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SAFARI - RANDOMISED TRIAL ON COMPLEX THERAPY OF ARTERIAL HYPERTENSION AND DISLIPIDEMY. THE MAIN RESULTS

https://doi.org/10.20996/1819-6446-2009-5-1-51-56

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Abstract

Aim. To evaluate possibility of complex pharmaceutical effect simultaneously on 2 risk factors – arterial hypertension (HT) and hypercholesterolemia (HH) in patients with high risk of cardiovascular complications (CVC).

Material and methods. 101 patients with HT of 1-2 stage, HH and high risk of CVC (SCORE>5) were included in the study. Patients were randomized in 2 groups: active therapy group (ATG) and control group (CG). ATG patients were actively treated for HT and HH control. The long-acting nifedipine (Nifecard XL, LEK) 30 mg once daily (OD) was prescribed as start antihypertensive drug. Hydrochlorothiazide 12,5 mg/day OD and bisiprolol 5 mg OD was added if antihypertensive effect was insufficient. Atorvastatin (Tulip, LEK) 20-40 mg OD was prescribed for HH control. Management of CG patients was performed by doctors of out-patient clinics. The study duration was 12 weeks.

Results. Systolic and diastolic blood pressure (BP) levels in ATG patients were lower than these in CG patients. Target BP level was reached in 88,4% of ATG patients and only in 48,9% of CG patients. Cholesterol of low density lipoprotein (CH LPLD) level was also lower in ATG patients than this in CG patients. Target CH LPLD level was reached in 37,2 % of ATG patients and in 8,3 % of CG patients. Relative risk of CVC was significantly lower in ATG patients than this in CG patients.

Conclusion. SAFARI trial shows that effective pharmaceutical simultaneous control of 2 key risk factors, HT and HH, results in risk reduction of CVC.

About the Authors

S. Y. Martsevich
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


N. P. Kutishenko
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


V. V. Yakusevich
Yaroslavl State Medical Academy
Russian Federation

Chair of Clinical Pharmacology

Revolucionnaya ul. 5, Yaroslavl, 150000



A. D. Deev
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


A. A. Serazhim
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


T. V. Bobkova
Yaroslavl State Medical Academy
Russian Federation

Chair of Clinical Pharmacology

Revolucionnaya ul. 5, Yaroslavl, 150000



L. P. Volkonskaya
Yaroslavl State Medical Academy
Russian Federation

Chair of Clinical Pharmacology

Revolucionnaya ul. 5, Yaroslavl, 150000



V. P. Voronina
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


N. A. Dmitrieva
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


O. V. Lerman
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


J. V. Lukina
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


M. A. Maksimova
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


A. A. Serazhim
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


S. N. Tolpygina
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


E. V. Shilova
State Research Center for Preventive Medicine of Rosmedtechnology
Russian Federation
Petroverigsky per. 10, Moscow, 101990


References

1. Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur Heart J 2007;28(19):2375-414.

2. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007;25(6):1105-87.

3. Wright J.T. Jr, Dunn J.K., Cutler J.A. et al. for the ALLHAT Collaborative Research Group. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA 2005;293(13):1595–608.

4. Dahl￾f B., Sever P.S., Poulter N.R. et al.; 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(9489):895-906.

5. Gaede P., Vedel P., Larsen N. et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 2003;348(5):383-93.

6. Марцевич С.Ю., Алимова Е.В., Горбунов В.М., и др. Эффективность новой лекарственной формы нифедипина пролонгированного действия - Нифекарда-XL при лечении артериальной гипертонии. Российский кардиологический журнал 2003;(5):55-8

7. Семенова Ю.Э., Марцевич С.Ю., Перова Н.В. и др. Оценка эффективности и безопасности дженерика аторвастатина у больных с гиперлипидемией. Рациональная Фармакотерапия в Кардиологии 2005;(3):24-8.


For citation:


Martsevich S.Y., Kutishenko N.P., Yakusevich V.V., Deev A.D., Serazhim A.A., Bobkova T.V., Volkonskaya L.P., Voronina V.P., Dmitrieva N.A., Lerman O.V., Lukina J.V., Maksimova M.A., Serazhim A.A., Tolpygina S.N., Shilova E.V. SAFARI - RANDOMISED TRIAL ON COMPLEX THERAPY OF ARTERIAL HYPERTENSION AND DISLIPIDEMY. THE MAIN RESULTS. Rational Pharmacotherapy in Cardiology. 2009;5(1):51-56. (In Russ.) https://doi.org/10.20996/1819-6446-2009-5-1-51-56

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)