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Rational Pharmacotherapy in Cardiology

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Combined Therapy of Arterial Hypertension. The Opinion of a Clinical Pharmacologist

https://doi.org/10.20996/1819-6446-2020-08-12

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Abstract

Modern tactics of treatment of arterial hypertension (AH) involves the use of both monotherapy and combination therapy. Monotherapy is recommended primarily for low-risk patients with systolic blood pressure (BP)< 150 mm Hg. Monotherapy should also be preferred in very high risk patients with high normal BP and frail elderly patients. However, combination therapy is recommended for most hypertensive patients as initial therapy. Starting combination therapy is more effective in lowering BP than monotherapy. Even at low doses, it is usually more effective than maximum dose monotherapy. The most commonly prescribed combinations today contain a renin-angiotensin system blocker (angiotensin converting enzyme inhibitors or angiotensin II receptor blocker) with a calcium antagonist or diuretic. The combination of lisinopril with amlodipine not only proved its high efficiency in various international and Russian studies, but also turned out to be pharmacoeconomically more profitable. Fixed combinations of lisinopril and amlodipine are the optimal choice in the treatment of hypertensive patients, due to all the advantages of both components: higher efficacy and safety rates compared to monotherapy and better patient adherence to treatment.

About the Authors

M. V. Zhuravleva
Scientific Centre for Expert Evaluation of Medicinal Products; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Marina V. Zhuravleva – MD, PhD, Professor, Deputy Director, Scientific Centre for Expert Evaluation of Medicinal Products; Professor, Chair of Clinical Pharmacology and Propedeutics of Internal Diseases, Sechenov University

Petrovskii bulv. 8-2, Moscow, 127051, 

Trubetskaya ul. 8-2, Moscow, 119991



E. V. Luchinina
Saratov State Medical University named after V.I. Razumovsky
Russian Federation

Elena V. Luchinina – MD, PhD, Associate Professor, Chair of Occupational Pathology, Hematology and Clinical Pharmacology

Bolshaya Sadovaya ul. 137, Saratov, 410012



T. V. Shelekhova
Saratov State Medical University named after V.I. Razumovsky
Russian Federation

Tatyana V. Shelekhova – MD, PhD, Professor, Head of Chair of Occupational Pathology, Hematology and Clinical Pharmacology

Bolshaya Sadovaya ul. 137, Saratov, 410012



S. Yu. Serebrova
Scientific Centre for Expert Evaluation of Medicinal Products; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Svetlana Yu. Serebrova – MD, PhD, Professor, Chair of Clinical Pharmacology and Propedeutics of Internal Diseases, Sechenov University; Professor, Scientific Centre for Expert Evaluation of Medicinal Products

Petrovskii bulv. 8-2, Moscow, 127051, 

Trubetskaya ul. 8-2, Moscow, 119991



S. A. Belkov
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation

Sergey A. Belkov – MD, PhD, Professor, Leading Analyst, Scientific Centre for Expert Evaluation of Medicinal Products 

Petrovskii bulv. 8-2, Moscow, 127051



A. I. Dmitriev
Moscow City Clinical Hospital named after I.V. Davydovsky
Russian Federation

Artem I. Dmitriev – MD

Yauzskaya ul. 11, Moscow, 109240



G. I. Gorodetskaya
Scientific Centre for Expert Evaluation of Medicinal Products; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Galina I. Gorodetskaya – MD, PhD, Assistant, Chair of Clinical Pharmacology and Propedeutics of Internal Diseases, Sechenov University; Leading Analyst, Scientific Centre for Expert Evaluation of Medicinal Products

Petrovskii bulv. 8-2, Moscow, 127051, 

Trubetskaya ul. 8-2, Moscow, 119991



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For citation:


Zhuravleva M.V., Luchinina E.V., Shelekhova T.V., Serebrova S.Yu., Belkov S.A., Dmitriev A.I., Gorodetskaya G.I. Combined Therapy of Arterial Hypertension. The Opinion of a Clinical Pharmacologist. Rational Pharmacotherapy in Cardiology. 2020;16(4):601-606. (In Russ.) https://doi.org/10.20996/1819-6446-2020-08-12

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ISSN 1819-6446 (Print)
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