Rational Pharmacotherapy in Cardiology

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The possible indications for the choice of two component antihypertensives combinations are presented. The advantages of ACE inhibitor+calcium channel blocker combination are shown in terms of antihypertensive efficacy, organoprotective properties, and positive metabolic effects. Clinical aspects of ACE inhibitor+thiazide diuretic combination usage, its possible side effects and ways to minimize them are considered.

About the Authors

O. D. Ostroumova
Moscow State University of Medicine and Dentistry
Russian Federation
Delegatskaya ul. 20/1, Moscow, 127473

E. A. Smolyarchuk
Moscow State University of Medicine and Dentistry
Russian Federation
Delegatskaya ul. 20/1, Moscow, 127473

I. V. Khvorostyanaya
Moscow State University of Medicine and Dentistry
Russian Federation
Delegatskaya ul. 20/1, Moscow, 127473


1. National guidelines for diagnosis and treatment of hypertension. The Experts Committee of RMSAHand RSSC. Kardiovaskulyarnaya terapiya i profilaktika 2008; 7(6) prilozhenie 2:1-32. Russian (Национальные рекомендации по диагностике и лечению артериальной гипертонии. Комитет экспертов РМОАГ и ВНОК. Кардиоваскулярная терапия и профилактика 2008; 7(6) приложение 2:1-32).

2. Chazov E.I., Chazova I.E., editors. Guidelines for arterial hypertension. M.: Media Medika; 2005. S.596- 610, 655-677. Russian (Чазов Е.И., Чазова И.Е., редакторы. Руководство по артериальной гипертонии. М.: Медиа Медика; 2005. С.596-610, 655-677).

3. 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.

4. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The Seventh Report. Hypertension 2003; 42(6): 1206-1252.

5. Chazova I.E., Ratova L.G. Combination therapy of hypertension. M.: Media Medika; 2007. Russian (Чазова И.Е., Ратова Л.Г. Комбинированная терапия артериальной гипертонии. М.: Медиа Медика; 2007).

6. Johnson B.F. The emerging problem of plasma lipid changes during antihypertensive therapy.J Cardiovasc Pharmacol 1982;4 Suppl 2:S213-21.

7. Chrysant S.G. The Lisinopril-Hydrochlorthiazide Group. Antihypertensive effectiveness of low-dose hydrochlorthiazide combination. A large multicentral study. Arch Intern Med 1994; 154(7): 737-43.

8. Antonios T.F., Cappuccio F.P., Markandu N.D. et al. A diuretic is more effective than a beta-blocker in hypertensive patients not controlled on amlodipine and lisinopril. Hypertension 1996; 27(6): 1325-8.

9. Chazova I.E., Ratova L.G. KLIP-AKKORD: full dose fixed combination in the treatment of 6,346 patients with hypertension. Bolezni serdtsa i sosudov 2006; 3: 25-30. Russian (Чазова И.Е., Ратова Л.Г. от имени исследователей КЛИП-АККОРД. КЛИП-АККОРД: полнодозовая фиксированная комбинация в лечении 6 346 пациентов с артериальной гипертонией. Болезни сердца и сосудов 2006; 3: 25-30).

10. Belenkov Yu.N., Chazova I.E., Ratova L.G. et al. Evaluating of the moexipril efficacy in patients with mild or moderate arterial hypertension and left ventricular hypertrophy (ENIGMAtrail). Sistemnye gipertenzii 2005; 1: 22-5. Russian (Беленков Ю.Н., Чазова И.Е., Ратова Л.Г. и др. Оценка эффективности моэксиприла у больных мягкой и умеренной артериальной гипертонией с гипертрофией миокарда левого желудочка (исследование ЭНИГМА). Системные гипертензии 2005; 1: 22-5).

11. Pool J.L., Cushman W.C., Saini R.K. et al. Use of the factorial design and quadratic response surface models to evaluate the fosinopril and hydrochlorthiazide combination therapy in hypertension. Am J Hypertens 1997; 10(1): 117-23.

12. Patel A.; ADVANCE Collaborative Group. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randimised controlled trial. Lancet 2007; 370(9590): 829-40.

13. Chazova I.E., Ratova L.G., Kolos I.P. et al. Nephroprotection in the treatment of hypertensive patients (results of IRIS trail). Sistemnye gipertenzii 2005; 1: 3-6. Russian (Чазова И.Е., Ратова Л.Г., Колос И.П. и др. Нефропротекция в лечении больных артериальной гипертонией (результаты исследования ИРИС). Системные гипертензии 2005; 1: 3-6).

14. Sommers SC, Melarmed J. Renal pathology of essential hypertension. Am J Hypertens 1990; 3 (7): 583-7.

15. 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 theAnglo-Scandinaviam Cardiac Outcomes Trial — Blood-Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005; 366(9489): 895-906.

16. Coldberg A.I., Dunlay M.C., Sweet C.S. Safety and tolerability of losartan potassium, an angiotensin II receptor antagonists, compared with hydrochlorthiazide, atenolol, felodipine ER, and angiotensinconverting enzyme inhibitors for the treatment of systemic hypertension. Am J Cardiol 1995; 75(12): 793-5.

17. Elliott H.L., Meredith P.A. Clinical implications of the trough-peak ratio. Blood Pressure Monit 1996; 6 (suppl 1): 47-51.

18. JohnstonD.L., Lesowray R.,HumenD.P., KostukW.J. Clinical and hemodynamic evaluation of propranolol in combination with verapamil, nifedipine and diltiazem inexertional angina pectoris: a placebo-controlled, double-blind, randomized, cross-over study. Am J Cardiol 1985; 55(6): 680-7.

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

20. Ostroumova O.D., Shaposhnik I.I., Paukov S.V. et al. Combination therapy of hypertension: what's new? Russkiy meditsinskiy zhurnal 2007;15(20):3-7. Russian (Остроумова О.Д., Шапошник И.И., Пауков С.В. и др. Комбинированная терапия артериальной гипертонии: что нового? Русский медицинский журнал 2007;15(20):3-7).

21. Davidovich I.M., Petrichko T.A. Combined therapy with amlodipin and lisinopril in arterial hypertension: efficacy of a low-dose combination. Ter Arkh 2006;78(5):65-8. Russian (Давидович И.М., Петричко Т.А. Комбинированная терапия амлодипином и лизиноприлом в лечении больных артериальной гипертензией: эффективность низкодозовой комбинации. Тер Архив 2006;5:1-4).

For citation:

Ostroumova O.D., Smolyarchuk E.A., Khvorostyanaya I.V. NEW APPROACHES OF THE HYPERTENSION TREATMENT: FROM CHOOSING THE BEST DRUG TO CHOOSE THE OPTIMUM DRUGS COMBINATION. Rational Pharmacotherapy in Cardiology. 2010;6(5):709-716. (In Russ.)

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