomendatsii
6. Haralambos P, Gavras, Salernob CM. The angiotensin II Type 1 receptor blocker losartan in clinical practice: a review. Clin Ther 1996; 18 (6): 1058–67.
7. Oparil S. Newly emerging pharmacologic differences in angiotensin II receptor blockers. Am J Hypertens 2000; 13 (1 Pt 2): 18S–24S.
8. Edwards RM, Aiyar N, Ohlstein EH et al. Pharmacological characterization of the nonpeptide angiotensin II receptor antagonist, SK&F 108566. J Pharmacol Exp Ther 1992; 260: 175–81.
9. Israili ZH. Clinical pharmacokinetics of angiotensin II (AT1) receptor blockers in hypertension. J Hum Hypertens 2000; 14 (Suppl. 1): S73–86.
10. Puig JG et al. Effect of eprosartan and losartan on uric acid metabolism in patients with essential hypertension. J Hypertens 1999; 17: 1033–9.
11. Wurzner C et al. Comparative effects of losartan and ibresartan on serum uric acid in hypertensive patients with hyperuricaemia and gout. J Hypertens 2001; 19: 1855–60.
12. Pitt B et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE). Lancet 1997; 349: 747–52.
13. Brenner BM, Cooper ME, de Zeeuw D et al. The losartan renal protection study – rationale, study design and baseline characteristics of RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan). N Engl J Med 2001; 345: 861–9.
14. Julius S, Kjeldsen SE et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE. Lancet 2004; 363: 2022–31.
15. Granger CB, McMurray JJV et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial Lancet 2003; 362: 772–6.
16. Warner GT, Jarvis B. Olmesartan medoxomil. Drugs 2002; 62 (9): 1345–53; discussion 1354–6.
17. Von Bergmann K, Laeis P, Püchler K et al. Olmesartan medoxomil: influence of age, renal and hepatic function on the pharmacokinetics of olmesartan medoxomil. J Hypertens 2001; 19 (Suppl. 1): S33–S40.
18. Püchler К, Laeis Р, Witte PU, Brunner HR. Blood pressure and endocrine effects of single doses of CS-866, a novel angiotesin II antagonist, in salt-restricted hypertensive patients. J Hypertens 1997; 15 (2): 1809–12.
19. Püchler К, Laeis Р, Stumpe КО. Blood pressure response, but not adverse event incidence, correlates with dose of angiotensin II antagonist. J Hypertens 2001; 19 (Suppl. 1): 41–8.
20. Van Mieghem W. A multi-centre, double-blind, efficacy, tolerability and safety study of the oral angiotensin II-antagonist olmesartan medoxomil versus atenolol in patients with mild to moderate essential hypertension (Abstract). J Hypertens 2001; 19 (Suppl. 1): S152.
21. Ball KJ, Williams PA, Stumpe KO. Relative efficacy of an angiotensin II antagonist compared with other antihypertensive agents: olmesartan medoxomil versus antihypertensives. J Hypertens 2001; 19 (Suppl. 1): S49–S56.
22. Chrysant SG, Marbury T. The antihypertensive efficacy and safety of olmesartan medoxomil compared with amlodipine for mild-tomoderate hypertension. Am J Hypertens 2002; 15: A57 (Abstract).
23. David HG, Smith. Strategies to Meet Lower Blood Pressure Goals With a New Standard in Angiotensin II Receptor Blockade. Am J Hypertens 2002; 15: 108–14.
24. Brunner HR, Laeise Р. Сlinical efficacy of olmesartan medoxomil. J Hypertens 2003; 21 (2): 43–6.
25. David HG, Smith, Dubiel R, Jones M. Use of 24-hour ambulatory plod pressure monitoring to assess antihypertensive efficacy. A comparison of olmesartan medoxomil, losartan potassium, valsartan and irbesartan. Am J Cardiovasc Drugs 2005; 5 (1): 41–50.
26. Brunner HR, Arakawa К. Antihypertensive efficacy of olmesartan medoxomil and candesartan cilexetil in achieving 24-hour blood pressure reductions and ambulatory blood pressure goals. Clin Drug Invest 2006; 26 (4): 185–93.
27. Ritz E, Viberti GC, Ruilope LM et al. Determinants of urinary albumin excretion within the normal range in patients with type 2 diabetes: the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) study. Diabetologia 2010; 53 (1): 49–57.
28. 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.
29. Arao T, Okada Y, Mori H et al. Antihypertensive and methabolic effects of high-dose olmesartan and telmisartan in type 2 diabetes patients with hypertension. Endocr J 2013.
30. Hirohata A, Yamamoto K, Miyoshi T et al. Impact of olmesartan on progression of coronary atherosclerosis a serial volumetric intravascular ultrasound analysis from the OLIVUS (impact of OLmesartan on progression of coronary atherosclerosis: evaluation by intravascular ultrasound) trial. J Am Coll Cardiol 2010; 55 (10): 976–82.
31. Scholze JR, Schaefer A, Kreutz R. Safety and efficacy of olmesartan: an observational pooled-analysis of 156 682 hypertensive patients. Expert Opin Drug Saf 2011.
________________________________________________
1. Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens 2009; 27: 963–75.
2. Britton KA, Gaziano JM, Djousse L. Normal systolic blood pressure and risk of heart failure in US male physicians. Eur J Heart Fail 2009; 11: 1129–34.
3. Redon J, Olsen MH, Cooper RS et al. Stroke mortality trends from 1990 to 2006 in 39 countries from Europe and Central Asia: implications for control of high blood pressure. Eur Heart J 2011; 32: 1424–31.
4. 2013 ESH/ESC 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 2013; 31 (7): 1281–357.
5. Диагностика и лечение артериальной гипертонии. Клин. рекомендации Минздрава РФ, 2013; http://cardioweb.ru/klinicheskie-rekomendatsii
6. Haralambos P, Gavras, Salernob CM. The angiotensin II Type 1 receptor blocker losartan in clinical practice: a review. Clin Ther 1996; 18 (6): 1058–67.
7. Oparil S. Newly emerging pharmacologic differences in angiotensin II receptor blockers. Am J Hypertens 2000; 13 (1 Pt 2): 18S–24S.
8. Edwards RM, Aiyar N, Ohlstein EH et al. Pharmacological characterization of the nonpeptide angiotensin II receptor antagonist, SK&F 108566. J Pharmacol Exp Ther 1992; 260: 175–81.
9. Israili ZH. Clinical pharmacokinetics of angiotensin II (AT1) receptor blockers in hypertension. J Hum Hypertens 2000; 14 (Suppl. 1): S73–86.
10. Puig JG et al. Effect of eprosartan and losartan on uric acid metabolism in patients with essential hypertension. J Hypertens 1999; 17: 1033–9.
11. Wurzner C et al. Comparative effects of losartan and ibresartan on serum uric acid in hypertensive patients with hyperuricaemia and gout. J Hypertens 2001; 19: 1855–60.
12. Pitt B et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE). Lancet 1997; 349: 747–52.
13. Brenner BM, Cooper ME, de Zeeuw D et al. The losartan renal protection study – rationale, study design and baseline characteristics of RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan). N Engl J Med 2001; 345: 861–9.
14. Julius S, Kjeldsen SE et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE. Lancet 2004; 363: 2022–31.
15. Granger CB, McMurray JJV et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial Lancet 2003; 362: 772–6.
16. Warner GT, Jarvis B. Olmesartan medoxomil. Drugs 2002; 62 (9): 1345–53; discussion 1354–6.
17. Von Bergmann K, Laeis P, Püchler K et al. Olmesartan medoxomil: influence of age, renal and hepatic function on the pharmacokinetics of olmesartan medoxomil. J Hypertens 2001; 19 (Suppl. 1): S33–S40.
18. Püchler К, Laeis Р, Witte PU, Brunner HR. Blood pressure and endocrine effects of single doses of CS-866, a novel angiotesin II antagonist, in salt-restricted hypertensive patients. J Hypertens 1997; 15 (2): 1809–12.
19. Püchler К, Laeis Р, Stumpe КО. Blood pressure response, but not adverse event incidence, correlates with dose of angiotensin II antagonist. J Hypertens 2001; 19 (Suppl. 1): 41–8.
20. Van Mieghem W. A multi-centre, double-blind, efficacy, tolerability and safety study of the oral angiotensin II-antagonist olmesartan medoxomil versus atenolol in patients with mild to moderate essential hypertension (Abstract). J Hypertens 2001; 19 (Suppl. 1): S152.
21. Ball KJ, Williams PA, Stumpe KO. Relative efficacy of an angiotensin II antagonist compared with other antihypertensive agents: olmesartan medoxomil versus antihypertensives. J Hypertens 2001; 19 (Suppl. 1): S49–S56.
22. Chrysant SG, Marbury T. The antihypertensive efficacy and safety of olmesartan medoxomil compared with amlodipine for mild-tomoderate hypertension. Am J Hypertens 2002; 15: A57 (Abstract).
23. David HG, Smith. Strategies to Meet Lower Blood Pressure Goals With a New Standard in Angiotensin II Receptor Blockade. Am J Hypertens 2002; 15: 108–14.
24. Brunner HR, Laeise Р. Сlinical efficacy of olmesartan medoxomil. J Hypertens 2003; 21 (2): 43–6.
25. David HG, Smith, Dubiel R, Jones M. Use of 24-hour ambulatory plod pressure monitoring to assess antihypertensive efficacy. A comparison of olmesartan medoxomil, losartan potassium, valsartan and irbesartan. Am J Cardiovasc Drugs 2005; 5 (1): 41–50.
26. Brunner HR, Arakawa К. Antihypertensive efficacy of olmesartan medoxomil and candesartan cilexetil in achieving 24-hour blood pressure reductions and ambulatory blood pressure goals. Clin Drug Invest 2006; 26 (4): 185–93.
27. Ritz E, Viberti GC, Ruilope LM et al. Determinants of urinary albumin excretion within the normal range in patients with type 2 diabetes: the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) study. Diabetologia 2010; 53 (1): 49–57.
28. 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.
29. Arao T, Okada Y, Mori H et al. Antihypertensive and methabolic effects of high-dose olmesartan and telmisartan in type 2 diabetes patients with hypertension. Endocr J 2013.
30. Hirohata A, Yamamoto K, Miyoshi T et al. Impact of olmesartan on progression of coronary atherosclerosis a serial volumetric intravascular ultrasound analysis from the OLIVUS (impact of OLmesartan on progression of coronary atherosclerosis: evaluation by intravascular ultrasound) trial. J Am Coll Cardiol 2010; 55 (10): 976–82.
31. Scholze JR, Schaefer A, Kreutz R. Safety and efficacy of olmesartan: an observational pooled-analysis of 156 682 hypertensive patients. Expert Opin Drug Saf 2011.
Авторы
Т.Е.Морозова*, Т.Б.Андрущишина, С.В.Гонтаренко
ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России
*temorozova@gmail.com