Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum92100ArticlesСтатьиResearch ArticlePreimushchestva kombinatsii antagonista kal'tsiya s ingibitorom angiotenzinprevrashchayushchego fermenta perindoprilom po sravneniyu so standartnoy terapiey arterial'noy gipertonii vysokogo riskaПреимущества комбинации антагониста кальция с ингибитором ангиотензинпревращающего фермента периндоприлом по сравнению со стандартной терапией артериальной гипертонии высокого рискаKobalavaZh. DКобалаваЖ. ДTolkachevaV. VТолкачеваВ. ВKotovskayaYu. VКотовскаяЮ. ВРУДН, Москва1505200685VOL 8, NO5 (2006)ТОМ 8, №5 (2006)212728122021Copyright ©; 2006, Consilium MedicumCopyright ©; 2006, ООО "Консилиум Медикум"2006Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/92100

Недостаточное предупреждение сердечно-сосудистой заболеваемости на фоне традиционной терапии, необходимость оценки множественных факторов риска, отсутствие исследований по оценке эффективности режимов комбинированной терапии, а также потребность в накоплении данных о влиянии новых антигипертензивных препаратов на риск сердечно-сосудистых осложнений явились поводом для проведения крупномасштабного многоцентрового клинического исследования ASCOT (Anglo-Scandinavian Cardiac Outcome Trial). Исследование состояло из двух частей - антигипертензивной и липидснижающей терапии. В антигипертензивной части исследования (ASCOT-BPLA) сравнивали традиционный режим терапии (b-блокатор ± диуретик) и новый режим (антагонист кальция ± ингибитор ангиотензинпревращающего фермента - ИАПФ). В липидснижающей части исследования (ASCOT-LLA) сравнивали терапию статином с плацебо у пациентов с общим холестерином сыворотки крови (ОХС) £ 6,5 ммоль/л (250 мг/дл).Объединенный подход, направленный на снижение АД и уменьшение гиперхолестеринемии, является оптимальной терапевтической стратегией, направленной на снижение атерогенеза и предупреждение сердечно-сосудистых осложнений у пациентов с множественными сердечно-сосудистыми факторами риска. В качестве механизма снижения риска при этом потенциально может рассматриваться улучшение эластических свойств крупных артерий.

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