2012


To access this material please log in or register

Register Authorize
2012/№2

Initial combined therapy of hypertension – variable combinations of ACE inhibitors and diuretics

Gendlin G. E., Ostrovskaya Yu. I., Melekhov А. V.

Keywords: hypertension, diuretics, ace inhibitors

DOI: 10.18087 / rhj.2012.2.1678

Combined hypertension therapy is a basic approach in treatment of patients at high risk of complications, with accompanying DM and CHD. The combination of ACE inhibitors and diuretics is considered rational due to mutual potentiation of hypotensive effect, as well as leveling of side effects of each agent. There is a variable combination of ACE inhibitors and Indapamide – Enzix. Results of clinical studies showed that early introduction of Enzix to the treatment of patients with 1–2 degree hypertension in comparison with standard hypotensive therapy allows to achieve target levels more often, improve the quality of life, reduce number of hospitalizations. This drug has considerable advantage over the fixed combinations: possibility of more flexible dosing of Enalapril in the combination with Indapamide depending on a clinical case.
  1. Леонова М. В., Белоусов Д. Ю. Аналитическая группа исследования ПИФАГОР Первое российское фармакоэпидемиологическое исследование артериальной гипертонии. Качественная клиническая практика № 3 2002 г. стр.47–53
  2. Hansson L, Zanchetti A, Carruthers SG 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. HOT Study Group. 1998;351 (9118):1755–1762.
  3. Gupta AK, Nasothimiou EG, Chang CL et al. Baseline predictors of resistant hypertension in the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT): a risk score to identify those at high-risk. J Hypertens. 2011;29 (10):2004–2013.
  4. González-Juanatey JR, García-Acuña JM, Pose A et al. Reduction of QT and QTc dispersion during long – term treatment of systemic hypertension with enalapril. Am J Cardiol. 1998;81 (2):170–174.
  5. Fox KM; EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet. 2003;362 (9386):782–788.
  6. The HOPE (Heart Outcomes Prevention Evaluation) Study: the design of a large, simple randomized trial of an angiotensin-converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events. The HOPE study investigators. Can J Cardiol. 1996;12 (2):127–1237.
  7. Pahor M, Tatti P. The Fosinopril versus Amlodipine Cardiovascular Events Trial (FACET) and combination therapies. Am J Cardiol. 1999;83 (5):819–820.
  8. Neal B, MacMahon S, Chapman N; Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists' Collaboration. Lancet. 2000;356 (9246):1955–1964.
  9. Ambrosioni E, Safar M, Degaute JP et al. Low-dose antihypertensive the­rapy with 1.5 mg sustained-release indapamide: results of randomised double-blind controlled studies. European study group. J Hypertens. 1998;16 (11):1677–1684.
  10. Emeriau JP, Knauf H, Pujadas JO et al. A comparison of indapamide SR 1.5 mg with both amlodipine 5 mg and hydrochlorothiazide 25 mg in elderly hypertensive patients: a randomized double-blind controlled study. J Hypertens. 2001;19 (2):343–350.
  11. Marre M, Puig JG, Kokot F et al. Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes: the NESTOR Study. J Hypertens. 2004;22 (8):1613–1622.
  12. Post-stroke antihypertensive treatment study. A preliminary result. PATS Collaborating Group. Chin Med J (Engl). 1995;108 (9):710–717.
  13. PROGRESS Collaborative Group. Randomized trial of a perindopril – based blood – pressure – lowering regimen among 6105 individuals with previous stroke or transient ischemic attack. Lancet. 2001;358 (9287):1033–1041.
  14. Beckett NS, Peters R, Fletcher AE et al; HYVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358 (18):1887–1898.
  15. Беленков Ю. Н., Мареев В. Ю. – от имени рабочей группы исследования ЭПИГРАФ. Эналаприл Плюс Индапамид в лечении стабильной артериальной Гипертонии: оценка эффективности и безопасности РАциональной комбинированной Фармакотерапии (ЭПИГРАФ). Первые результаты Российского многоцентрового исследования. Сердце. 2003;2 (1):3–7.
  16. Беленков О. Н. – от имени рабочей группы исследования ЭПИГРАФ-2. Эналаприл плюс индапамид в лечении АГ:оценка эффективности и безопасности рациональной фармакотерапии. Применение нефиксированной комбинации эналаприла и индапамида (Энзикс). Дизайн и основные результаты исследования ЭПИГРАФ-2. Сердце. 2005;4 (5):277–286.
Gendlin G. E., Ostrovskaya Yu. I., Melekhov А. V. Initial combined therapy of hypertension – variable combinations of ACE inhibitors and diuretics. Russian Heart Journal. 2012;11(2):112-115

To access this material please log in or register

Register Authorize
Ru En