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Эффективность фиксированной комбинации рамиприл/амлодипин в лечении артериальной гипертонии, хронической болезни почек и сахарного диабета

https://doi.org/10.21518/2079-701X-2016-13-16-23

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Аннотация

Обзор посвящен проблеме поражения почек как органа-мишени артериальной гипертонии. Представлены данные о распространенности хронической болезни почек при артериальной гипертонии (АГ), диагностике и подходах к лечению. С позиций современных рекомендаций по лечению АГ рассмотрены вопросы о целевых уровнях артериального давления у больных с сочетанным поражением почек и/или сахарным диабетом, выборе антигипертензивных препаратов в данных клинических ситуациях, прежде всего рациональных комбинаций антигипертензивных средств. Обсуждаются результаты исследований, свидетельствующие о преимуществах комбинации ингибитора ангиотензинпревращающего фермента с антагонистом кальция для лечения больных с АГ, сахарным диабетом и поражением почек. Подчеркиваются преимущества рамиприла для лечения данной категории больных. Приведены данные крупного исследования RAMONA, в котором выявлена высокая эффективность и безопасность, а также положительные метаболические эффекты фиксированной комбинации рамиприла с амлодипином.

Об авторах

О. Д. ОСТРОУМОВА
Московский государственный медико-стоматологический университет им. А.И. Евдокимова; Первый Московский государственный медицинский университет им. И.М. Сеченова
Россия
д.м.н., профессор


А. А. ЗЫКОВА
Первый Московский государственный медицинский университет им. И.М. Сеченова
Россия
к.м.н.


Список литературы

1. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Кардиологический вестник, 2015, №1, с.3–30./Clinical recommendations. Diagnostics and

2. therapy of arterial hypertension. Kardiologichesky Vestnik, 2015, No.1, p. 3-30.

3. Mancia G., Fagard R., Narkiewicz K., Redon J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes P, Sleight P, Viigimaa M, Waeber B, Zannad F. 2013 ESH/ESC 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) Journal of Hypertansion 2013, 31 : 1281-1357.тензии. Журнал «Системные гипертензии» 2010; 3: 5–26./Diagnostics and therapy of arterial hypertension. Systemnye Gipertensii Journal, 2010; 3: 5-26.

4. Prevalence of low glomerular filtration rate in nondiabetic Americans: Third National Health and Nutrition Examination Survey (NHANES III) J Am Soc Nephrol 2002;13(5):1338-1349.

5. McCullough PA, Li S, Jurkovitz CT. et al. CKD and cardiovascular disease in screened highrisk volunteer and general populations: the Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999-2004.// Am J Kidney Dis. 2008; 51 (4 Suppl 2): – 38–45.

6. Sarafidis P.A., Li S., Chen S.C. Hypertension awareness, treatment, and control in chronic kidney diseseas. Am. J. Med. 2008; 121: 332–340.

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

8. Britton KA, Gaziano JM, Djousse L. Normal systolic blood pressure and risk of heart failure in US male physicians. Eur J Heart Fail 2009; 11:1129–1134.

9. Kalaitzidis RG, Bakris GL. Prehypertension: is it relevant for nephrologists? Kidney Int 2010; 77:194–200.

10. Asia Pacific Cohort Studies Collaboration. Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens 2003; 21:707–716.

11. Brown DW, Giles WH, Greenlund KJ. Blood pressure parameters and risk of fatal stroke, NHANES II mortality study. Am J Hypertens 2007; 20:338–341.

12. Sehestedt T, Jeppesen J, Hansen TW, Wachtell K, Ibsen H, Torp-Pedersen C, et al. Risk prediction is improved by adding markers of subclinical organ damage to SCORE. Eur Heart J 2010; 31:883–891.

13. Sehestedt T, Jeppesen J, Hansen TW, Rasmussen S, Wachtell K, Ibsen H, et al. Thresholds for pulse wave velocity, urine albumin creatinineratio and left ventricular mass index using SCORE, Framingham and ESH/ESC risk charts. J Hypertens 2012; 30:1928–1936.

14. Volpe M, Battistoni A, Tocci G, Agabiti Rosei E, Catapano AL, Coppo R, et al. Cardiovascular risk assessment beyond systemic coronary risk estimation: a role for organ damage markers. J Hypertens 2012; 30:1056–1064.

15. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function: measured and estimated glomerular filtration rate. N Engl J Med 2006; 354:2473–2483.

16. Matsushita K, Mahmodi BK, Woodward M, Emberson JM, Jafar JH, Jee SH, et al. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estmated glomerular filtration rate. JAMA 2012; 307:1941–1951.

17. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67:2089–2100

18. Moe S, Drueke T, Cunningham J, Goodman W, Martin K, Olgaard K, et al. Definition, evaluation and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2006; 69:1945–1953.

19. Parving HH. Initiation and progression of diabetic nephropathy. N Engl J Med 1996; 335:1682–1683.

20. Ruilope LM, Rodicio JL. Clinical relevance of proteinuria and microalbuminuria. Curr Opin Nephrol Hypertens 1993; 2:962–967.

21. Redon J, Williams B. Microalbuminuria in essential hypertension: redefining the threshold. J Hypertens 2002; 20:353–355.

22. Jensen JS, Feldt-Rasmussen B, Strandgaard S, Schroll M, Borch-Johnsen K. Arterial hypertension, microalbuminuria and risk of ischemic heart disease. Hypertension 2000; 35:898–903.

23. de Leeuw PW, Ruilope LM, Palmer CR, Brown MJ, Castaigne A, Mancia G, et al. Clinical significance of renal function in hypertensive patients at high risk: results from the INSIGHT trial. Arch Intern Med 2004; 164:2459–2464.

24. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology and Epidemiology and Prevention. Circulation 2003; 108:2154–2169.

25. Gerstein HC, Mann JF, Yi Q, Zinman B, Dinneen SF, Hoogwerf B, et al. Albuminuria and risk of cardiovascular events, death and heart failure in diabetic and nondiabetic individuals. JAMA 2001; 286:421–426.

26. Jager A, Kostense PJ, Ruhe HG, Heine RJ, Nijpels G, Dekker JM, et al. Microalbuminuria and peripheral arterial disease are independent predictors of cardiovascular and all-cause mortality, especially among hypertensive subjects: fiveyear follow-up of the Hoorn Study. Arterioscler Thromb Vac Biol 1999; 19:617–624.

27. Bigazzi R, Bianchi S, Baldari D, Campese VM. Microalbuminuria predicts cardiovascular events and renal insufficiency in patients with essential hypertension. J Hypertens 1998; 16:1325–1333.

28. National Kidney Foundation. K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Executive summary. Am J Kid Dis 2004; 43 (Suppl 1): S16–S33.

29. Hillege HL, Fidler V, Diercks GF, van Gilst WH, de Zeeuw D, van Veldhuisen DJ, et al. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation 2002; 106:1777–1782.

30. Ninomiya T, Perkovic V, de Galan BE, Zoungas S, Pillai A, Jardine M, et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol 2009; 20:1813–1821.

31. Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet 2010; 375:2073–2081.

32. Ruilope LM, Salvetti A, Jamerson K, Hansson L, Warnold I, Wedel H, Zanchetti A. Renal function and intensive lowering of blood pressure in hypertensive participants of the hypertension optimal treatment (HOT) study. J Am Soc Nephrol 2001; 12:218–225.

33. De Leeuw PW, Thijs L, Birkenhager WH, Voyaki SM, Efstratopoulos AD, Fagard RH, et al. Prognostic significance of renal function in elderly patients with isolated systolic hypertension: results from the Syst-Eur trial. J Am Soc Nephrol 2002; 13:2213–2222.

34. Segura J, Ruilope LM, Zanchetti A. On the importance of estimating renal function for cardiovascular risk assessment. J Hypertens 2004; 22:1635–1639.

35. Rahman M, Pressel S, Davis BR, Nwachuku C, Wright JT Jr, Whelton PK, et al. Cardiovascular outcomes in high-risk hypertensive patients stratified by baseline glomerular filtration rate. Ann Intern Med 2006; 144:172–180.

36. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Stamler J. End-stage renal disease in African-American and white men. 16-year MRFIT findings. JAMA 1997; 277:1293–1298.

37. Jafar TH, Stark PC, Schmid CH, Landa M, Maschio G, de Jong PE, et al. Progression of chronic kidney disease: the role of blood pressure control, proteinuria and angiotensin- converting enzyme inhibition: a patient-level meta-analysis. Ann Intern Med 2003; 139:244–252.

38. Klahr S, Levey AS, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW, Striker G. The effects of

39. dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group. N Engl J Med 1994; 330:877– 884.

40. Wright JT Jr, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA 2002; 288:2421–2431.

41. Ruggenenti P, Perna A, Loriga G, Ganeva M, Ene-Iordache B, Turturro M, et al. Bloodpressure controlfor renoprotection in patients with nondiabetic chronic renal disease (REIN-2): multicentre, randomized controlled trial. Lancet 2005; 365:939–946.

42. Sarnak MJ, Greene T, Wang X, Beck G, Kusek JW, Collins AJ, Levey AS. The effect of a lower target blood pressure on the progression of kidney disease: long-term follow-up of the modification of diet in renal disease study. Ann Intern Med 2005; 142:342–351.

43. Appel LJ, Wright JT Jr, Greene T, Agodoa LY, Astor BC, Bakris GL, et al. Intensive bloodpressure control in hypertensive chronic kidney disease. N Engl J Med 2010; 363:918– 929.

44. Upadhyay A, Earley A, Haynes SM, Uhlig K. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier. Ann Intern Med 2011; 154:541–548.

45. Heerspink HJ, Ninomiya T, Zoungas S, de Zeeuw D, Grobbee DE, Jardine MJ, et al. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials. Lancet 2009; 373:1009–1015.

46. Schmieder RE, Hilgers KF, Schlaich MP, Schmidt BM. Renin-angiotensin system and cardiovascular risk. Lancet 2007; 369:1208–1219.

47. Kunz R, Friedrich C, Wolbers M, Mann JF. Metaanalysis: effect of monotherapy and combination therapy with inhibitors of the rennin angiotensin system on proteinuria in renal disease. Ann Intern Med 2008; 148:30–48.

48. Haller H, Ito S, Izzo JL Jr, Januszewicz A, Katayama S, Menne J, et al., ROADMAP Trial Investigators. Olmesartan for the delay or prevention of microalbuminuria in type 2 diabetes. N Engl J Med 2011; 364:907–917.

49. Ruggenenti P, Fassi A, Ilieva AP, Iliev IP, Chiurchiu C, Rubis N, et al. Effects of verapamil added-on trandolapril therapy in hypertensive type 2 diabetes patients with microalbuminuria: the BENEDICT-B randomized trial. J Hypertens 2011; 29:207–216.

50. Bakris GL, Serafidis PA, Weir MR, Dalhof B, Pitt B, Jamerson K, et al., ACCOMPLISH Trial Investi ga tors. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of randomised controlled trial. Lancet 2010; 375:1173–1181.

51. Jamerson K, Weber MA, Bakris GL, et al for the ACCOMPLISH Trial Investigators. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high–risk patients. N Engl J Med 2008; 359: 2417–28.

52. Tomcsany J.A. Ramiprilés Amlodipin kombináció vérnyomáscsökkentô hatékonyságának MOnitorozása és beavatkozással Nem járó Adatgyûjtése (RAMONA tanulmány). Hypertonia és Nephrologia, 2013;17: 49–96.

53. Culleton BF, Larson MG, Wilson PW, Evans JC, Parfrey PS, Levy D. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney Int 1999; 56:2214–2219.

54. Chen J.H., Chuang S.Y., Chen H.J. et al. Serum uric acid level as an independent risk factor for all-cause, cardiovascular, and ischemic stroke mortality: a Chinese cohort study. Arthritis Rheum. 2009; 61(2): 225–232.

55. Koivisto V.A., Stevens L. K., Mattock M. et al. Cardiovascular disease and its risk factors in IDDM in Europe. EURODIAB IDDM. Complication Study Groop. Diabetes Care. 1996;19 (7):689–697.

56. Chair H., Sowers J.R. National high blood pressure education program working groop report on hypertension in diabetes. Hypertension. 1994; 23:145-158.

57. Шестакова М.В. Сахарный диабет и артериальная гипертония. В руководстве по артериальной гипертонии под ред. акад.РАН Е.И.Чазова, член-корр. РАН И.Е. Чазовой. Москва, Медиа Медика, 2005, с.415–433./Shestakova M.V. Diabetes mellitus and arterial hypertension. In the guide on arterial hypertension ed. by academician of RAS E.I. Chazov, a corresponding member of RAS I.E. Chazova. Moscow, Media Medica, 2005, p. 415-433.

58. HOPE Study Investigators. The HOPE (Heart Outcomes Prevention Evaluations) 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. Can J Cardiol 11996; 12: 127–37.

59. Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on ardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICROHOPE sub-study. Lancet 2000; 355:253–259.

60. Gerstein HC, Bosch J, Pogue J, et al. Rationale and design of a large study to evaluate the renal and cardiovascular effects of an ACE inhibitor and vitamin E in high-risk patients with diabetes: the MICRO-HOPE study. Diabetes Care 1996; 19: 1225–28.


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