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Current Trends in the Treatment of Hypertension: Focus on Improving Prognosis. The Capabilities of an Amlodipine/Telmisartan Single-Pill Combination

https://doi.org/10.20996/1819-6446-2019-15-6-906-917

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Abstract

Nowadays, the modern approach to antihypertensive therapy is to prescribe in the most hypertensive patients fixed-dose combinations of antihypertensive drugs as initial therapy. This concept is reflected in the latest revisions of European and Russian guidelines for the management of arterial hypertension (AH). Above mentioned principle is referred as “single-pill combination” strategy and is given high priority in clinical practice with a high evidence level. According to this approach, one of the possible first line single-pill combinations is the combination of an angiotensin II receptor blocker and a calcium channel blocker. In both classes, the reference and the best representatives include, respectively, telmisartan and amlodipine, as a result of broad experience in their practical application and, most importantly, extensive body of evidence regarding to its effectiveness and safety. Both antihypertensive drugs are distinguished by an extra-longstanding antihypertensive effect that exceeds such one of other representatives in their classes, thereby a stable blood pressure control throughout the day is realized, and most importantly, in the early morning hours, that are the most dangerous in terms of adverse cardiovascular and cerebrovascular events. Another important telmisartan and amlodipine characteristics is their targetorgan protective properties, which is realized at all the levels. In addition, telmisartan has a unique ability to activate PPAR-у-receptors and improves the carbohydrate metabolism and lipid profile, which is advantageous in patients with concomitant metabolic syndrome and diabetes mellitus. The telmisartan and amlodipine features and their proven ability to improve prognosis in hypertensive patients served as background for creating a singlepill combination of these antihypertensive drugs, which fully meet with the requirements of current clinical guidelines for AH management and in which these drugs synergistically coupling resulting in more effective blood pressure control, increases the reliability of target-organ protection, and also improves the therapy safety profile.

About the Authors

O. D. Ostroumova
Pirogov Russian National Research Medical University, Russian Clinical and Research Center of Gerontology; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Olga D. Ostroumova – MD, PhD, Head of Laboratory of Clinical Pharmacology and Pharmacotherapy, Russian Gerontology Clinical Research Center, Pirogov Russian National Research Medical University; Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine, Sechenov University

Pervaya Leonova ul. 16, Moscow, 129226, 

Trubetskaya ul. 8-2, Moscow, 119991



A. I. Kochetkov
Pirogov Russian National Research Medical University, Russian Clinical and Research Center of Gerontology
Russian Federation

Alexey I. Kochetkov – MD, PhD, Researcher, Laboratory of Clinical Pharmacology and Pharmacotherapy, Russian Gerontology Clinical Research Center, Pirogov Russian National Research Medical University; Assistant, Chair of Aging Diseases, Pirogov Russian National Research Medical University  

Pervaya Leonova ul. 16, Moscow, 129226



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For citation:


Ostroumova O.D., Kochetkov A.I. Current Trends in the Treatment of Hypertension: Focus on Improving Prognosis. The Capabilities of an Amlodipine/Telmisartan Single-Pill Combination. Rational Pharmacotherapy in Cardiology. 2019;15(6):906-917. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-6-906-917

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