Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum92216ArticlesСтатьиResearch ArticleObosnovanie i effektivnost' kombinirovannoy antigipertenzivnoy i gipolipidemicheskoy terapii u patsientov s arterial'noy gipertonieyОбоснование и эффективность комбинированной антигипертензивной и гиполипидемической терапии у пациентов с артериальной гипертониейKobalavaZh. DКобалаваЖ. ДTolkachevaV. VТолкачеваВ. ВРоссийский университет дружбы народовГКБ №64, МоскваРоссийский университет дружбы народовГКБ №64, Москва15112006811VOL 8, NO11 (2006)ТОМ 8, №11 (2006)364228122021Copyright ©; 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/92216

В последнее время наблюдается рост сердечно-сосудистых заболеваний, которые являются основной причиной смерти во всем мире. Артериальная гипертония (АГ) - основной фактор риска сердечно-сосудистых заболеваний. Высокая частота встречаемости сочетания АГ и дислипидемии в популяции вызывает особое беспокойство. В последнее время наиболее интересным является изучение комбинированного влияния антигипертензивной и гиполипидемической терапии на частоту сердечно-сосудистых осложнений у пациентов с АГ. В исследовании ASCOT выявлено отчетливое достоверное преимущество комбинированной терапии амлодипином/ингибиторами АПФ (ИАПФ) в отношении общей смертности и сердечно-сосудистых событий у пациентов с множественными факторами риска. Впервые в проспективном исследовании показана эффективность антигипертензивной и гиполипидемической терапии у пациентов без стандартных показаний к применению липидснижающих препаратов.

артериальная гипертонияантигипертензивная терапиягиполипидемическая терапиядислипидемияMuntner P, He J, Roccella E.J. The impact of JNC-VI guidelines on treatment recommendations in the US population. Hypertension 2002; 39:897-902Sever P.S, Dahlof B, Poulter N.R, et al; ASCOT investigators. Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial. J Hypertens. 2001; 19: 1139-1147.ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial: 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; 288:2981-2997.Sever P.S, Dahlof B, Poulter N.R, et al; ASCOT investigators. Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial. J Hypertens. 2001; 19: 1139-1147.Dahlof B, Sever P.S, Poulter N.R, for the ASCOT investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet. 2005; 366: 895-906.Sever P on behalf of the ASCOT investigators. ASCOT-LLA revisited: Interaction of antihypertensive and lipid - lowering therapy. American Heart Association Scientific Sessions; November 14, 2005; Dallas, TX.Staessen J.A, Birkenhger W.H. Evidence that new antihypertensives are superior to older drugs. Lancet 2005: DOI: 10.1016/50140-6736(05)67147-4. Available at: http://www.lancet.comSever P.S, Dahlof B, Poulter N.R, Wedel H et al. ASCOT investgators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower - than - average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial -- Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003; 361:1149-1158.Sever P.S, Poulter N.P, Dahlof B, Wedel H. Different time course for prevention of coronary and stroke events by atorvastatin in the Anglo-Scandinavian Cardiac Outcomes Trial - Lipid - Lowering Arm (ASCOT-LLA).Poulter N.R, Wedel H, Dahlьf B, et al, for the ASCOT Investigators. Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA). Lancet 2005; 366, 907-913Sever P.S, Dahlof B, Poulter N.P, Wedel H. Anglo-Scandinavian Cardiac Outcomes Trial: Lipid Lowering Arm (ASCOT LLA) revisited: interaction of antihypertensive and lipid lowering therapy. Circulation. 2005; 112(17 Suppl):II-134. Abstract 730Sever P.S, Poulter N.P. Blood pressure reduction is not the only determinant of outcome. Circulation 2006; 113: 2754-2774.Williams B, Lacy P.S, Thom S.M, Cruickshank K, Stanton A, Collier D, Hughes A.D, Thurston H, O'Rourke M; CAFE Investigators; Anglo- Scandinavian Cardiac Outcomes Trial Investigators; CAFE Steering Committee and Writing Committee. 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;113:1213-1225.Morgan T, Lauri J, Bertram D, Anderson A. Effect of different antihypertensive drug classes on central aortic pressure. Am J Hypertens. 2004; 17:118 -123.Hirata K, Vlachopoulos C, Adji A, O'Rourke M.F. Benefits from angiotensin - converting enzyme inhibitor "beyond blood pressure lowering," beyond blood pressure or beyond the brachial artery? J Hypertens. 2005; 23:551-556.London G.M, Asmar R.G, O'Rourke M.F, Safar M.E. Mechanism(s) of selective systolic blood pressure reduction after a low - dose combination of perindopril/indapamide in hypertensive subjects: comparison with atenolol. J Am Coll Cardiol. 2004;43:92-99.Liu J, Heikkila P, Meng Q.H et al. Expression of low and high density lipoprotein receptor genes in human adrenals. Eur J Endocrinol 2000; 142: 677-82Verdecchia P, Reboldi G, Angeli F, Gattobigio R, Bentivoglio M, Thijs L, Staessen J.A, Porcellati C. Angiotensin - converting enzyme inhibitors and calcium channel blockers for coronary heart disease and stroke prevention. Hypertension. 2005;46:386 -392.Mason R.P, Walter M.F, Day C.A, Jacob R.F. Intermolecular differences of 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitors contribute to distinct pharmacologic and pleiotropic actions. Am J Cardiol. 2005; 96:11F-23F.Jukema J.W, van der Hoorn J.W. Amlodipine and atorvastatin in atherosclerosis: a review of the potential of combination therapy. Expert Opin Pharmacother. 2004;5:459-468.Messerli F.H., Pinto L., Tang S. et al. Does the presence of hypertension affect cardiovascular benefits of statin therapy? Results from a meta - regression analysis of 69984 patients. Abstract 4D.4 on page S151. 2006.