Systemic HypertensionSystemic HypertensionСистемные гипертензии2075-082X2542-2189Intermedservice Ltd2898410.26442/SG28984ArticlesСтатьиResearch ArticleModern approaches to combined therapy of arterial hypertensionСовременные подходы к комбинированной терапии артериальной гипертензииNapalkovD AНапалковДмитрий Александрович

д-р мед. наук, проф. каф. факультетской терапии №1 лечебного факультета

ZhilenkoA VЖиленкоАнна Владимировна

врач-терапевт лечебно-диагностического отд-ния УКБ №1 ГБОУ ВПО Первый МГМУ

ГБОУ ВПО Первый МГМУ им. И.М.Сеченова Минздрава России, Москва15122013104VOL 10, NO4 (2013)ТОМ 10, №4 (2013)444909042020Copyright ©; 2013, Consilium MedicumCopyright ©; 2013, ООО "Консилиум Медикум"2013Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://journals.eco-vector.com/2075-082X/article/view/28984

The article discusses some of the changes in the 2013 European Guidelines in comparison with the previous revision with an emphasis on practical activities of cardiologists and therapists as well as the combined therapy of high blood pressure. Also, special attention is paid to one of the preferred combinations of antihypertensives – a combination of ACE inhibitor and calcium antagonist and, in particular perindopril and amlodipine.

В статье обсуждаются некоторые изменения, произошедшие в Европейских рекомендациях 2013 г. по сравнению с предыдущим пересмотром, с уклоном на практическую деятельность терапевтов и кардиологов и комбинированную терапию повышенного артериального давления. Также особое внимание уделено одной из наиболее предпочтительных комбинаций антигипертензивных препаратов – сочетанию ингибитора ангиотензинпревращающего фермента (АПФ) и антагониста кальция и, в частности, периндоприла и амлодипина.

hypertensionan ACE inhibitora calcium antagonistperindoprilamlodipineартериальная гипертензияингибитор АПФантагонист кальцияпериндоприламлодипинMancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Eur Heart J 2013 doi:10.1093/eurheartj/eht151Wald D.S, Law M, Morris J.K et al. Combination therapy vs. monotherapy in reducing blood pressure: meta - analysis on 11,000 participants from 42 trials. Am J Med 2009; 122: 290–300.Corrao G, Parodi A, Zambon A et al. Reduced discontinuation of antihypertensive treatment by two - drug combination as first step. Evidence from daily life practice. J Hypertens 2010; 28: 1584–90.ADVANCE Collaborative Group. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007; 370: 829–40.Liu L, Zhang Y, Liu G et al. The Felodipine Event Reduction (FEVER) Study: a randomized long - term placebo - controlled trial in Chinese hypertensive patients. J Hypertens 2005; 23: 2157–72.Jamerson K, Weber M.A, Bakris G.L et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high - risk patients. N Engl J Med 2008; 359: 2417–28.Zanchetti A, Bond M.G, Hennig M et al. Calcium antagonist lacidipine slows down progression of asymptomatic carotid atherosclerosis: principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double - blind, long - term trial. Circulation 2002; 106: 2422–7.Blood Pressure Lowering Treatment Trialists’ Collaboration. Do men and women respond differently to blood pressure - lowering treatment? Results of prospectively designed overviews of randomized trials. Eur Heart J 2008; 29: 2669–80.ALLHAT officers and co - ordinators 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.Hansson L, Lindholm L.H, Niskanen L et al. Effect of angiotensin - converting - enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet 1999; 353: 611–6.Julius S, Kjeldsen S.E, Weber M et al. VALUE trial group. Outcomes inhypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022–31.Black H.R, Elliott W.J, Grandits G et al. CONVINCE Trial group. Principal results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) trial. JAMA 2003; 289: 2073–82.Pepine C.J, Handberg E.M, Cooper-De Hoff R.M et al. INVEST investigators. A calcium antagonist vs a non - calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA 2003; 290: 2805–16.Hansson L, Lindholm L.H, Ekbom T et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet 1999; 354: 1751–6.Hansson L, Hedner T, Lund-Johansen P et al. Randomised trial of effects of calcium antagonists compared with diuretics and b - blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 2000; 356: 359–65.Dalhof B, Sever P.S, Poulter N.R et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required vs. atenolol adding bendroflumethiazide as required in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) a multicentrerandomised controlled trial. Lancet 2005; 366: 895–906.Dahlof B, Devereux R.B, Kjeldsen S.E et al. LIFE Study Group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.Hansson L, Hedner T, Lund-Johansen P et al. Randomised trial of effects of calcium antagonists compared with diuretics and b - blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 2000; 356: 359–65.SHEP Co - operative Research Group. 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). JAMA 1991; 265: 3255–64.Coope J, Warrender T.S. Randomised trial of treatment of hypertension in elderly patients in primary care. BMJ 1986; 293: 1145–51.Dahlof B, Lindholm L.H, Hansson L et al. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet 1991; 338: 1281–5.Mancia G, Grassi G, Zanchetti A. New - onset diabetes and antihypertensive drugs. J Hypertens 2006; 24: 3–10.Williams B, Lacy P.S, Thom S.M et al. Differential impact of blood pressure - lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213–25.Boutouyrie P, Achouba A, Trunet P, Laurent S. Amlodipine - valsartan combination decreases central systolic blood pressure more effectively than the amlodipine - atenolol combination: the EXPLOR study. Hypertension 2010; 55: 1314–22.Matsui Y, Eguchi K, O’Rourke M.F et al. Differential effects between a calcium channel blocker and a diuretic when used in combination with angiotensin II receptor blocker on central aortic pressure in hypertensive patients. Hypertension 2009; 54: 716–23.Scheen A.J, Krzesinski G.M. Combinaison fixe perindopril - amlodipine (Coveram) dans le traitement de l’hypertensionarterielleet de l’insuffisancecoronaire. Rev Med Liege 2009; 64 (4): 223–7.Fox K.M. 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: 782–8.