«Новые» молекулы в составе рациональных комбинаций антигипертензивных препаратов: вопросы выбора

«Новые» молекулы в составе рациональных комбинаций антигипертензивных препаратов: вопросы выбора

Кисляк О.А., Червякова Ю.Б. «Новые» молекулы в составе рациональных комбинаций антигипертензивных препаратов: вопросы выбора. Системные гипертензии. 2015; 12 (4): 42–45.

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Kislyak O.A., Chervyakova Yu.B. «New» molecules composed of rational combinations of antihypertensive drugs: issues of choice. Systemic Hypertension. 2015; 12 (4): 42–45.

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Аннотация

В статье обсуждаются факторы, определяющие выбор антигипертензивных препаратов, в частности блокаторов рецепторов ангиотензина (БРА) и тиазидных диуретиков (ТД). Приводятся данные об особенностях 8-го сартана в линейке БРА азилсартана медоксомила, препарата Эдарби, его отличиях от других сартанов. Среди основных свойств Эдарби, которые могут определить его выбор для лечения пациентов с артериальной гипертензией, называются значительная прочность связывания данного БРА с АТ1-рецептором и длительность его действия, а также особые свойства, способствующие повышению чувствительности тканей к инсулину. Обсуждается целесообразность создания фиксированных комбинаций азилсартана медоксомина с ТД хлорталидоном, препарата Эдарби Кло.

Ключевые слова: артериальная гипертензия, блокаторы рецепторов ангиотензина, азилсартан медоксомил, тиазидные диуретики, хлорталидон.

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The article discusses the factors that determine the choice of antihypertensive drugs, especially blockers of receptors of angiotensin and thiazide diuretics. The data about the peculiarities of azilsartan medoxomil, it differs from other sartans. Among the main properties of azilsartan medoxomil, which may determine his choice for the treatment of patients with arterial hypertension, is called the significant strength of the binding of blockers of receptors of angiotensin to AT1 receptor and its duration of action, as well as special properties that improve tissue sensitivity to insulin. Discussed the feasibility of establishing fixed combinations azilsartan medoxomil with thiazide diuretics chlorthalidone.

Key words: arterial hypertension, angiotensin receptor blocker therapy, azilsartan medoxomil, thiazide diuretics, chlorthalidone.

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Список литературы

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13. Barrios V, Escobar С. Which thiazide to choose as add-on therapy for hypertension? Integrated Blood Pressure Control 2014; 7: 35–47.
14. Roush GC, Buddharaju V, Ernst ME, Holford TR. Chlorthalidone: Mechanisms of Action and Effect on Cardiovascular Events. Curr Hypertens Rep; 2013; 15: 514–21. doi 10.1007/s11906-013-0372–1.
15. SHEP Cooperative Research Group. Prevention of stroke by anti-hypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265 (24): 3255–64.
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17. The ALLHAT Officers and Coordinators 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.
18. Weber MA. The ALLHAT report: A case of information and misinformation. J Clin Hypertens 2003; 5: 9–13.
19. Clinicaltrials.gov. Efficacy and safety of azilsartan medoxomil co-administered with chlorthalidone in participants with essential hypertension. Study NCT00591773. http:// clinicaltrials.gov/ct2/show/NCT00591773?term=NCT00591773&rank=1. Accessed December 13, 2011.
20. Sica D, Bakris GL, White WB et al. Blood pressure-lowering efficacy of the fixed-dose combination of azilsartan medoxomil and chlorthalidone: a factorial study. J Clin Hypertens (Greenwich) 2012; 14: 284–92.
21. Cheng JWM. Azilsartan/chlorthalidone combination therapyfor blood pressure controlIntegrated Blood Pressure Control 2013: 6: 39–48.
22. Cushman WC et al. Hypertension 2012; 60: 310–8.
23. Bakris G et al. Am J Med 2012; 125: 1229. e1-1229.e10.

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1. Rossiiskoe meditsinskoe obshchestvo po arterial'noi gipertonii (RMOAG), Vserossiiskoe nauchnoe obshchestvo kardiologov (VNOK). Diagnostika i lechenie arterial'noi gipertenzii. Rossiiskie rekomendatsii (chetvertyi peresmotr). Sistemnye gipertenzii. 2010; 7 (3): 5–26. [in Russian]
2. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Journal of Hypertension. 2013; 31: 1281–357.
3. Diagnostika i lechenie arterial'noi gipertenzii. Klinicheskie rekomendatsii, razrabotannye po porucheniiu MZ RF. M., 2013. http://www.gipertonik.ru/clinical_recommendations [in Russian]
4. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 2009; 338: b1665.
5. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311 (5): 507–20. doi:10.1001/jama.2013.284427.
6. Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension 2010; 55 (2): 399–407.
7. Farsang C. Indications for and utilization of angiotensin receptor II blockers in patients at high cardiovascular risk. Vasc Health Risk Manag 2011; 7: 605–22.
8. Kajiya T, Ho C, Wang J et al. Molecular and cellular effects of azilsartan: a new generation angiotensin II receptor blocker. J Hypertens 2011; 29: 2476–83.
9. Takagi H, Mizuno Y, Niwa M et al for the ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. A meta-analysis of randomized controlled trials of azilsartan therapy for blood pressure reduction. Hypertension Research advance online publication, 10 October 2013; doi:10.1038/hr.2013.142
10. Bakris GL, Domenic Sica D, Weber M et al. The Comparative Effects of Azilsartan Medoxomil and Olmesartan on Ambulatoryand Clinic Blood Pressure. J Clin Hypertens 2011; 13 (2): 81–8.
11. Kobalava Zh.D., Villeval'de S.V.. Azilsartana medoksomil: novye vozmozhnosti v lechenii arterial'noi gipertonii. Farmakologicheskie svoistva. doi: http://dx.doi.org/10.18565/cardio.2014.12.57-62 [in Russian]
12. Ostroumova O.D. Azilsartan – novyi predstavitel' klassa blokatorov retseptorov k angiotenzinu II. doi: http://dx.doi.org/10.18565/cardio.2014.9.65-71 [in Russian]
13. Barrios V, Escobar С. Which thiazide to choose as add-on therapy for hypertension? Integrated Blood Pressure Control 2014; 7: 35–47.
14. Roush GC, Buddharaju V, Ernst ME, Holford TR. Chlorthalidone: Mechanisms of Action and Effect on Cardiovascular Events. Curr Hypertens Rep; 2013; 15: 514–21. doi 10.1007/s11906-013-0372–1.
15. SHEP Cooperative Research Group. Prevention of stroke by anti-hypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265 (24): 3255–64.
16. Wright JrJT, Probstfield JL, Cushman WC et al. ALLHAT findings revisited in the context of subsequent analyses, other trials, and meta-analyses. Arch Intern Med 2009; 169 (9): 832–42.
17. The ALLHAT Officers and Coordinators 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.
18. Weber MA. The ALLHAT report: A case of information and misinformation. J Clin Hypertens 2003; 5: 9–13.
19. Clinicaltrials.gov. Efficacy and safety of azilsartan medoxomil co-administered with chlorthalidone in participants with essential hypertension. Study NCT00591773. http:// clinicaltrials.gov/ct2/show/NCT00591773?term=NCT00591773&rank=1. Accessed December 13, 2011.
20. Sica D, Bakris GL, White WB et al. Blood pressure-lowering efficacy of the fixed-dose combination of azilsartan medoxomil and chlorthalidone: a factorial study. J Clin Hypertens (Greenwich) 2012; 14: 284–92.
21. Cheng JWM. Azilsartan/chlorthalidone combination therapyfor blood pressure controlIntegrated Blood Pressure Control 2013: 6: 39–48.
22. Cushman WC et al. Hypertension 2012; 60: 310–8.
23. Bakris G et al. Am J Med 2012; 125: 1229. e1-1229.e10.

Авторы

О.А.Кисляк*, Ю.Б.Червякова

ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*kisliakoa@mail.ru

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O.A.Kislyak*, Yu.B.Chervyakova

N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*kisliakoa@mail.ru

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