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Эффективность и безопасность применения фиксированной комбинации азилсартана медоксомила с хлорталидоном у больных сахарным диабетом
Эффективность и безопасность применения фиксированной комбинации азилсартана медоксомила с хлорталидоном у больных сахарным диабетом
Жернакова Ю.В., Чазова И.Е. Эффективность и безопасность применения фиксированной комбинации азилсартана медоксомила с хлорталидоном у больных сахарным диабетом. Системные гипертензии. 2020; 17 (4): 68–73. DOI: 10.26442/2075082X.2020.4.200556
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Аннотация
Все последние международные и национальные рекомендации, регламентирующие лечение больных артериальной гипертонией, предлагают унифицированный подход к назначению антигипертензивной терапии. Абсолютному большинству пациентов, к которым относятся и больные сахарным диабетом, показаны комбинированные лекарственные средства. В качестве препаратов первого ряда рекомендуются средства, воздействующие на ренин-ангиотензиновую систему, блокаторы кальциевых каналов или диуретики. Требования, предъявляемые к диуретикам для применения у этой категории пациентов, особенно жесткие. При необходимости использования у больных сахарным диабетом в составе антигипертензивной терапии мочегонного предпочтение должно отдаваться тиазидоподобным диуретикам. Всем этим требованиям соответствует комбинированный препарат Эдарби® Кло, представляющий собой фиксированную комбинацию блокатора рецепторов ангиотензина азилсартана медоксомила и тиазидоподобного диуретика хлорталидона. Наряду с выраженным антигипертензивным эффектом Эдарби® Кло оказывает положительное влияние на метаболические показатели, параметры воспаления и предотвращает поражение органов-мишеней, что позволяет рекомендовать его как средство выбора у данной категории больных.
Ключевые слова: метаболический синдром, артериальная гипертония, комбинированные препараты, органы-мишени.
Key words: metabolic syndrome, arterial hypertension, combined drugs, target organs.
Ключевые слова: метаболический синдром, артериальная гипертония, комбинированные препараты, органы-мишени.
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Key words: metabolic syndrome, arterial hypertension, combined drugs, target organs.
Полный текст
Список литературы
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14. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and LipidLowering Treatment to Prevent Heart Attack Trial. JAMA 2002; 288 (23): 2981.
15. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991; 265 (24): 3255.
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17. Whelton PK, Carey RM, Aronow WS et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/
ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71: e13–e115.
18. Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension 2010; 55: 399–407.
19. Bakris G et al. Comparative efficacy and safety of chlorthalidone and hydrochlorothiazide – meta-analysis. Am J Med 2012; 125: 1229.e1‒1229.e10.
20. Чазова И.Е., Жернакова Ю.В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии. 2019; 16 (1): 6–31.
[Chazova I.E., Zhernakova J.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019; 16 (1): 6–31 (in Russian).]
2. De Buyzere ML, Clement DL. Management of hypertension in peripheral arterial disease. Prog Cardiovasc Dis 2008; 50: 238–63.
3. Lewington S, Clarke R, Qizilbash N et al. Age-specific relevance of usual blood pressure to vascular mortality: a met analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–13.
4. Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 – Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials. J Hypertens 2017; 35: 922–44.
5. Perkovic V, Verdon C, Ninomiya T et al. The relationship between proteinuria and coronary risk: a systematic review and meta-analysis. PLoS Med 2008; 5 (10): e207.
6. Gaede P, Vedel P, Parving HH, Pedersen O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study. Lancet 1999; 353: 617–22.
7. Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122: 290–300.
8. MacDonald TM, Williams B, Webb DJ et al., British Hypertension Society Programme of Prevention And Treatment of Hypertension With Algorithm-based Therapy (PATHWAY). Combination therapy is superior to sequential monotherapy for the initial treatment of hypertension: a double-blind randomized controlled trial. J Am Heart Assoc 2017; 6: e006986.
9. Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment in hypertension: 9. Discontinuations for adverse events attributed to different classes of antihypertensive drugs: meta-analyses of randomized trials. J Hypertens 2016; 34: 1921–32.
10. Yusuf S, Lonn E, Pais P et al., HOPE-3 Investigators. Blood-pressure and cholesterol lowering in persons without cardiovascular disease. N Engl J Med 2016; 374: 2032–43.
11. Corrao G, Zambon A, Parodi A et al. Discontinuation of and changes in drug therapy for hypertension among newly-treated patients: a population-based study in Italy. J Hypertens 2008; 26: 819–24.
12. Carter BL, Ernst ME, Cohen JD. Hydrochlorothiazide versus Chlorthalidone: evidence supporting their interchangeability. Hypertension 2004; 43: 4–9.
13. Musini V, Nazer M, Bassett K et al. Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. Cochrane Database Syst Rev 2014 May 29; 5.
14. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and LipidLowering Treatment to Prevent Heart Attack Trial. JAMA 2002; 288 (23): 2981.
15. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991; 265 (24): 3255.
16. Williams B et al. Newcastle Guideline Development and Research Unit. http://www.nice.org.uk/guidance/CG127
17. Whelton PK, Carey RM, Aronow WS et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/
ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71: e13–e115.
18. Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension 2010; 55: 399–407.
19. Bakris G et al. Comparative efficacy and safety of chlorthalidone and hydrochlorothiazide – meta-analysis. Am J Med 2012; 125: 1229.e1‒1229.e10.
20. Chazova I.E., Zhernakova J.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019; 16 (1): 6–31 (in Russian).
[Boitsov S.A., Balanova Iu.A., Shal'nova S.A. et al. Arterial'naia gipertoniia sredi lits 25–64 let: rasprostranennost', osvedomlennost', lechenie i kontrol'. Po materialam issledovaniia ESSE. Kardiovaskuliarnaia terapiia i profilaktika. 2014; 14 (4): 4–14 (in Russian).]
2. De Buyzere ML, Clement DL. Management of hypertension in peripheral arterial disease. Prog Cardiovasc Dis 2008; 50: 238–63.
3. Lewington S, Clarke R, Qizilbash N et al. Age-specific relevance of usual blood pressure to vascular mortality: a met analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–13.
4. Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 – Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials. J Hypertens 2017; 35: 922–44.
5. Perkovic V, Verdon C, Ninomiya T et al. The relationship between proteinuria and coronary risk: a systematic review and meta-analysis. PLoS Med 2008; 5 (10): e207.
6. Gaede P, Vedel P, Parving HH, Pedersen O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study. Lancet 1999; 353: 617–22.
7. Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122: 290–300.
8. MacDonald TM, Williams B, Webb DJ et al., British Hypertension Society Programme of Prevention And Treatment of Hypertension With Algorithm-based Therapy (PATHWAY). Combination therapy is superior to sequential monotherapy for the initial treatment of hypertension: a double-blind randomized controlled trial. J Am Heart Assoc 2017; 6: e006986.
9. Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment in hypertension: 9. Discontinuations for adverse events attributed to different classes of antihypertensive drugs: meta-analyses of randomized trials. J Hypertens 2016; 34: 1921–32.
10. Yusuf S, Lonn E, Pais P et al., HOPE-3 Investigators. Blood-pressure and cholesterol lowering in persons without cardiovascular disease. N Engl J Med 2016; 374: 2032–43.
11. Corrao G, Zambon A, Parodi A et al. Discontinuation of and changes in drug therapy for hypertension among newly-treated patients: a population-based study in Italy. J Hypertens 2008; 26: 819–24.
12. Carter BL, Ernst ME, Cohen JD. Hydrochlorothiazide versus Chlorthalidone: evidence supporting their interchangeability. Hypertension 2004; 43: 4–9.
13. Musini V, Nazer M, Bassett K et al. Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. Cochrane Database Syst Rev 2014 May 29; 5.
14. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and LipidLowering Treatment to Prevent Heart Attack Trial. JAMA 2002; 288 (23): 2981.
15. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991; 265 (24): 3255.
16. Williams B et al. Newcastle Guideline Development and Research Unit. http://www.nice.org.uk/guidance/CG127
17. Whelton PK, Carey RM, Aronow WS et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/
ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71: e13–e115.
18. Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension 2010; 55: 399–407.
19. Bakris G et al. Comparative efficacy and safety of chlorthalidone and hydrochlorothiazide – meta-analysis. Am J Med 2012; 125: 1229.e1‒1229.e10.
20. Чазова И.Е., Жернакова Ю.В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии. 2019; 16 (1): 6–31.
[Chazova I.E., Zhernakova J.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019; 16 (1): 6–31 (in Russian).]
________________________________________________
2. De Buyzere ML, Clement DL. Management of hypertension in peripheral arterial disease. Prog Cardiovasc Dis 2008; 50: 238–63.
3. Lewington S, Clarke R, Qizilbash N et al. Age-specific relevance of usual blood pressure to vascular mortality: a met analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–13.
4. Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 – Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials. J Hypertens 2017; 35: 922–44.
5. Perkovic V, Verdon C, Ninomiya T et al. The relationship between proteinuria and coronary risk: a systematic review and meta-analysis. PLoS Med 2008; 5 (10): e207.
6. Gaede P, Vedel P, Parving HH, Pedersen O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study. Lancet 1999; 353: 617–22.
7. Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122: 290–300.
8. MacDonald TM, Williams B, Webb DJ et al., British Hypertension Society Programme of Prevention And Treatment of Hypertension With Algorithm-based Therapy (PATHWAY). Combination therapy is superior to sequential monotherapy for the initial treatment of hypertension: a double-blind randomized controlled trial. J Am Heart Assoc 2017; 6: e006986.
9. Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment in hypertension: 9. Discontinuations for adverse events attributed to different classes of antihypertensive drugs: meta-analyses of randomized trials. J Hypertens 2016; 34: 1921–32.
10. Yusuf S, Lonn E, Pais P et al., HOPE-3 Investigators. Blood-pressure and cholesterol lowering in persons without cardiovascular disease. N Engl J Med 2016; 374: 2032–43.
11. Corrao G, Zambon A, Parodi A et al. Discontinuation of and changes in drug therapy for hypertension among newly-treated patients: a population-based study in Italy. J Hypertens 2008; 26: 819–24.
12. Carter BL, Ernst ME, Cohen JD. Hydrochlorothiazide versus Chlorthalidone: evidence supporting their interchangeability. Hypertension 2004; 43: 4–9.
13. Musini V, Nazer M, Bassett K et al. Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. Cochrane Database Syst Rev 2014 May 29; 5.
14. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and LipidLowering Treatment to Prevent Heart Attack Trial. JAMA 2002; 288 (23): 2981.
15. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991; 265 (24): 3255.
16. Williams B et al. Newcastle Guideline Development and Research Unit. http://www.nice.org.uk/guidance/CG127
17. Whelton PK, Carey RM, Aronow WS et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/
ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71: e13–e115.
18. Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension 2010; 55: 399–407.
19. Bakris G et al. Comparative efficacy and safety of chlorthalidone and hydrochlorothiazide – meta-analysis. Am J Med 2012; 125: 1229.e1‒1229.e10.
20. Chazova I.E., Zhernakova J.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019; 16 (1): 6–31 (in Russian).
Авторы
Ю.В. Жернакова*1,2, И.Е. Чазова1
1 Институт клинической кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*juli001@mail.ru
1 Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
*juli001@mail.ru
1 Институт клинической кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*juli001@mail.ru
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1 Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
*juli001@mail.ru
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