medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2015-12-6-11medsovet-1605Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯARTERIAL HYPERTENSIONВыбор комбинированной антигипертензивной терапии у пациентов с сахарным диабетом 2-го типаThe choice of combination antihypertensive therapy in patients with type 2 diabetesКошельскаяО. А.KoshelskayaO. A.noemail@neicon.ruЖуравлеваО. А.ZhuravlevaO. A.noemail@neicon.ruКарповР. С.KarpovR. S.noemail@neicon.ruНаучно-исследовательский институт кардиологии, ТомскРоссияTomsk Research Institute of CardiologyRussian Federation201530122015012611Copyright © Кошельская О.А., Журавлева О.А., Карпов Р.С., 20152015Кошельская О.А., Журавлева О.А., Карпов Р.С.Koshelskaya O.A., Zhuravleva O.A., Karpov R.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1605

В статье рассматриваются вопросы оптимального выбора комбинированной антигипертензивной терапии у больных с сахарным диабетом 2. Обсуждается эффективность использования у диабетических пациентов с АГ комбинированной терапии, основанной на двух вариантах блокады РААС (ингибитор ангиотензин-превращающего фермента или антагонист рецепторов ангиотензина II) в сочетании с индапамидом ретард и амлодипином, и схемой лечения, не включающей в себя блокаторы РААС и базирующейся на комбинации дигидропиридинового блокатора кальциевых каналов, индапамида ретард и кардиоселек-тивного бета-блокатора. Приводится опыт клинического применения трех вышеперечисленных схем антигипертензивной терапии, обосновывается преимущество использования комбинации периндоприла и амлодипина перед назначением валсартана и амлодипина или амлодипина и метопролола сукцината.

The article tells about optimum choice of combination antihypertensive therapy in patients with diabetes mellitus 2. The article discusses the efficacy of combination therapy based on two types of RAAS blockade (angiotensin-converting enzyme inhibitor or angiotensin II receptor antagonist) with indapamide retard and amlodipine, and the treatment regimen without RAAS blockers, which is based on the combination of dihydropyridine calcium channel blocker, indapamide retard and cardioselective beta blocker. The clinical experience with the three mentioned schemes of anti-hypertensive therapy is described; the benefits of combination of perindopril and amlodipine prior to valsartan and amlodipine or amlodipine and metoprolol succinate are demonstrated.

артериальная гипертониясахарный диабеткомбинированная антигиперензивная терапияингибиторы ангиотензин-превращающего ферментаантагонисты рецепторов ангиотензинаII блокаторы кальциевых каналовhypertensiondiabetes mellituscombination antihypReferencesIDF Diabetes Atlas. 5th edition. 2011/2012. Available from: http://www.idf.org/diabetesatlas.IDF Diabetes Atlas. 5th edition. 2011/2012. Available from: http://www.idf.org/diabetesatlas.Sowers JR, Whaley-Connell A, Hayden M. The role of overweight and obesity in the cardiore-nal syndrome. Cardiorenal Med, 2011, 1:5-12.Sowers JR, Whaley-Connell A, Hayden M. The role of overweight and obesity in the cardiore-nal syndrome. Cardiorenal Med, 2011, 1:5-12.Sowers JR. Diabetes mellitus and vascular disease. Hypertension, 2013, 61(5): 943-947.Sowers JR. Diabetes mellitus and vascular disease. Hypertension, 2013, 61(5): 943-947.Dedov II, Shestakova MV. Standarts of specialized diabetes care, 7th Edition. Diabetes mellitus J., 2015, 18(1): 1-112. 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The authors declare that there are no conflicts of interest present.