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Influence of the combined antihypertensive therapy, including combination of ACE inhibitors and dihydropyridine calcium channel blocker (DCCB), on frequency of cardiovascular events is studied in many trails. Advantages of the combination of ACE inhibitor and DCCB which is one of the most rational are discussed. Both components are vasodilators and have synergistic mode of action in arterial hypertension. Combination of ACE inhibitor and DCCB allows neutralizing of antiregulatory mechanisms reducing drug efficacy. Results of clinical trails which promoted of the fixed combination of lisinopril (10 mg) and amlodipine (5 mg) are presented. Safety and organoprotective properties of this combination are also shown according to the trail results.

About the Authors

V. I. Podzolkov
Moscow Medical Academy named after I.M.Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991

A. I. Tarzimanova
Moscow Medical Academy named after I.M.Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991


1. 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.

2. Vasan R.S., LarsonM.G., Leip E.P. et al.Assessment offrequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet 2001;358(9294):1682–6.

3. Диагностика и лечение артериальной гипертензии. Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов. Кардиоваскулярная терапия и профилактика 2008;7(6 приложение 2):3-32.

4. Шальнова С.А., Баланова Ю.А., Константинов В.В. и др. Артериальная гипертония: распространенность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения Российской Федерации. Российский кардиологичекий журнал 2006;(4):45-50.

5. Morgan T.O., Anderson A.I., MacInnis R.J. ACE inhibitors, beta-blockers, calcium blockers, and diuretics for the control of systolic hypertension. Am J Hypertens 2001;14(3): 241-7.

6. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. 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(23):2981– 97.

7. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991;265(24):3255–64.

8. Dahlöf B., Devereux R.B., Kjeldsen S.E. et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002;359(9311):995–1003.

9. Hansson L., Zanchetti A., Carruthers S.G. et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998;351(9118):1755–62.

10. Waeber B. Managing hypertension in high-risk patients: lessons and promises from the STRATHE and ADVANCE trials. J Hypertens Suppl 2006;24(3):S19-27

11. Dahlöf B., Sever P.S., Poulter N.R. et al, 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(9489):895-906.

12. JamersonK.A.,BakrisG.L., Wun C. C. et al. Rationale and design of the avoidingcardiovascular events through combination therapy inpatients living with systolichypertension (ACCOMPLISH) trial: the first randomized controlled trialto compare the clinical outcome effects offirst-line combination therapies in hypertension. Am J Hypertens 2004;17(9):793–801.

13. Подзолков В.И., Осадчий К.К. Новые горизонты комбинированной терапии артериальной гипертензии. Лечащий врач 2008;(6):31-9.

14. Zanchetti A., Ruilope L.M., Cuspidi C. et al. Comparative effects of the ACE inhibitor fosinopril and the calcium antagonist amlodipine on left ventricular hypertrophy and urinary albumin excretion in hypertensive patients. Results of FOAM, a multicenter European study [Abstract]. J Hypertens 2001;19(Suppl 2):S92.

15. Randomised placebo-controlled trial of lisinopril in normotensive patients with insulindependent diabetes and normoalbuminuria or microalbuminuria. The EUCLIDStudy Group. Lancet 1997;349(9068):1787-92.

16. Hernández R.H., Armas-Hernández M.J., Velasco M. Calcium antagonists and atherosclerosis protection in hypertension. Am J Ther 2003;10(6):409-14.

17. Jørgensen B., Thaulow E.; Coronary Angioplasty Amlodipine Restenosis Study. Effects of amlodipine on ischemia after percutaneous transluminal coronary angioplasty: secondary results ofthe CoronaryAngioplastyAmlodipine Restenosis (CAPARES) Study.Am Heart J 2003;145(6):1030-5.

18. NissenS.E., TuzcuE.M., Libby P. et al,CAMELOT Investigators. Effectof antihypertensive agents on cardiorprovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA 2004;292(18):2217–25.

19. McCarty M.F. Concurrent treatment with an ACE inhibitor may amplify the utility of calcium supplementation for control of hypertension. Med Hypotheses 2004;63(5):818-22.

20. Farsang, C., a HAMLET vizsgálók nevében: A lisinopril és az amlodipin kombinációjá- nak elonyei az antihypertenzív terápiában. Hypertonia és Nephrologia 2004;8:72-8.

For citation:

Podzolkov V.I., Tarzimanova A.I. RATIONAL COMBINATIONS IN HYPERTENSION TREATMENT. Rational Pharmacotherapy in Cardiology. 2010;6(2):192-196. (In Russ.)

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