Zakiev VD, Kotovskaya YuV, Tkacheva ON. Sartans in the treatment of arterial hypertension: focus on telmisartan and azilsartan. A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(9):810–817.
DOI: 10.26442/00403660.2023.09.202423
Сартаны в лечении артериальной гипертензии: фокус на телмисартан и азилсартан
Закиев В.Д., Котовская Ю.В., Ткачева О.Н. Сартаны в лечении артериальной гипертензии: фокус на телмисартан и азилсартан. Терапевтический архив. 2023;95(9):810–817.
DOI: 10.26442/00403660.2023.09.202423
Zakiev VD, Kotovskaya YuV, Tkacheva ON. Sartans in the treatment of arterial hypertension: focus on telmisartan and azilsartan. A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(9):810–817.
DOI: 10.26442/00403660.2023.09.202423
Активность ренин-ангиотензин-альдостероновой системы является одним из основных патогенетических механизмов, лежащих в основе сердечно-сосудистых заболеваний на всех этапах сердечно-сосудистого континуума. В данной статье рассматривается роль телмисартана и азилсартана как самых сильных сартанов по своему антигипертензивному эффекту в современной кардиологической практике. Азилсартан и в особенности телмисартан обладают выраженной органопротекцией и превосходят другие антигипертензивные средства в отношении снижения артериального давления. Однако влияние азилсартана на жесткие конечные точки не изучалось, в то время как эффективность телмисартана оценивалась во множестве клинических исследований, включая 3 крупных рандомизированных клинических исследования с участием нескольких тысяч пациентов. В статье также представлены расчеты, свидетельствующие об экономической эффективности телмисартана по сравнению с азилсартаном.
The activity of the renin-angiotensin-aldosterone system is one of the main pathogenetic mechanisms underlying cardiovascular diseases at all stages of the cardiovascular continuum. This article discusses the role of telmisartan and azilsartan as the most powerful sartans in modern cardiology. Azilsartan and especially telmisartan have a significant organoprotection and are superior to other antihypertensive drugs in terms of lowering blood pressure. However, the effect of azilsartan on hard endpoints has not been studied while the efficacy of telmisartan on hard endpoints has been evaluated in plenty clinical trials including 3 large randomized clinical trials with several thousand patients. The article also presents calculations showing the better cost-effectiveness of telmisartan compared to azilsartan.
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1. Mehta JK, Kaur G, Buttar HS, et al. Role of the renin-angiotensin system in the pathophysiology of coronary heart disease and heart failure: Diagnostic biomarkers and therapy with drugs and natural products. Front Physiol. 2023;14:1034170. DOI:10.3389/fphys.2023.1034170
2. Bhardwaj G. How the antihypertensive losartan was discovered. Expert Opin Drug Discov. 2006;1(6):609-18. DOI:10.1517/17460441.1.6.609
3. State register of medicines. Available at: https://grls.rosminzdrav.ru/Default.aspx. Accessed: 15.07.2023 (in Russian).
4. Turnbull F; Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362(9395):1527-35. DOI:10.1016/s0140-6736(03)14739-3
5. Baguet JP, Robitail S, Boyer L, et al. A meta-analytical approach to the efficacy of antihypertensive drugs in reducing blood pressure. Am J Cardiovasc Drugs.
2005;5(2):131-40. DOI:10.2165/00129784-200505020-00007
6. 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. DOI:10.1136/bmj.b1665
7. Wei J, Galaviz KI, Kowalski AJ, et al. Comparison of Cardiovascular Events Among Users of Different Classes of Antihypertension Medications: A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2020;3(2):e1921618. DOI:10.1001/jamanetworkopen.2019.21618
8. Klingbeil AU, Schneider M, Martus P, et al. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med. 2003;115(1):41-6. DOI:10.1016/s0002-9343(03)00158-x
9. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021‑104. DOI:10.1093/eurheartj/ehy339
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Авторы
В.Д. Закиев*, Ю.В. Котовская, О.Н. Ткачева
ОСП «Российский геронтологический научно-клинический центр» ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*zakiev739@gmail.com
________________________________________________
Vadim D. Zakiev*, Yulia V. Kotovskaya, Olga N. Tkacheva
Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
*zakiev739@gmail.com