rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2014-10-1-92-98rpcardio-152Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯTREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION AND METABOLIC SYNDROME. THE ROLE OF THE COMBINATION DRUGSЛЕЧЕНИЕ ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ И МЕТАБОЛИЧЕСКИМ СИНДРОМОМ. МЕСТО КОМБИНИРОВАННЫХ ПРЕПАРАТОВШиловА. М.ShilovA. M.Alexmshilov@mail.ruДулаеваМ. С.DulaevaM. S.Alexmshilov@mail.ruОсияА. О.OsiaA. O.Alexmshilov@mail.ruЛишутаА. С.LishutaA. S.Alexmshilov@mail.ruПервый Московский государственный медицинский университет имени И.М. СеченоваРоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation2014230920151019298Copyright © Shilov A.M., Dulaeva M.S., Osia A.O., Lishuta A.S., 20152015Шилов А.М., Дулаева М.С., Осия А.О., Лишута А.С.Shilov A.M., Dulaeva M.S., Osia A.O., Lishuta A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/152

Data about the current approach to the choice of dual antihypertensive combinations in various clinical situations for treatment of hypertension are presented. Advantages and indications for the combination of an ACE inhibitor with a dihydropyridine calcium channel blocker are reviewed. Data from prospective studies on the efficacy and safety of combination of third generation calcium channel blocker lercanidipine with ACE inhibitor enalapril are presented.

Приведены данные о современном подходе к выбору двухкомпонентных антигипертензивных комбинаций в разных клинических ситуациях при лечении АГ. Рассмотрены преимущества и показания к назначению комбинации ингибитора АПФ с дигидропиридиновым антагонистом кальция. Приведены данные проспективных исследований об эффективности и безопасности комбинации антагониста кальция третьего поколения лерканидипина с ингибитором АПФ эналаприлом.

артериальная гипертониякомбинированная терапияфиксированные комбинации лекарственных препаратовэналаприллерканидипинarterial hypertensioncombination therapyfixed-dose drug combinationenalaprillercanidipineReferencesNational guidelines for the diagnosis and treatment of hypertension. Cardiovascular Therapy and Prevention 2008; 7 (6) suppl 2: 1-31. Russian (Национальные рекомендации по диагностике и лечению артериальной гипертонии. Кардиоваскулярная терапия и профилактика 2008; 7(6) Приложение 2: 1-31).National guidelines for the diagnosis and treatment of hypertension. Cardiovascular Therapy and Prevention 2008; 7 (6) suppl 2: 1-31. Russian (Национальные рекомендации по диагностике и лечению артериальной гипертонии. Кардиоваскулярная терапия и профилактика 2008; 7(6) Приложение 2: 1-31).National guidelines for the diagnosis and treatment of hypertension (4th revision). Systemic Hypertension 2010; (3): 5-26. Russian (Национальные рекомендации по диагностике и лечению артериальной гипертонии (4-й пересмотр). Системные гипертензии 2010; (3): 5-26).National guidelines for the diagnosis and treatment of hypertension (4th revision). Systemic Hypertension 2010; (3): 5-26. Russian (Национальные рекомендации по диагностике и лечению артериальной гипертонии (4-й пересмотр). Системные гипертензии 2010; (3): 5-26).2007 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). Blood Press 2007;16(3):135-232.2007 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). Blood Press 2007;16(3):135-232.2013 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 Hypertension 2013; 31 (7):1281–13572013 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 Hypertension 2013; 31 (7):1281–1357Lüscher TF. Heterogeneity of endothelial dysfunction in hypertension. Eur Heart J 1992;13 Suppl D:50-5.Lüscher TF. Heterogeneity of endothelial dysfunction in hypertension. Eur Heart J 1992;13 Suppl D:50-5.Higashi Y, Kihara Y, Noma K. Endothelial dysfunction and hypertension in aging. Hypertens Res 2012;35(11):1039-47.Higashi Y, Kihara Y, Noma K. Endothelial dysfunction and hypertension in aging. Hypertens Res 2012;35(11):1039-47.Zhang M, Wang G, Wang A, et al. Association of hypertension with coexistence of abnormal metabolism and inflammation and endothelial dysfunction. Blood Press 2013;22(3):151-7.Zhang M, Wang G, Wang A, et al. Association of hypertension with coexistence of abnormal metabolism and inflammation and endothelial dysfunction. Blood Press 2013;22(3):151-7.Masoli O, Redruello M, Baliño NP, et al. Use of nebivolol for the treatment of endothelial dysfunction in patients with hypertension: the EDEN registry. J Cardiovasc Pharmacol 2008;51(2):202-7.Masoli O, Redruello M, Baliño NP, et al. Use of nebivolol for the treatment of endothelial dysfunction in patients with hypertension: the EDEN registry. J Cardiovasc Pharmacol 2008;51(2):202-7.Toma L, Stancu CS, Sanda GM, Sima AV. Anti-oxidant and anti-inflammatory mechanisms of amlodipine action to improve endothelial cell dysfunction induced by irreversibly glycated LDL. Biochem Biophys Res Commun 2011;411(1):202-7.Toma L, Stancu CS, Sanda GM, Sima AV. Anti-oxidant and anti-inflammatory mechanisms of amlodipine action to improve endothelial cell dysfunction induced by irreversibly glycated LDL. Biochem Biophys Res Commun 2011;411(1):202-7.Tzemos N, Lim PO, MacDonald TM. Valsartan improves endothelial dysfunction in hypertension: a randomized, double-blind study. Cardiovasc Ther 2009;27(3):151-8.Tzemos N, Lim PO, MacDonald TM. Valsartan improves endothelial dysfunction in hypertension: a randomized, double-blind study. Cardiovasc Ther 2009;27(3):151-8.Sharifi AM, Li JS, Endemann D, Schiffrin EL. Effects of enalapril and amlodipine on small-artery structure and composition, and on endothelial dysfunction in spontaneously hypertensive rats. J Hypertens 1998;16(4):457-66.Sharifi AM, Li JS, Endemann D, Schiffrin EL. Effects of enalapril and amlodipine on small-artery structure and composition, and on endothelial dysfunction in spontaneously hypertensive rats. J Hypertens 1998;16(4):457-66.Tsuji S, Node K. Vascular endothelial dysfunction as a mechanistic factor for metabolic syndrome. Nihon Rinsho 2011;69 Suppl 1:295-300.Tsuji S, Node K. Vascular endothelial dysfunction as a mechanistic factor for metabolic syndrome. Nihon Rinsho 2011;69 Suppl 1:295-300.National guidelines for diagnosis and treatment of metabolic syndrome. Cardiovascular Therapy and Prevention 2007; 6 (6) suppl 2: 1-22. Russian (Национальные рекомендации по диагностике и лечению метаболического синдрома. Кардиоваскулярная терапия и профилактика 2007;6 (6) Приложение 2: 1-22)National guidelines for diagnosis and treatment of metabolic syndrome. Cardiovascular Therapy and Prevention 2007; 6 (6) suppl 2: 1-22. Russian (Национальные рекомендации по диагностике и лечению метаболического синдрома. Кардиоваскулярная терапия и профилактика 2007;6 (6) Приложение 2: 1-22)IDF DIABETES ATLAS (Sixth edition). Available at: http://www.idf.org/sites/default/files/EN_6E_At- las_Full_0.pdf. Accessed : 23.02.2014IDF DIABETES ATLAS (Sixth edition). Available at: http://www.idf.org/sites/default/files/EN_6E_At- las_Full_0.pdf. Accessed : 23.02.2014Materson BJ, Reda DJ, Cushman WC et al. Singledrug therapy for hypertension in men. a comparison of six antihypertensive agents with placebo. N Engl J Med 1993; 328: 9-14.Materson BJ, Reda DJ, Cushman WC et al. Singledrug therapy for hypertension in men. a comparison of six antihypertensive agents with placebo. N Engl J Med 1993; 328: 9-14.Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122 (3): 290-300.Wald DS, Law M, Morris JK et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122 (3): 290-300.Hilleman DE. Adherence and health care costs with single-pill fixed-dose combinations in hypertension management. J Manag Care Pharm 2014;20(1):93-100.Hilleman DE. Adherence and health care costs with single-pill fixed-dose combinations in hypertension management. J Manag Care Pharm 2014;20(1):93-100.Sicras Mainar A1, Galera Llorca J, Muñoz Ortí G, Navarro Artieda R. Influence of compliance on the incidence of cardiovascular events and health costs when using single-pill fixed-dose combinations for the treatment of hypertension. Med Clin (Barc) 2011;136(5):183-91.Sicras Mainar A1, Galera Llorca J, Muñoz Ortí G, Navarro Artieda R. Influence of compliance on the incidence of cardiovascular events and health costs when using single-pill fixed-dose combinations for the treatment of hypertension. Med Clin (Barc) 2011;136(5):183-91.ASCOT – blood pressure arm confirms efficacy of amlodipine/perindopril (Norvasc)/Coversyl) regimen. Cardiovasc J S Afr 2005;16(5):271-2ASCOT – blood pressure arm confirms efficacy of amlodipine/perindopril (Norvasc)/Coversyl) regimen. Cardiovasc J S Afr 2005;16(5):271-2Bakris GL, Sarafidis PA, Weir MR, et al. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet 2010 3;375(9721):1173-81.Bakris GL, Sarafidis PA, Weir MR, et al. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet 2010 3;375(9721):1173-81.Davis BR, Whelton PK; ALLHAT Collaborative Research Group. Benazepril plus amlodipine or hydrochlorothiazide for hypertension. N Engl J Med 2009;360(11):1148-9Davis BR, Whelton PK; ALLHAT Collaborative Research Group. Benazepril plus amlodipine or hydrochlorothiazide for hypertension. N Engl J Med 2009;360(11):1148-9Yusuf S, Teo KK, Pogue J et al. ONTARGET Investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008; 358 (15): 1547-59.Yusuf S, Teo KK, Pogue J et al. ONTARGET Investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008; 358 (15): 1547-59.Parving HH, Brenner BM, McMurray JJ. ALTITUDE Investigators. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 2012; 367 (23): 2204-13Parving HH, Brenner BM, McMurray JJ. ALTITUDE Investigators. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 2012; 367 (23): 2204-13Jamerson K, Weber MA, Bakris GL et al. ACCOMPLISH Trial Investigators.Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359 (23): 2417-28Jamerson K, Weber MA, Bakris GL et al. ACCOMPLISH Trial Investigators.Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359 (23): 2417-28Borghi C, Santi F. Fixed combination of lercanidipine and enalapril in the management of hypertension: focus on patient preference and adherence. Patient Prefer Adherence 2012;6:449-55.Borghi C, Santi F. Fixed combination of lercanidipine and enalapril in the management of hypertension: focus on patient preference and adherence. Patient Prefer Adherence 2012;6:449-55.Fixed combination enalapril/lercanidipine in routine treatment: consistent RR reduction with kidney protection. MMW Fortschr Med 2011;153(3):42-3.Fixed combination enalapril/lercanidipine in routine treatment: consistent RR reduction with kidney protection. MMW Fortschr Med 2011;153(3):42-3.Scholze J, Bramlage P, Trenkwalder P, Kreutz R. Efficacy and safety of a fixed-dose combination of lercanidipine and enalapril in daily practice. A comparison of office, self-measured and ambulatory blood pressure. Expert Opin Pharmacother 2011;12(18):2771-9.Scholze J, Bramlage P, Trenkwalder P, Kreutz R. Efficacy and safety of a fixed-dose combination of lercanidipine and enalapril in daily practice. A comparison of office, self-measured and ambulatory blood pressure. Expert Opin Pharmacother 2011;12(18):2771-9.Oksa A, Stefíková K, Fedelesová V, et al. Metabolic effects of enalapril in the treatment of essential hypertension. Cor Vasa 1992;34(4):329-41.Oksa A, Stefíková K, Fedelesová V, et al. Metabolic effects of enalapril in the treatment of essential hypertension. Cor Vasa 1992;34(4):329-41.Toyo-Oka T., Nayler W.G. Third generation calcium entry blockers. Blood Pressure 1996; 5(4): 206-8.Toyo-Oka T., Nayler W.G. Third generation calcium entry blockers. Blood Pressure 1996; 5(4): 206-8.Burnier M. Renal protection with calcium antagonists: the role of lercanidipine. Curr Med Res Opin 2013;29(12):1727-35.Burnier M. Renal protection with calcium antagonists: the role of lercanidipine. Curr Med Res Opin 2013;29(12):1727-35.Borghi C. Lercanidipine in hypertension. Vasc Health Risk Manag 2005;1(3):173-82.Borghi C. Lercanidipine in hypertension. Vasc Health Risk Manag 2005;1(3):173-82.Millar-Craig M, Shaffu B, Greenough A, et al. Lercanidipine vs lacidipine in isolated systolic hypertension. J Hum Hypertens 2003;17(11):799-806.Millar-Craig M, Shaffu B, Greenough A, et al. Lercanidipine vs lacidipine in isolated systolic hypertension. J Hum Hypertens 2003;17(11):799-806.Borghi C, Cicero AF. Rationale for the use of a fixed-dose combination in the management of hypertension: efficacy and tolerability of lercanidipine/enalapril. Clin Drug Investig 2010;30(12):843-54.Borghi C, Cicero AF. Rationale for the use of a fixed-dose combination in the management of hypertension: efficacy and tolerability of lercanidipine/enalapril. Clin Drug Investig 2010;30(12):843-54.Egan CG, Pontremoli R. Role of the fixed-dose combination lercanidipine-enalapril in renal protection. J Nephrol 2011;24(4):428-37.Egan CG, Pontremoli R. Role of the fixed-dose combination lercanidipine-enalapril in renal protection. J Nephrol 2011;24(4):428-37.Barrios V, Escobar C, de la Figuera M, et al. High doses of lercanidipine are better tolerated than other dihydropyridines in hypertensive patients with metabolic syndrome: results from the TOLERANCE study. Int J Clin Pract 2008;62(5):723-8.Barrios V, Escobar C, de la Figuera M, et al. High doses of lercanidipine are better tolerated than other dihydropyridines in hypertensive patients with metabolic syndrome: results from the TOLERANCE study. Int J Clin Pract 2008;62(5):723-8.Al-Thanoon ZA, Mahmood IH. Effects of Losartan vs. Enalapril on the Markers of Metabolic Syndrome. Oman Med J 2012;27(1):27-30.Al-Thanoon ZA, Mahmood IH. Effects of Losartan vs. Enalapril on the Markers of Metabolic Syndrome. Oman Med J 2012;27(1):27-30.

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