Сложный пациент: особенности антигипертензивной терапии у больного сахарным диабетом и хронической болезнью почек
Сложный пациент: особенности антигипертензивной терапии у больного сахарным диабетом и хронической болезнью почек
Сложный пациент: особенности антигипертензивной терапии у больного сахарным диабетом и хронической болезнью почек. Справочник поликлинического врача. 2018; 5: 41–45.
________________________________________________
Difficult patient: features of antihypertensive therapy in a patient with diabetes mellitus and chronic kidney disease. Handbook for Practitioners Doctors. 2018; 5: 41–45.
Сложный пациент: особенности антигипертензивной терапии у больного сахарным диабетом и хронической болезнью почек
Сложный пациент: особенности антигипертензивной терапии у больного сахарным диабетом и хронической болезнью почек. Справочник поликлинического врача. 2018; 5: 41–45.
________________________________________________
Difficult patient: features of antihypertensive therapy in a patient with diabetes mellitus and chronic kidney disease. Handbook for Practitioners Doctors. 2018; 5: 41–45.
Артериальная гипертензия (АГ) – одно из наиболее распространенных и социально значимых заболеваний, важнейший фактор риска, определяющий прогноз заболеваемости и смертности от сердечно-сосудистых заболеваний (ССЗ). АГ редко возникает изолированно, она ассоциируется с другими факторами риска ССЗ, такими как сахарный диабет (СД) и метаболический синдром (МС). Этой комбинации свойственно взаимоусиливающее повреждающее действие, направленное на органы-мишени: сердце, головной мозг, почки, сосуды. Лечение больного, имеющего такой букет заболеваний, представляет собой трудную задачу. О том, какое решение предлагают европейские рекомендации 2018 г., мы беседуем с доктором медицинских наук, профессором Ольгой Дмитриевной Остроумовой.
1. NCD Risk Factor Collaboration. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet 2017; 389 (10064): 37–55. DOI: 10.1016/S0140-6736(16)31919-5
2. Общероссийская общественная организация Ассоциация врачей общей практики (семейных врачей). Секция «Сочетанные патологии». Коморбидная патология в клинической практике. Клинические рекомендации. Кардиоваскулярная терапия и профилактика. 2017; 16 (6): 5–56. DOI: 10.15829/1728-8800-2017-6 / Obshcherossiiskaia obshchestvennaia organizatsiia Assotsiatsiia vrachei obshchei praktiki (semeinykh vrachei). Sektsiia "Sochetannye patologii". Komorbidnaia patologiia v klinicheskoi praktike. Klinicheskie rekomendatsii. Kardiovaskuliarnaia terapiia i profilaktika. 2017; 16 (6): 5–56. DOI: 10.15829/1728-8800-2017-6 [in Russian]
3. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; p. 1–98. DOI: 10.1093/eurheartj/ehy339
4. Samson SL, Garber AJ. Metabolic syndrome. Endocrinology Metabolism Clin North Am 2014; 43 (1): 1–23. PMID: 24582089.
5. Nwaneri C, Cooper H, Bowen-Jones D. Mortality in type 2 diabetes mellitus: magnitude of the evidence from a systematic review and meta-analysis. Br J Diabe Vasc Dis 2013; 4 (13): 192–207. DOI: 10.1177/1474651413495703
6. Sarwar N, Gao P, Seshasai SR et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 2010; 375: 2215–22. DOI: 10.1016/S0140-6736(10)60484-9
7. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. JAMA 1979; 241: 2035–8.
8. Haffner SM, Lehto S, Ronnemaa T. Mortality from coronary artery disease in subject with type 2 diabetes and nondiabetic subjects with and without myocardial infarction. New Engl J Med 1998; 339: 229–34. DOI: 10.1056/NEJM199807233390404
9. UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53. DOI: 10.1016/S0140-6736(98)07019-6
10. Блокаторы кальциевых каналов: описание фармакологической группы в Энциклопедии РЛС. Регистр лекарственных средств России, РЛС. https://www.rlsnet.ru/fg_index_id_215.htm / Blokatory kal'tsievykh kanalov: opisanie farmakologicheskoi gruppy v Entsiklopedii RLS. Registr lekarstvennykh sredstv Rossii, RLS. https://www.rlsnet.ru/fg_index_id_215.htm [in Russian]
11. Fagard RH, Staessen JA. Treatment of isolated systolic hypertension in the elderly: the Syst-Eur trial. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Clin Experiment Hypertens 1999; 21(5–6): 491–7. PMID: 10423075.
12. Wang JG, Staessen JA, Gong L, Liu L. Chinese trial on isolated systolic hypertension in the elderly. Systolic Hypertension in China (Syst-China) Collaborative Group. Arch Int Med 2000; 160 (2): 211–20. PMID: 10647760.
13. Tuomilehto J, Rastenyte D, Birkenhager WH et al. Effects of calcium channel blockers in older patients with diabetes and systolic hypertension. New Engl J Med 1999; 340 (9): 677–84.
14. Farský Š, Strišková A, Borčin M. Hypertension Treatment in Patients with Metabolic Syndrome and/or Type 2 Diabetes Mellitus: Analysis of the Therapy Effectivity and the Therapeutic Inertia in Outpatient Study. Cardiol Res Pract 2018; 2018 (1): 8387613. DOI: 10.1155/2018/8387613
15. Rohr G, Reimnitz P, Blanke P. Treatment of hypertensive emergency. Comparison of a new dosage form of the calcium antagonist nitrendipine with nifedipine capsules. Intensive Care Med 1994; 20 (4): 268–71. PMID: 8046120.
16. Mancini M, Marotta T, Ferrara LA. Metabolic neutrality in nitrendipine therapy. J Cardiovasc Pharmacol Ther 1991;18 (1): 3–30.
17. Ferrara LA, Marotta T. Nitrendipine and metabolic balance. J Cardiovasc Pharmacol Ther 1991; 18 (5): 19–21.
18. Grandinetti O, Feraco E. Middle term evaluation of amlodipine vs. nitrendipine: efficacy, safety and metabolic effects in elderly hypertensive patients. Clin Experiment Hypertens 1993; 15 (1): 197–210. PMID: 8513310.
19. Roush GC, Ernst ME, Kostis JB et al. Head-to-Head Comparisons of Hydrochlorothiazide With Indapamide and Chlorthalidone: Antihypertensive and Metabolic Effects. Hypertension 2015; 65 (5): 1041–6. DOI:10.1161/hypertensionaha.114.05021
20. Voyaki SM, Staessen JA, Thijs L et al. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Follow-up of renal function in treated and untreated older patients with isolated systolic hypertension. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. J Hypertens 2001; 19 (3): 509–11. PMID: 11288822.
21. Bretzel RG, Bollen CC, Maeser E, Federlin KF. Nephroprotective effects of nitrendipine in hypertensive type I and type II diabetic patients. Am J Kidney Dis 1993; 21 (3): 53–64. PMID: 8503436.
22. Kopf D, Schmitz H, Beyer J et al. A double-blind trial of perindopril and nitrendipine in incipient diabetic nephropathy. Diabet Nutr Metab 2001; 14 (5): 245–52. PMID: 11806464.
23. Van Bortel L, Böhm R, Mooy J et al. Pharmacokinetics of nitrendipine in terminal renal failure. Eur J Clin Pharmacol 1989; 36 (5): 467–71. PMID: 2753064.
24. Aronoff GR. Pharmacokinetics of nitrendipine in patients with renal failure: comparison to normal subjects. J Cardiovasc Pharmacol Ther 1984; 6 (7): 974–6. PMID: 6085387.
25. Marre M, Garcia Puig J, Kokot F et al. Effect of indapamide SR on microalbuminuria--the NESTOR study (Natrilix SR versus Enalapril Study in Type 2 diabetic hypertensives with micrOalbuminuRia) – rationale and protocol for the main trial. J Hypertens 2003; 21 (1): 19–24. PMID: 12769163.
26. Марцевич С.Ю., Суханов Я.В., Белолипецкая В.Г., Кутишенко Н.П. Исследование биоэквивалентности как способ доказательства идентичности оригинального препарата и препарата-дженерика. Рос. кардиол. журн. 2005; 2 (52): 76–8. DOI: 10.15829/1560-4071-2005-2-76-78 / Martsevich S.Iu., Sukhanov Ia.V., Belolipetskaia V.G., Kutishenko N.P. Issledovanie bioekvivalentnosti kak sposob dokazatel'stva identichnosti original'nogo preparata i preparata-dzhenerika. Ros. kardiol. zhurn. 2005; 2 (52): 76–8. DOI: 10.15829/1560-4071-2005-2-76-78 [in Russian]
27. Марцевич С.Ю., Кутишенко Н.П., Деев А.Д., Якусевич В.В. Изучение эффективности и переносимости препарата Индап в сравнении с препаратами Арифон и Арифон ретард у больных мягкой и умеренной артериальной гипертонией, назначаемых как в виде монотерапии, так и в комбинации с ингибиторами АПФ. Многоцентровое, открытое, рандомизированное перекрестное исследование. Рос. кардиол. журн. 2006; 2: 73–7. DOI: 10.15829/1560-4071-2006-2-73-77 / Martsevich S.Iu., Kutishenko N.P., Deev A.D., Iakusevich V.V. Izuchenie effektivnosti i perenosimosti preparata Indap v sravnenii s preparatami Arifon i Arifon retard u bol'nykh miagkoi i umerennoi arterial'noi gipertoniei, naznachaemykh kak v vide monoterapii, tak i v kombinatsii s ingibitorami APF. Mnogotsentrovoe, otkrytoe, randomizirovannoe perekrestnoe issledovanie. Ros. kardiol. zhurn. 2006; 2: 73–7. DOI: 10.15829/1560-4071-2006-2-73-77 [in Russian]
________________________________________________
1. NCD Risk Factor Collaboration. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet 2017; 389 (10064): 37–55. DOI: 10.1016/S0140-6736(16)31919-5
2. Obshcherossiiskaia obshchestvennaia organizatsiia Assotsiatsiia vrachei obshchei praktiki (semeinykh vrachei). Sektsiia "Sochetannye patologii". Komorbidnaia patologiia v klinicheskoi praktike. Klinicheskie rekomendatsii. Kardiovaskuliarnaia terapiia i profilaktika. 2017; 16 (6): 5–56. DOI: 10.15829/1728-8800-2017-6 [in Russian]
3. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; p. 1–98. DOI: 10.1093/eurheartj/ehy339
4. Samson SL, Garber AJ. Metabolic syndrome. Endocrinology Metabolism Clin North Am 2014; 43 (1): 1–23. PMID: 24582089.
5. Nwaneri C, Cooper H, Bowen-Jones D. Mortality in type 2 diabetes mellitus: magnitude of the evidence from a systematic review and meta-analysis. Br J Diabe Vasc Dis 2013; 4 (13): 192–207. DOI: 10.1177/1474651413495703
6. Sarwar N, Gao P, Seshasai SR et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 2010; 375: 2215–22. DOI: 10.1016/S0140-6736(10)60484-9
7. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. JAMA 1979; 241: 2035–8.
8. Haffner SM, Lehto S, Ronnemaa T. Mortality from coronary artery disease in subject with type 2 diabetes and nondiabetic subjects with and without myocardial infarction. New Engl J Med 1998; 339: 229–34. DOI: 10.1056/NEJM199807233390404
9. UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53. DOI: 10.1016/S0140-6736(98)07019-6
10. Blokatory kal'tsievykh kanalov: opisanie farmakologicheskoi gruppy v Entsiklopedii RLS. Registr lekarstvennykh sredstv Rossii, RLS. https://www.rlsnet.ru/fg_index_id_215.htm [in Russian]
11. Fagard RH, Staessen JA. Treatment of isolated systolic hypertension in the elderly: the Syst-Eur trial. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Clin Experiment Hypertens 1999; 21(5–6): 491–7. PMID: 10423075.
12. Wang JG, Staessen JA, Gong L, Liu L. Chinese trial on isolated systolic hypertension in the elderly. Systolic Hypertension in China (Syst-China) Collaborative Group. Arch Int Med 2000; 160 (2): 211–20. PMID: 10647760.
13. Tuomilehto J, Rastenyte D, Birkenhager WH et al. Effects of calcium channel blockers in older patients with diabetes and systolic hypertension. New Engl J Med 1999; 340 (9): 677–84.
14. Farský Š, Strišková A, Borčin M. Hypertension Treatment in Patients with Metabolic Syndrome and/or Type 2 Diabetes Mellitus: Analysis of the Therapy Effectivity and the Therapeutic Inertia in Outpatient Study. Cardiol Res Pract 2018; 2018 (1): 8387613. DOI: 10.1155/2018/8387613
15. Rohr G, Reimnitz P, Blanke P. Treatment of hypertensive emergency. Comparison of a new dosage form of the calcium antagonist nitrendipine with nifedipine capsules. Intensive Care Med 1994; 20 (4): 268–71. PMID: 8046120.
16. Mancini M, Marotta T, Ferrara LA. Metabolic neutrality in nitrendipine therapy. J Cardiovasc Pharmacol Ther 1991;18 (1): 3–30.
17. Ferrara LA, Marotta T. Nitrendipine and metabolic balance. J Cardiovasc Pharmacol Ther 1991; 18 (5): 19–21.
18. Grandinetti O, Feraco E. Middle term evaluation of amlodipine vs. nitrendipine: efficacy, safety and metabolic effects in elderly hypertensive patients. Clin Experiment Hypertens 1993; 15 (1): 197–210. PMID: 8513310.
19. Roush GC, Ernst ME, Kostis JB et al. Head-to-Head Comparisons of Hydrochlorothiazide With Indapamide and Chlorthalidone: Antihypertensive and Metabolic Effects. Hypertension 2015; 65 (5): 1041–6. DOI:10.1161/hypertensionaha.114.05021
20. Voyaki SM, Staessen JA, Thijs L et al. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Follow-up of renal function in treated and untreated older patients with isolated systolic hypertension. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. J Hypertens 2001; 19 (3): 509–11. PMID: 11288822.
21. Bretzel RG, Bollen CC, Maeser E, Federlin KF. Nephroprotective effects of nitrendipine in hypertensive type I and type II diabetic patients. Am J Kidney Dis 1993; 21 (3): 53–64. PMID: 8503436.
22. Kopf D, Schmitz H, Beyer J et al. A double-blind trial of perindopril and nitrendipine in incipient diabetic nephropathy. Diabet Nutr Metab 2001; 14 (5): 245–52. PMID: 11806464.
23. Van Bortel L, Böhm R, Mooy J et al. Pharmacokinetics of nitrendipine in terminal renal failure. Eur J Clin Pharmacol 1989; 36 (5): 467–71. PMID: 2753064.
24. Aronoff GR. Pharmacokinetics of nitrendipine in patients with renal failure: comparison to normal subjects. J Cardiovasc Pharmacol Ther 1984; 6 (7): 974–6. PMID: 6085387.
25. Marre M, Garcia Puig J, Kokot F et al. Effect of indapamide SR on microalbuminuria--the NESTOR study (Natrilix SR versus Enalapril Study in Type 2 diabetic hypertensives with micrOalbuminuRia) – rationale and protocol for the main trial. J Hypertens 2003; 21 (1): 19–24. PMID: 12769163.
26. Martsevich S.Iu., Sukhanov Ia.V., Belolipetskaia V.G., Kutishenko N.P. Issledovanie bioekvivalentnosti kak sposob dokazatel'stva identichnosti original'nogo preparata i preparata-dzhenerika. Ros. kardiol. zhurn. 2005; 2 (52): 76–8. DOI: 10.15829/1560-4071-2005-2-76-78 [in Russian]
27. Martsevich S.Iu., Kutishenko N.P., Deev A.D., Iakusevich V.V. Izuchenie effektivnosti i perenosimosti preparata Indap v sravnenii s preparatami Arifon i Arifon retard u bol'nykh miagkoi i umerennoi arterial'noi gipertoniei, naznachaemykh kak v vide monoterapii, tak i v kombinatsii s ingibitorami APF. Mnogotsentrovoe, otkrytoe, randomizirovannoe perekrestnoe issledovanie. Ros. kardiol. zhurn. 2006; 2: 73–7. DOI: 10.15829/1560-4071-2006-2-73-77 [in Russian]
Авторы
Ольга Дмитриевна Остроумова – д-р мед. наук, проф. каф. факультетской терапии и профболезней ФГБОУ ВО «МГМСУ им. А.И.Евдокимова», зав. лаб. клинической фармакологии и фармакотерапии обособленного структурного подразделения ФГБОУ ВО «РНИМУ им. Н.И.Пирогова» «Российский геронтологический научно-клинический центр»