TherapyTherapyТерапия2412-40362713-1823Bionika Media28878110.18565/therapy.2022.1.174-181ArticlesСтатьиResearch ArticleTreatment of arterial hypertension in high risk comorbid patients: possibilities of amlodipine and losartan combinationЛечение артериальной гипертензии у коморбидных пациентов высокого риска: возможности комбинации амлодипина и лозартанаLarinaVera N.ЛаринаВера Николаевна

MD, professor, head of the Department of polyclinic therapy of the Faculty of general medicine

д.м.н., профессор, зав. кафедрой поликлинической терапии лечебного факультета

larinav@mail.ruN.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of RussiaФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России1501202281VOL 8, NO1 (2022)ТОМ 8, №1 (2022)17418126022023Copyright ©; 2022, “Bionika Media” LLCCopyright ©; 2022, ООО «Бионика Медиа»2022“Bionika Media” LLCООО «Бионика Медиа»https://journals.eco-vector.com/2412-4036/about/editorialPolicieshttps://journals.eco-vector.com/2412-4036/article/view/288781

The problem of failure to achieve the target blood pressure (BP) level remains actual for many countries in the world, including Russia. The modern strategy for the treatment of arterial hypertension (AH) is based on an integrated approach, including the correction of risk factors and prescribing of combined antihypertensive therapy at the stage of initial therapy, primarily for high cardiovascular risk patients. Combinations of calcium channel blockers of the dihydropyridine series and renin-angiotensin system, which have demonstrated the ability of significant reduction of the risk of cardiovascular complications development, are considered to be the most rational. A number of experimental and clinical studies have confirmed the high efficacy and safety of the fixed combination of amlodipine and losartan for BP control in people with AH. Taking all the abovementioned into account, the purpose of the review is to discuss the possibilities and perspectives for prescribing a fixed combination of amlodipine and losartan in multimorbid patients with arterial hypertension at high cardiovascular risk.

Проблема недостижения целевого уровня артериального давления (АД) остается актуальной для многих стран мира, включая Россию. Современная стратегия лечения артериальной гипертензии (АГ) строится на комплексном подходе, включающем коррекцию факторов риска и назначение комбинированной антигипертензивной терапии на этапе стартовой терапии, в первую очередь пациентам с высоким сердечно-сосудистым риском. Наиболее рациональными считаются комбинации блокаторов кальциевых каналов дигидропиридинового ряда и ренин-ангиотензиновой системы, которые продемонстрировали способность существенно снижать риск развития кардиоваскулярных осложнений. В ряде экспериментальных и клинических исследований была подтверждена высокая эффективность и безопасность фиксированной комбинации амлодипина и лозартана для контроля АД у лиц с АГ. Учитывая вышесказанное, целью обзора является обсуждение возможностей и перспектив назначения фиксированной комбинации амлодипина и лозартана у мультиморбидных пациентов с АГ высокого сердечно-сосудистого риска.

arterial hypertensionlosartanamlodipinefixed combination of antihypertensive agentscombined therapyартериальная гипертензиялозартанамлодипинфиксированная комбинация антигипертензивных средствкомбинированная терапияRoth G.A., Mensah G.A., Johnson C.O. et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: Update from the GBD 2019 study. J Am Coll Cardiol. 2020; 76(25): 2982-3021. https://dx.doi.org/10.1016/j.jacc.2020.11.010.Чазова И.Е. Артериальная гипертония в свете современных рекомендаций. Терапевтический архив. 2018; 9: 4-7.Ротарь О.П., Толкунова К.М., Солнцев В.Н. с соавт. Приверженность к лечению и контроль артериальной гипертензии в рамках российской акции скрининга МММ19. Российский кардиологический журнал. 2020; 3: 3745GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053): 1659-724. https://dx.doi.org/10.1016/S0140-6736(16)31679-8.Muntner P., Hardy S.T., Fine L.J. et al. Trends in blood pressure control among US adults with hypertension, 1999-2000 to 2017-2018. JAMA. 2020; 324(12): 1190-200. https://dx.doi.org/10.1001/jama.2020.14545.Шальнова С.А., Деев А.Д., Метельская В.А. с соавт. Информированность и особенности терапии статинами у лиц с различным сердечно-сосудистым риском: исследование ЭССЕ-РФ. Кардиоваскулярная терапия и профилактика. 2016; 4: 29-37.Кобалава Ж.Д., Конради А.О., Недогода С.В. с соавт. Артериальная гипертензия у взрослых. Клинические рекомендации 2020. Российский кардиологический журнал. 2020; 3: 3786Williams B., Mancia G., Spiering W.et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018; 39(33): 3021-104. https://dx.doi.org/10.1093/eurheartj/ehy339.Yoon D.Y., Park S.I., Jung J.A. et al.Comparison of pharmacokinetics of a fixed-dose combination of amlodipine/losartan/rosuvastatin with concomitant administration of amlodipine/losartan and rosuvastatin in healthy volunteers. Drug Des Devel Ther. 2020; 14: 661-68. https://dx.doi.org/10.2147/DDDT.S233014.Небиеридзе Д.В., Сафарян А.С., Выгодин В.А. с соавт. Современные возможности достижения целевого артериального давления у пациентов с артериальной гипертонией в условиях амбулаторной практики: результаты исследования ЛИДЕР. Рациональная фармакотерапия в кардиологии. 2018; 1: 12-20.Lindholm L.H., Ibsen H., Dahlot B. et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): A randomised trial against atenolol. Lancet. 2002; 359(9311): 1004-10. https://dx.doi.org/10.1016/S0140-6736(02)08090-X.Pitt B., Segal R., Martinez F.A. et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (evaluation of losartan in the elderly study, ELITE). Lancet. 1997; 349(9054): 747-52. https://dx.doi.org/10.1016/s0140-6736(97)01187-2.Dickstein K., Kjekshus J., OPTIMAAL Trial Steering Committee and Investigators. Optimal Trial in Myocardial Infarction with the Angiotensin II Antagonist Losartan.Comparison of baseline data, initial course, and management: losartan versus captopril following acute myocardial infarction (The OPTIMAAL Trial). OPTIMAAL Trial Steering Committee and Investigators. Optimal Trial in Myocardial Infarction with the Angiotensin II Antagonist Losartan. Am J Cardiol. 2001; 87(6): 766-71, A7. https://dx.doi.org/10.1016/s0002-9149(00)01500-9.Danlof B., Devereux R.B., Kieldsen S.E. et al.; for the LIFE study group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet. 2002; 359 (9311): 995-1003. https://dx.doi.org/10.1016/S0140-6736(02)08089-3.Tershakovec A.M., Keane W.F., Zhang Z. et al. Effect of LDL cholesterol and treatment with losartan on endstage renal disease in the RENAAL study. Diabetes Care. 2008; 31 (3): 445-47. https://dx.doi.org/10.2337/dc07-0196Инструкция по медицинскому применению лекарственного препарата Лозап® АМ. Регистрационный номер: ЛП-001481. Государственный реестр лекарственных средств Минздрава России. Доступ: https://grls.rosminzdrav.ru (дата обращения 11.01.2022)Dewland T.A., Soliman E.Z., Davis B.R. et al. Effect of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) on conduction system disease. JAMA Intern Med. 2016; 176(8): 1085-92. https://dx.doi.org/10.1001/jamainternmed.2016.2502.Quentin C., Gerasimaite R., Freidzon A. et al. Direct visualization of amlodipine intervention into living cells by means of fluorescence microscopy. Molecules. 2021; 26(10): 2997. https://dx.doi.org/10.3390/molecules26102997.Murdoch D., Heel R.C. Amlodipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in cardiovascular disease. Drugs. 1991; 41(3): 478-505. https://dx.doi.org/10.2165/00003495-199141030-00009.Volpe M., Rump L.C., Ammentorp B. et al. Efficacy and safety of triple antihypertensive therapy with the olmesartan/amlodipine/ hydrochlorothiazide combination. Clin Drug Investig. 2012; 32(10): 649-64. https://dx.doi.org/10.1007/BF03261919.Oparil S., Weber M. Hypertension: Companion to Brenner & Rector's The Kidney. 2nd ed. Philadelphia: Elsevier Saunders. 2005; pp. 60-76. ISBN-13: 978-0721602585.Osswald H., Muhlbauer B. The pharmacological basis for the combination of calcium channel antagonists and angiotensin converting enzyme inhibitors in the treatment of hypertension. J Hypertens Suppl. 1995; 13(2): S21-28. https://dx.doi.org/10.1097/00004872-199508001-00004.Srivastava A., Kaze A.D., McMullan C.J. et al. Uric acid and the risks of kidney failure and death in individuals with CKD. Am J Kidney Dis. 2018; 71(3): 362-70. https://dx.doi.org/10.1053/j.ajkd.2017.08.017.Alderman M., Aiyer K. Uric acid: role in cardiovascular disease and effects of losartan. Curr Med Res Opin. 2004; 20(3): 369-79. https://dx.doi.org/10.1185/030079904125002982.Gabin J.M., Tambs K., Saltvedt I. et al. Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study. Alzheimers Res Ther. 2017; 9(1): 37. https://dx.doi.org/10.1186/s13195-017-0262-x.Vemuri P., Lesnick T.G., Przybelski S.A. et al. Age, vascular health, and Alzheimer disease biomarkers in an elderly sample. Ann Neurol. 2017; 82(5): 706-18. https://dx.doi.org/10.1002/ana.25071.Iadecola C., Yaffe K., Biller J. et al. Impact of hypertension on cognitive function: a scientific statement from the American Heart Association. Hypertension. 2016; 68(6): e67-e94. https://dx.doi.org/10.1161/HYP.0000000000000053.Cao J., Hou J., Ping J. et al. Advances in developing novel therapeutic strategies for Alzheimer's disease. Mol Neurodegeneration. 2018; 13: 64. https://dx.doi.org/10.1186/s13024-018-0299-8.Forette F., Seux M.L., Staessen J.A. et al. Prevention of dementia in randomised double-blind placebo-controlled systolic hypertension in Europe (Syst-Eur) trial. Lancet. 1998; 352(9137): 1347-51. https://dx.doi.org/10.1016/S0140-6736(98)03086-4.Paris D., Bachmeier C., Patel N. et al. Selective antihypertensive dihydropyridines lower Aß accumulation by targeting both the production and the clearance of Aß across the blood-brain barrier. Mol Med. 2011; 17(3-4): 149-62. https://dx.doi.org/10.2119/molmed.2010.00180.Szabo-Reed A.N., Vidoni E., Binder E.F. et al. Rationale and methods for a multicenter clinical trial assessing exercise and intensive vascular risk reduction in preventing dementia (rrAD Study). Contemp Clin Trials. 2019; 79: 44-54. https://dx.doi.org/10.1016/j.cct.2019.02.007.Zhang L.K., Sun Y., Zeng H. et al. Calcium channel blocker amlodipine besylate therapy is associated with reduced case fatality rate of COVID-19 patients with hypertension [published correction appears in Cell Discov. 2021 ;7(1): 29]. Cell Discov. 2020; 6(1): 96. https://dx.doi.org/10.1038/s41421-020-00235-0.Wang T., Wan Y., Lin S. et al. Evaluation of pharmacokinetics and safety with bioequivalence of amlodipine in healthy Chinese volunteers: Bioequivalence study findings. J Clin Lab Anal. 2020; 34: e23228. https://dx.doi.org/10.1002/jcla.23228.Semenzato L., Botton J., Drouin J. et al. Antihypertensive drugs and COVID-19 risk. A cohort study of 2 million hypertensive patients. Hypertension. 2021; 77: 833-42. https://dx.doi.org/10.1161/HYPERTENSIONAHA.120.16314.Choi Y., Lee S., Cho S. et al.Comparisons of the pharmacokinetics and tolerability of fixed-dose combinations of amlodipine besylate/ losartan and amlodipine camsylate/losartan in healthy subjects: a randomized, open-label, single-dose, two-period, two-sequence crossover study. Drug Des Devel Ther. 2016; 10: 3021-28. https://dx.doi.org/10.2147/DDDT.S113891.Kim S.H., Ryu K.H., Lee N.H. et al. Efficacy of fixed-dose amlodipine and losartan combination compared with amlodipine monotherapy in stage 2 hypertension: a randomized, double blind, multicenter study. BMC Res Notes. 2011; 4: 461. https://dx.doi.org/10.1186/1756-0500-4-461.Cho E.J., Lee H.Y., Sung K.C. et al.Comparison of 24-hour ambulatory central blood pressure reduction efficacy between fixed amlodipine or up-titrated hydrochlorothiazide plus losartan: The K-Central Study. Am J Hypertens. 2019; 32(10): 992-1002. https://dx.doi.org/10.1093/ajh/hpz050.