References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2018-16-14-23

medsovet-2628

Research Article

АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ

ARTERIAL HYPERTENSION

Церебропротективные свойства блокаторов рецепторов к ангиотензину ii: фокус на кандесартан

Cerebroprotective effects of angiotensin II receptor blockers: candesartan focus

Остроумова

О. Д.

Ostroumova

O. D.

профессор, д.м.н., профессор кафедры факультетской терапии и профболезней;

профессор кафедры клинической фармакологии и пропедевтики внутренних болезней

Moscow

Кочетков

А. И.

Kochetkov

A. I.

к.м.н., ассистент кафедры факультетской терапии и профболезней

Moscow

Остроумова

Т. М.

Ostroumova

T. M.

аспирантка, старший лаборант кафедры нервных болезней и нейрохирургии лечебного факультета

Moscow

Павлеева

Е. Е.

Pavleeva

E. E.

к.м.н., ассистент кафедры пропедевтики внутренних болезней и гастроэнтерологии

Moscow

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет)РоссияYevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russia; Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)Russian Federation

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава РоссииРоссияYevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of RussiaRussian Federation

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет)РоссияSechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)Russian Federation

2018

26092018

0161423

2018

Остроумова О.Д., Кочетков А.И., Остроумова Т.М., Павлеева Е.Е.

Ostroumova O.D., Kochetkov A.I., Ostroumova T.M., Pavleeva E.E.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/2628

Статья посвящена роли антигипертензивных препаратов в церебротекции, их значению в снижении риска развития инсульта и когнитивных расстройств у пациентов с артериальной гипертонией (АГ). В статье приведены определение, классификация и патогенетические механизмы нарушения когнитивных функций при повышенном артериальном давлении (АД). Представлена эпидемиологическая характеристика распространенности инсульта и когнитивных расстройств при АГ. Рассмотрено влияние повышенного АД как фактора, увеличивающего риск развития цереброваскулярных осложнений. Особое внимание уделено проблеме резкого подъема АД в ранние утренние часы, характерной для больных АГ. Обсуждается клиническое значение избыточного утреннего подъема АД. Подчеркиваются трудности и важность коррекции утренних подъемов артериального давления как одной из задач антигипертензивной терапии. Приведены данные об отличительных особенностях фармакокинетики и фармакодинамики кандесартана – блокатора рецепторов ангиотензина II со сверхдлительным периодом действия. С точки зрения доказательной медицины показана клиническая эффективность кандесартана в лечении АГ и снижении риска цереброваскулярных осложнений, прежде всего инсульта и когнитивных нарушений.

The article is devoted to the role of antihypertensive drugs in cerebroprotection, importance of such drugs in reducing the risk of stroke and cognitive disorders in patients with arterial hypertension (AH). The article provides the definition, classification and pathogenetic mechanisms of cognitive impairment in elevated blood pressure (BP). It also presents epidemiological characteristics of the incidence of stroke and cognitive disorders in hypertension. The influence of elevated blood pressure as a factor increasing the risk of cerebrovascular complications is considered. Particular attention is paid to the issue of a sharp rise in BP in the early morning hours, which is typical for patients with AH. The clinical significance of excessive early morning hypertension is discussed. The authors emphasize the difficulties and importance of correcting the morning rises in blood pressure as one of the objectives of antihypertensive therapy. The article presents data on the distinctive features of the pharmacokinetics and pharmacodynamics of candesartan, an angiotensin II receptor blocker with an extremely long-term action. The clinical efficacy of candesartan in the treatment of AH and the risk of cerebrovascular complications, especially stroke and cognitive impairment, has been demonstrated from the point of view of evidence-based medicine.

артериальная гипертонияинсульткогнитивные расстройстваутренний подъем артериального давлениякандесартан

Arterial hypertensionstrokecognitive impairmentmorning rise in blood pressurecandesartan

References1

Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA et al; Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) and the GBD Stroke Experts Group. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet, 2014, 383: 245–254.

Global Burden of Disease Study 2013 Collaborators: Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2015, 386: 743– 800.

Ovbiagele B, Goldstein LB, Higashida RT, Howard VJ, Johnston SC, Khavjou OA et al; American Heart Association Advocacy Coordinating Committee and Stroke Council. Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association. Stroke, 2013, 44: 2361–2375.

Геморрагический инсульт. Практическое руководство. Под ред. Скворцовой В.И., Крылова В.В. М.: ГЭОТАР-Медиа, 2005, 160 с.

Hemorrhagic stroke. A practical guidelines. Under the editorship of Skvortsova VI, Krylov VV. M.: GEOTAR-Media 2005, 160 p.

Гусев Е.И., Скворцова В.И., Стаховская Л.В. Проблема инсульта в Российской Федерации: время активных совместных действий. Журнал неврологии и психиатрии, 2007, 8: 4-10.

Gusev EI, Skvortsova VI, Stakhovskaya LV. The issue of stroke in the Russian Federation: time to take active joint actions. Zhurnal Nevrologii i Psikhiatrii, 2007, 8: 4-10.

Верещагин Н.В. Гетерогенность инсульта в клинической практике. Атмосфера. Нервные болезни, 2004, 1: 19-20.

Vereshchagin NV. Heterogeneity of stroke in clinical practice. Atmosfera. Nervnye Bolezni, 2004, 1: 19-20.

Savoia C, Volpe M, Grassi G, Borghi C, Agabiti Rosei E, Touyz RM. Personalized medicine-a modern approach for the diagnosis and management of hypertension. Clin Sci (Lond), 2017, 131(22): 2671-2685.

Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D 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.

D’Agostino RB Sr., Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation, 2008, 117(6): 743-753.

Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A et al. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ, 2008, 336(7659): 1475-1482.

Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ, 2009, 338: b1665.

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet, 2002, 360: 1903–1913.

Чазова И.Е., Ратова Л.Г., Бойцов С.А., Небиеридзе Д.В. Диагностика и лечение артериальной гипертензии (Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов). Системные гипертензии, 2010, 3: 5–26.

Chazova IE, Ratova LG, Boytsov SA, Nebieridze DV. Diagnosis and treatment of arterial hypertension (the Russian Medical Society and the AllRussian Scientific Society of Cardiology Guidelines for Arterial Hypertension). Sistemnye Gipertenzii, 2010, 3: 5-26

Staessen JA, Wang J-G, Thijs L. Cardiovascular prevention and blood pressure reduction: a quantitative overview updated until 1 March 2003. J Hypertens, 2003, 21: 1055-1076.

Reboldi G, Angeli F, Cavallini C, Gentile G, Mancia G, Verdecchia P. Comparison between angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the risk of myocardial infarction, stroke and death: a meta-analysis. J Hypertens, 2008, 26(7): 1282– 1289.

Захаров В.В., Локшина А.Б. Когнитивные нарушения в общеклинической практике. М., 2009, 8 с.

Zakharov VV, Lokshina AB. Cognitive impairment in general clinical practice. M., 2009, 8 p.

Diagnostic and statistical manual of mental diseases (DSM-V). 5th ed. London: American Psychiatric Association, 2013. 970 p.

Jelic V, Kivipelto M, Winblad B. Clinical trials in mild cognitive impairment: lessons for the future. Journal of Neurology, Neurosurgery and Psychiatry, 2006, 77(4): 429–438.

Larrieu S, Letenneur L, Orgogozo JM. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology, 2002, 59: 1594-1599.

Левин О.С. Диагностика и лечение деменции в клинической практике. М.: «МЕДпрессинформ», 248 с.

Levin OS. Diagnosis and treatment of dementia in clinical practice. М.: MEDpress-inform, 248 p.

Henderson AS. Dementia. World Health Organization, Geneva, 1994, 70 p.

Amaducci L, Andrea L. The epidemiology of the dementia in Europe. In: A.Culebras, J.Matias Cuiu, G. Roman (eds) : New concepts in vascular dementia . Barselona : Prous Science Publishers, 1993, pp 1927.

Левин О.С., Дамулин И.В. Диффузные изменения белого вещества (лейкоареоз) и проблема сосудистой деменции. Под ред. Н.Н. Яхно, И.В. Дамулина: Достижения в нейрогериатрии. 1995. Ч. 2: 189-231.

Levin OS, Damulin IV. Diffuse white matter changes (leukoareosis) and the issue of vascular dementia. Edited by Yakhno NN, Damulina IV: Achievements in the neuro-geriatrics. 1995. Part 2: 189-231.

Awad IA, Masaryk T, Magdinec M. Pathogenesis of subcortical hypertense lesions on MRI of the brain. Stroke, 1993, 24: 1339-1346.

Inzitari D, Marinoni M, Ginanneschi A. Pathophysiology of leucoaraiosis. In: New concepts in vascular dementia. A. Culebras, J. Matias Guiu, G. Roman (eds). Barcelona: Prous Science Publishers. 1993. P.103-113.

Fisher CM. Lacunar strokes and infarcts. Neurology, 1982, 32: 871-876.

Hachinski VC, Lassen NA, Marshall J. Multiinfarct dementia. A case of mental deterioration in the elderly. Lancet, 1974, 2: 207-210.

Дамулин И.В. Сосудистая деменция. Неврологический Ж, 1999, 3(4): 411.

Damulin IV. Vascular dementia. Nevrologicheskiy Zh, 1999, 3 (4): 411.

Лурия А.Р. Высшие корковые функции человека. Изд. 2. М.: Издательство МГУ, 1969 г.

Luriya AR. Higher cortical functions in man. 2nd Edition. Moscow: MGU Publishing House, 1969.

Лурия А.Р. Основы нейропсихологии. М.: Издательство МГУ, 1973.

Luriya AR. Fundamentals of Human Neuropsychology. M.: Moscow State University Press, 1973.

Лурия А.Р. Лобные доли и регуляция психических процессов. М.: Изд-во Московского Университета, 1966.

Luriya AR. Frontal lobes and regulation of mental processes. M.: Publishing House of Moscow University, 1966.

Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L et al. 15-years longitudinal study of blood pressure and dementia. Lancet, 1996, 347: 1141-1145.

Launer LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ. The assotiation between midlife blood pressure levels and late–life cognitive function. The Honolulu–Asia Aging Study. JAMA, 1995, 274: 1846–1851.

Cacciatore F, Abete P, Ferrara N, Paolisso G, Amato L, Canonico S et al. The role of blood pressure in cognitive impairment in an elderly population. J of Hypertension, 1997, 15: 135– 142.

Elias PK, D’Agostino RB, Elias MF, Wolf PA. Blood pressure, hypertension, and age as risk factors for poor cognitive performance. Exp Aging Res, 1995, 21: 393–417.

Singh–Manoux A, Marmot M. High blood pressure was associated with cognitive function in middle–age in the Whitehall II study. J Clin Epidemiol, 2005, 58: 1308–1315.

Forette F, Seux ML, Staessen JA, Thijs L, Babarskiene MR, Babeanu S et al; Systolic Hypertension in Europe Investigators. The Prevention of Dementia with Antihypertensive Treatment. New evidence from the Systolic Hypertension (Syst-Eur) Study. Arch Intern Med, 2002, 162(18): 2046-2052.

Lithell H, Hansson L, Skoog I, Elmfeldt D, Hofman A, Olofsson B et al, SCOPE Study Group. The study on cognition and prognosis in the elderly (SCOPE). Principal results of a randomised double-blind intervention trial. J Hypertens, 2003, 21: 875–86.

PROGRESS collaborative study group. Randomised trial of perindopril based blood pressure-lowering regimen among 6108 individuals with previous stroke or transient ischaemic attack. Lancet, 2001, 358: 1033–41.

Marpillat NL, Macquin-Mavier I, Tropeano A-I, Bachoud-Levi A-C, Maison P. Antihypertensive classes, cognitive decline andincidence of dementia: a networkmeta-analysis. Journal of Hypertension, 2013, 31(6): 1073-82.

Chiu W-C, Ho W-C, Lin M-H, Lee H-H, Yeh Y-Ch, Wang J-D, et al. Health Data Analysis in Taiwan (hDATa) Research Group. Angiotension receptor blockers reduce the risk of dementia. Journal of Hypertension, 2014, 32: 938–947.

Hajjar I, Brown L, Mack WJ, Chui H. Impact of Angiotensin Receptor Blockers on Alzheimer Disease Neuropathology in a Large Brain Autopsy Series. Arch Neurol, 2012, 69(12): 1632- 1638.

Kaplan NM. Morning surge in blood pressure. Circulation, 2003; 107: 1347.

Peixoto AJ, White WB. Circadian blood pressure: clinical implications based on the pathophysiology of its variability. Kidney Int, 2007, 71(9): 855-60.

Willich SN. Circadian variation and triggering of cardiovascular events. Vasc Med, 1999, 4: 41–49.

Argentino C, Toni D, Rasura M, Violi F, Sacchetti ML, Allegretta A et al. Circadian variation in the frequency of ischemic stroke. Stroke, 1990, 21: 387–389.

Willich SN, Levy D, Rocco MB, Tofler GH, Stone PH, Muller JE. Circadian variation in the incidence of sudden cardiac death in the Framingham Heart Study population. Am J Cardiol, 1987, 60: 801-806.

Elliott WJ. Circadian variation in the timing of stroke onset. А meta-analysis. Stroke, 1998, 29: 992–996.

Kario K, Shimada K, Pickering TG. Clinical implication of morning blood pressure surge in hypertension. J Cardiovasc Pharmacol, 2003, 42(Suppl 1): S87-91.

Kario К, Pickering ТG, Umeda Y, Hoshide S, Hoshide Y, Morinari M et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives. A prospective study. Circulation, 2003, 107: 1401-1406.

Шевченко О.П., Праскурничий Е.А., Яхно Н.Н., Парфенов В.А. Артериальная гипертония и церебральный инсульт. М.: Реафарм, 2001: 21, 29-30, 42-43.

Shevchenko OP, Praskurnichiy EA, Yakhno NN, Parfenov VA. Arterial hypertension and cerebral stroke. M.: Reafarm, 2001: 21, 29-30, 42-43.

Slergiou GS, Vemmos KN, Pliarchopoulou KM, Synetos AG, Roussias LG, Mountokalakis TD. Parallel moning and evening surge in stroke onset, blood pressure, and physical activity. Stroke, 2002, 33: 1480-1486.

Redón J, Roca-Cusachs A, Mora-Macia J. Uncontrolled early morning blood pressure in medicated patients: the ACAMPA study. Blood Press Monit, 2002, 7: 111–116.

Kario K, Eguchi K, Umeda Y, Hoshide S, Hoshide Y, Morinari M et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives. Circulation, 2003, 108: 72e–73e.

Чазова И.Е., Ратова Л.Г. Роль суточного мониторирования артериального давления в оценке эффективности антигипертензивной терапии (Результаты суточного мониторирования артериального давления в программе КЛИП-АККОРД). Системные гипертензии (приложение к журналу Consilium Medicum), 2007, 9(1): 3-7.

Chazova IE, Ratova LG. The role of daily blood pressure monitoring in measuring the efficacy of antihypertensive therapy (Results of daily blood pressure monitoring in the CLIP-ACCORD program). Sistemnye Gipertenzii (annex to the journal Consilium Medicum), 2007, 9 (1): 3-7.

Kapiotis S, Jilma B, Quehenberger P, Ruzicka K, Handler S, Speiser W. Morning hypercoagulability and hypofibrinolysis: diurnal variations in circulating activated factor Vll, prothrombin fragment Fl+2, and plasmin-plasmin inhibitor complex. Circulation, 1997, 96: 19-21.

Dodt C, Breckling U, Derad I, Fehm HL, Born J. Plasma epinephrine and norepinephrine concentration of healthy humans associated with nighttime sleep and morning arousal. Hypertension, 1997; 30: 71-76.

Vanderheyden PML. Distinction between surmountable and insurmountable selective AT1 receptor antagonists by use of CHO-K1 cells expressing human angiotensin II AT1 receptors. Br J Pharmacol, 1999, 126: 1057–1065.

Le MT, De Backer JP, Hunyady L, Vanderheyden PM, Vauquelin G. Ligand binding and functional properties of human angiotensin AT1 receptors in transiently and stably expressed CHO-K1 cells. Eur J Pharmacol, 2005; 513 (1–2): 35–45.

Van Liefde I, Vauquelin G. Sartan-AT1 receptor interactions: in vitro evidence for insurmountable antagonism and inverse agonism. Mol Cell Endocrinol, 2009, 302 (2): 237–243.

Bhuiyan MA, Ishiguro M, Hossain M, Nakamura T, Ozaki M, Miura SI et al. Binding sites of valsartan, candesartan and losartan with angiotensin II receptor 1 subtype by molecular modeling. Life Sci, 2009, 85(3-4): 136.

Lacourciere Y, Asmar R. A comparison of the efficacy and duration of action of candesartan cilexetil and losartan as assessed by clinic and ambulatory blood pressure after a missed dose, in truly hypertensive patients. A placebo-controlled, forced titration study. Am J Hypertens, 1999, 12: 1181–1187.

Кобалава Ж.Д., Склизкова Л.А., Тарапата Н.П. Обоснование, опыт и перспективны применения кандесартана цилексетила. Клин. фармакол. и тер., 2001, 1: 92-96.

Kobalava ZhD, Sklizkova LA, Tarapata NP. Rationale, experience and prospects for the use of candesartan cilexetil. Klin. Farmakol. i Ter., 2001, 1: 92-96.

Easthope SE, Jarvis B. Candesartan cilexetil: an update of its use in essential hypertension. Drugs, 2002, 62: 1253-1287.

Imbs JL, Nisse-Durgeat S, French Collaborative Candesartan Study Group. Efficacy and tolerability of candesartan cilexetil vs. amlodipine as assessed by home blood pressure in hypertensive patients. Int J Clin Pract, 2005, 59: 78–84.

Malmqvist K, Kahan T, Dahl M. Angiotensin II type 1 (AT1) receptor blockade in hypertensive women: benefits of candesartan cilexetil versus enalapril or hydrochlorothiazide. Am J Hypertens, 2000, 13(5 Pt 1): 504-511.

Zhenfeng Zheng, Huilan Shi, Junya Jia, Dong Li, Shan Lin. A systematic review and metaanalysis of candesartan and losartan in the management of essential hypertension. J Renin Angiotensin Aldosterone Syst, 2011, 12(3): 365–374.

Minatoguchi S, Aoyama T, Kawai N, Iiwasa M, Oda M, Kida K et al. Comparative effect of candesartan and amlodipine, and effect of switching from valsartan, losartan, telmisartan and olmesartan to candesartan, on early morning hypertension and heart rate. Blood Press, 2013, 22(Suppl. 1): 29–37.

Hasegawa H, Takano H, Kameda Y, Kubota A, Kobayashi Y, Komuro I. Effect of switching from telmisartan, valsartan, olmesartan, or losartan to candesartan on morning hypertension. Clin Exp Hypertens, 2012, 34(2): 86–91.

Skoog I, Lithell H, Hansson L, Elmfeldt D, Hofman A, Olofsson B et al. Effect of baseline cognitive function and antihypertensive treatment on cognitive and cardiovascular outcomes: Study on COgnition and Prognosis in the Elderly (SCOPE). Am J Hypertens, 2005, 18(8): 1052-1059.

The authors declare that there are no conflicts of interest present.