Systemic HypertensionSystemic HypertensionСистемные гипертензии2075-082X2542-2189Intermedservice Ltd2871610.26442/SG28716ArticlesСтатьиResearch ArticleChto lezhit v osnove effektivnosti lecheniya perindoprilom bol'nykh ishemicheskoy bolezn'yu serdtsa – nebol'shoe snizhenie arterial'nogo davleniya ili nechto bol'shee? Itogi i perspektivy issledovaniya EUROPAЧто лежит в основе эффективности лечения периндоприлом больных ишемической болезнью сердца – небольшое снижение артериального давления или нечто большее? Итоги и перспективы исследования EUROPAKhirmanovV NХирмановВ НСанкт-Петербургская государственная медицинская академия им. И.И.Мечникова1503200411NO1 (2004)ТОМ 1, №1 (2004)343709042020Copyright ©; 2004, Consilium MedicumCopyright ©; 2004, ООО "Консилиум Медикум"2004Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://journals.eco-vector.com/2075-082X/article/view/28716

Завершено рандомизированное двойное слепое плацебо-контролируемое, многоцентровое исследование EUROPA (European trial on Reduction Of cardiac events with Perindopril in stable coronary Artery disease). Его результаты опубликованы в журнале Lancet (N 9386 за 2003 г.) [1] и впервые обсуждены на съезде Европейского общества кардиологов в сентябре прошедшего года. Это новое крупное международное исследование имеет большое значение для развития многих аспектов клинической и теоретической кардиологии. Один из них – причина достоверных преимуществ нового подхода к лечению больных ишемической болезнью сердца – представляется актуальным для обсуждения. Но прежде необходимо кратко сформулировать основные положения исследования EUROPA. Цель исследования. Как это следует из названия проекта, цель состояла в решении вопроса о том, эффективно ли применение ингибитора ангиотензинпревращающего фермента (ИАПФ) периндоприла (хорошо известного отечественным врачам под названием "Престариум") для лечения больных со стабильным течением ишемической болезни сердца (ИБС), не осложненной сердечной недостаточностью.

Fox K.M. EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators/Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double - blind, placebo - controlled, multicentre trial (the EUROPA study). Lancet 2003; 362 (9386): 782–8.Yusuf S, Sleight P, Pogue J et al. Effects of an angiotensin - converting - enzyme inhibitor, ramipril, on cardiovascular events in high - risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000; 342 (3): 1451–3.Chobanian A.V, Bakris G.L, Black H.R et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289 (19): 2560–72.European Society of Hypertension-European Society of Cardiology Guidelines Committee/2003 European Society of Hypertension - European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21 (6): 1011–53.Benetos A, Thomas F, Bean K.E, Guize L. Why cardiovascular mortality is higher in treated hypertensives versus subjects of the same age, in the general population. J Hypertens 2003; 21 (9): 1635–40.Boutitie F, Gueyffier F, Pocock S et al. INDANA Project Steering Committee. INdividual Data ANalysis of Antihypertensive intervention. J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta - analysis of individual - patient data. Ann Intern Med 2002; 136 (6): 438–48.Candido R, Jandeleit-Dahm K.A, Cao Z et al. Prevention of accelerated atherosclerosis by angiotensin - converting enzyme inhibition in diabetic apolipoprotein E-deficient mice. Circulation 2002; 106 (2): 246–53.Cook N.R, Cohen J, Hebert P.R et al. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med 1995; 155 (7): 701–9.Mac Mahon S, Peto R, Cutler J et al. Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335 (8692): 765–74.Britten M.B, Zeiher A.M, Schachinger V. Clinical importance of coronary endothelial vasodilator dysfunction and therapeutic options. J Intern Med 1999; 245 (4): 315–27.Brown N.J, Agirbasli M.A, Williams G.H et al. Effect of activation and inhibition of the renin - angiotensin system on plasma PAI-1. Hypertension 1998; 32 (6): 1225–32.Dzau V.J, Bernstein K, Celermajer D et al.Hornig B, Kohler C, Drexler H. Role of bradykinin in mediating vascular effects of angiotensin - converting enzyme inhibitors in humans. Circulation 1997; 95 (5): 1115–8.Lazar H, Lonn E, Luscher T et al. Pathophysiologic and therapeutic importance of tissue ACE: a consensus report. Cardiovasc Drugs Ther 2002; 16 (2): 149–60.Marui N, Offermann M.K, Swerlick R et al. Vascular cell adhesion molecule-1 (VCAM-1) gene transcription and expression are regulated through an antioxidant - sensitive mechanism in human vascular endothelial cells. J Clin Invest 1993; 92 (4): 1866–74.Matsumoto K, Morishita R, Moriguchi A et al. Inhibition of neointima by angiotensin - converting enzyme inhibitor in porcine coronary artery balloon - injury model. Hypertension 2001; 37 (2): 270–4.Vaughan D.E, Lazos S.A, Tong K. Angiotensin II regulates the expression of plasminogen activator inhibitor-1 in cultured endothelial cells: a potential link between the renin - angiotensin system and thrombosis. J Clin Invest 1995; 95 (3): 995–1001.Bartels G.L, Van den Heuvel A.F.M, Van Veldhuisen D.J, Van der Ent M, Remme W.J. Acute anti - ischemic effects of perindoprilat in men with coronary artery disease and their relation with left ventricular function. Am J Cardiol 1999; 83 (3): 332–6.Gomma A.H, Fox K.M, on behalf of the EUROPA Investigators / The EUROPA trial: design, baseline demography and status of the substudies. Cardiovasc Drugs Ther 2001; 15 (2): 169–79.Scientific Committee of the PERTINENT Sub-Study, EUROPA-PERTINENT Investigators/PERTINENT – perindopril - thrombosis, inflammation, endothelial dysfunction and neurohormonal activation trial: a sub - study of the EUROPA study. Cardiovasc Drugs Ther 2003; 17 (1): 83–91.