rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2020-03-03rpcardio-2176Research ArticleNOTES FROM PRACTICEКЛИНИЧЕСКИЙ ОПЫТThe Capabilities of Amlodipine/Lisinopril Single-Pill Combination in the Treatment of Newly Diagnosed Arterial Hypertension in a Middle-Aged Patient (Case Report)Возможности фиксированной комбинации амлодипин/лизиноприл в лечении впервые выявленной артериальной гипертензии у пациентки среднего возраста (клинический пример)КочетковА. И.KochetkovA. I.

Кочетков Алексей Иванович – кандидат медицинских наук, доцент, кафедра терапии и полиморбидной патологии

125993, Москва, ул. Баррикадная, 2/1

Alexey I. Kochetkov – MD, PhD, Associate Professor, Chair of Therapy and Polymorbid Pathology

Barrikadnaya ul. 2/1, Moscow, 125993

ЛопухинаМ. В.LopukhinaM. V.

Лопухина Мария Вадимовна – кандидат медицинских наук, заведующая отделением функциональной диагностики

111399, Москва, Федеративный проспект, 17

Mariya V. Lopukhina – MD, PhD, Head of Department of Functional Diagnostics

Federativnii pr. 17, Moscow, 111399

КотаеваЕ. А.KotaevaE. A.

Котаева Елена Александровна – кандидат медицинских наук, зав. кардиологическим отделением №5

125284, Москва, 2-й Боткинский пр-д, 5

Elena A. Kotaeva – MD, PhD, Head of Cardiology Department №5

Vtoroi Botkinskii pr. 5, Moscow, 125284

КириченкоА. А.KirichenkoA. A.

Кириченко Андрей Аполлонович – доктор медицинских наук, профессор, кафедра терапии и полиморбидной патологии

125993, Москва, ул. Баррикадная, 2/1

Andrey A. Kirichenko – MD, PhD, Professor, Chair of Therapy and Polymorbid Pathology

Barrikadnaya ul. 2/1, Moscow, 125993

ОстроумоваО. Д.OstroumovaO. D.

Остроумова Ольга Дмитриевна – доктор медицинских наук, профессор, зав. кафедрой терапии и полиморбидной патологии, РМАНПО; профессор, кафедра клинической фармакологии и пропедевтики внутренних болезней, Сеченовский университет

125993, Москва, ул. Баррикадная, 2/1, 

119991, Москва, ул. Трубецкая, 8 стр. 2

Olga D. Ostroumova – MD, PhD, Professor, Head of Chair of Therapy and Polymorbid Pathology, Russian Medical Academy of Continuous Professional Education; Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine, Sechenov University

Barrikadnaya ul. 2/1, Moscow, 125993, 

Trubetskaya ul. 8-2, Moscow, 119991

ostroumova.olga@mail.ruРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationГородская клиническая больница им. Е.О. МухинаРоссияE.O. Mukhin Municipal Clinical HospitalRussian FederationГородская клиническая больница имени С.П. БоткинаРоссияS.P. Botkin Municipal Clinical HospitalRussian FederationРоссийская медицинская академия непрерывного профессионального образования; Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияRussian Medical Academy of Continuous Professional Education; I.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202001052020162221230Copyright © Kochetkov A.I., Lopukhina M.V., Kotaeva E.A., Kirichenko A.A., Ostroumova O.D., 20202020Кочетков А.И., Лопухина М.В., Котаева Е.А., Кириченко А.А., Остроумова О.Д.Kochetkov A.I., Lopukhina M.V., Kotaeva E.A., Kirichenko A.A., Ostroumova O.D.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/2176

Arterial hypertension (AH) is one of the most significant modifiable risk factors that increase cardiovascular morbidity and mortality worldwide, including Russia. The complex of structural and functional changes in the heart that occurs during AH consists not only in the formation of left ventricular (LV) myocardial hypertrophy, but also in the myocardial stiffness increasing due to collagen formation and cardiomyocytes apoptosis. These abnormalities are substrate for diastolic function disturbances, electrical myocardial instability and ischemia. The article provides a clinical case of amlodipine/lisinopril single-pill combination (A/L SPC) use in real clinical practice in a patient with stage II grade 2 newly diagnosed AH and its effect on blood pressure and echocardiographic myocardial fibrosis markers, including speckle tracking parameters The high antihypertensive efficacy of A/L SPC, a favorable effect on blood pressure circadian rhythm, as well as pronounced target-organ protective properties, in particular the ability to reduce LV and left atrial stiffness, were demonstrated. So, we conclude that A/L SPC improve the elastic properties of the left heart.

Артериальная гипертония (АГ) является одним из наиболее значимых модифицируемых факторов риска, увеличивающих сердечно-сосудистую заболеваемость и смертность во всем мире, в том числе, и в Российской Федерации. Комплекс структурно-функциональных изменений в сердце, возникающих при АГ, заключается не только в формировании гипертрофии миокарда левого желудочка (ЛЖ), но и в повышении жесткости сердечной мышцы за счет коллагенообразования и апоптоза кардиомиоцитов, что в свою очередь является субстратом для нарушения диастолической функции, электрической нестабильности миокарда и потенцирует его ишемию. В статье приведен пример использования фиксированной комбинации амлодипин/лизиноприл (ФК А/Л) в реальной клинической практике у пациентки с впервые выявленной АГ II стадии 2 степени и ее влияния на уровень артериального давления и эхокардиографические маркеры нарушения упруго-эластических свойств миокарда, в том числе, с применением методики Speckle Tracking. Продемонстрирована высокая антигипертензивная эффективность ФК А/Л, благоприятное влияние на суточный профиль артериального давления, а также выраженные органопротективные свойства, в частности, способность снижать жесткость миокарда ЛЖ и левого предсердия, и тем самым улучшать упруго-эластические свойства левых отделов сердца.

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