medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2014-12-18-24medsovet-682Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯARTERIAL HYPERTENSIONДиуретики при лечении больных артериальной гипертензией: результаты сравнительного исследования ДОВЕРИЕDiuretics in the treatment of patients with arterial hypertension: results of the DOVERIE comparative studyШевченкоО. П.ShevchenkoOPnoemail@neicon.ruАверинЕ. Е.AverinEEnoemail@neicon.ruВыгодинВ. А.VygodinVAnoemail@neicon.ruРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова, МоскваРоссияPirogov Russian National Research Medical University, MoscowRussian FederationГосударственный научно-исследовательский центр профилактической медицины, МоскваРоссияNational Research Center for Preventive Medicine, MoscowRussian Federation2014301220140121824Copyright © Шевченко О.П., Аверин Е.Е., Выгодин В.А., 20142014Шевченко О.П., Аверин Е.Е., Выгодин В.А.Shevchenko O., Averin E., Vygodin V.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/682

Часто обсуждаются вопросы использования тиазидных, тиазидоподобных и петлевых диуретиков у больных с артериальной гипертензией. Прямых сравнительных исследований диуретиков разных классов при артериальной гипертензии крайне мало. Исследование ДОВЕРИЕ (эффективность и безопасность Диувера в кОмбинироВанной тЕрапии у пациентов с артеРиальной гипертонией в условИях первичного звена здравоохранЕния) было рандомизированным, сравнительным, открытым. По данным исследования выявлено, что антигипертензивный эффект и безопасность лечения торасемида и индапамида существенно не различаются. Добавление торасемида как к монотерапии иАПФ/БРА II, так и при замене гидрохлоротиазида в составе комбинированной терапии иАПФ/БРА II + ГХТЗ приводило к дополнительному достоверному снижению АД, что позволило достичь целевых значений АД у большинства больных. На фоне терапии торасемидом не наблюдалось увеличения ЧСС, не происходило значимых изменений уровня калия, мочевой кислоты и глюкозы.

The use of thiazide, thiazide-like and loop diuretics in patients with hypertension is widely discussed. So far, there have been few direct comparative studies of different classes of diuretics in hypertension. The randomized, comparative, open DOVERIE study (efficacy and safety of Diuver in combination therapy in hypertensive patients in outpatient setting) found that the antihypertensive effects and safety of torasemide and indapamide are not significantly different. Adding torasemide either to monotherapy with ACEI/ARB II or as substitute for hydrochlorothiazide in combination therapy with ACEI/ARB II + HCTZ resulted in a further significant decrease in blood pressure and allowed to reach target BP in a majority of patients. Therapy with torasemide was not associated with any increase in heart rate, significant changes in potassium levels, uric acid and glucose.

артериальная гипертонияторасемидиндапамидгидрохлоротиазидкомбинированная терапияhypertensiontorasemideindapamidehydrochlorothiazidecombination therapyReferencesГорбунов В.М., Оганов Р.Г. Торасемид - петлевой диуретик с особыми свойствами. Кардиоваскулярная терапия и проф., 2005, 5 (5).Горбунов В.М., Оганов Р.Г. Торасемид - петлевой диуретик с особыми свойствами. Кардиоваскулярная терапия и проф., 2005, 5 (5).Сидоренко Б.А., Преображенский Д.В., Батыралиев ТА. и др. Место диуретиков в лечении хронической сердечной недостаточности. Часть I Кардиология, 2005, 8: 76-83.Сидоренко Б.А., Преображенский Д.В., Батыралиев ТА. и др. Место диуретиков в лечении хронической сердечной недостаточности. Часть I Кардиология, 2005, 8: 76-83.Киношенко Е.И. Ковалева Е.А., Нудьга А.Н. и др. Петлевые диуретики и артериальная гипертония. Медицина неотложных состояний, 2011, 7: 98-100.Киношенко Е.И. Ковалева Е.А., Нудьга А.Н. и др. Петлевые диуретики и артериальная гипертония. Медицина неотложных состояний, 2011, 7: 98-100.Roca-Cusachs A et al. Clinical Effects of Torasemide Prolonged Release in Mild-to-Moderate Hypertension: A Randomized Noninferiority Trial Versus Torasemide Immediate Release. Cardiovasc Ther., 2008, 26(2): 91-100.Roca-Cusachs A et al. Clinical Effects of Torasemide Prolonged Release in Mild-to-Moderate Hypertension: A Randomized Noninferiority Trial Versus Torasemide Immediate Release. Cardiovasc Ther., 2008, 26(2): 91-100.Coca A. Effect of torasemide in monotherapy or associated to other antihypertensive drugs on pulse pressure in essential hypertension. American Journal of Hypertension, 15.Coca A. Effect of torasemide in monotherapy or associated to other antihypertensive drugs on pulse pressure in essential hypertension. American Journal of Hypertension, 15.Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertention. Drug Res, 1988; 38 (1): 190-193.Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertention. Drug Res, 1988; 38 (1): 190-193.Neugebauer G, Besenfelder E, van M llendorf E. Pharmacokinetics and metabolism of torasemide in man. Drug Res, 1988, 38(1): 164-166.Neugebauer G, Besenfelder E, van M llendorf E. Pharmacokinetics and metabolism of torasemide in man. Drug Res, 1988, 38(1): 164-166.Brater DC, Leinfelder J, Anderson SA. Clinical pharmacology of torasemide, a new loop diuretic. Clin Pharmacol Ther, 1987, 42: 187-192.Brater DC, Leinfelder J, Anderson SA. Clinical pharmacology of torasemide, a new loop diuretic. Clin Pharmacol Ther, 1987, 42: 187-192.Bоelke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of today, 1994, 8: 1-28.Bоelke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of today, 1994, 8: 1-28.Reyes AJ. Effects of diuretics on outputs and flows of urine and urinary sodium in healthy subjects. Drugs, 1991, 41(3): 35-39.Reyes AJ. Effects of diuretics on outputs and flows of urine and urinary sodium in healthy subjects. Drugs, 1991, 41(3): 35-39.Achhammer I, Metz P. Low dose loop diuretics in essential hypertension: Experience with torasemide. Drugs, 1991, 41(3): 80-91.Achhammer I, Metz P. Low dose loop diuretics in essential hypertension: Experience with torasemide. Drugs, 1991, 41(3): 80-91.Porcellati C, Verdecchia P, Schillaci G et al. La torasemide, nuovo diuretico del'ansa, nell trattamento dell'ipertensione arteriosa: Studio controlla to in doppla cecita. BasRazion Terapia, 1990, 20: 407-410.Porcellati C, Verdecchia P, Schillaci G et al. La torasemide, nuovo diuretico del'ansa, nell trattamento dell'ipertensione arteriosa: Studio controlla to in doppla cecita. BasRazion Terapia, 1990, 20: 407-410.Baumgart P, Walger P, von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. Progress in pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 169-181.Baumgart P, Walger P, von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. Progress in pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 169-181.Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res, 1988, 38(1): 190-193.Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res, 1988, 38(1): 190-193.Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmaco-therapy in elderly patients; randomized and double-blind study. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 183-209.Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmaco-therapy in elderly patients; randomized and double-blind study. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 183-209.Boelke T, Piesche L Influence of 2,5-5 mg torasemide o.d. versus 25-50 mg HCTZ/50-100 triamterene o.d. on serum parameters in elderly patients with mild to moderate hypertension. Diuretics IV: Chemistry, Pharmacology and clinical Applications, Excerpta Medica: Amsterdam 1993, 279-82.Boelke T, Piesche L Influence of 2,5-5 mg torasemide o.d. versus 25-50 mg HCTZ/50-100 triamterene o.d. on serum parameters in elderly patients with mild to moderate hypertension. Diuretics IV: Chemistry, Pharmacology and clinical Applications, Excerpta Medica: Amsterdam 1993, 279-82.Achhammer I, Eberhard R Comparison of serum potassium levels during long-term treatment of hypertension patients with 2,5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothi-azide o.d. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 211-220.Achhammer I, Eberhard R Comparison of serum potassium levels during long-term treatment of hypertension patients with 2,5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothi-azide o.d. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 211-220.Baumgart P. Torasemide in comparison with thiazides in the treatment of hypertension. Cardiovasc Drugs Ther., 1993, 7(1): 63-68.Baumgart P. Torasemide in comparison with thiazides in the treatment of hypertension. Cardiovasc Drugs Ther., 1993, 7(1): 63-68.Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res, 1988, 38(1): 190-193.Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res, 1988, 38(1): 190-193.Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmaco-therapy in elderly patients; randomized and double-blind study. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 183-209.Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmaco-therapy in elderly patients; randomized and double-blind study. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 183-209.Boelke T, Piesche L Influence of 2,5-5 mg torasemide o.d. versus 25-50 mg HCTZ/50-100 triamterene o.d. on serum parameters in elderly patients with mild to moderate hypertension. Diuretics IV: Chemistry, Pharmacology and clinical Applications, Excerpta Medica: Amsterdam 1993, 279-82.Boelke T, Piesche L Influence of 2,5-5 mg torasemide o.d. versus 25-50 mg HCTZ/50-100 triamterene o.d. on serum parameters in elderly patients with mild to moderate hypertension. Diuretics IV: Chemistry, Pharmacology and clinical Applications, Excerpta Medica: Amsterdam 1993, 279-82.Achhammer I, Eberhard R Comparison of serum potassium levels during long-term treatment of hypertension patients with 2,5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothi-azide o.d. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 211-220.Achhammer I, Eberhard R Comparison of serum potassium levels during long-term treatment of hypertension patients with 2,5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothi-azide o.d. Progress in Pharmacology and Clinical Pharmacology, Gustav-Fischer-Verlag: Stuttgart 1990, 8: 211-220.Baumgart P. Torasemide in comparison with thiazides in the treatment of hypertension. Cardiovasc Drugs Ther., 1993, 7(1): 63-68.Baumgart P. Torasemide in comparison with thiazides in the treatment of hypertension. Cardiovasc Drugs Ther., 1993, 7(1): 63-68.

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