rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2014-10-2-212-219rpcardio-26Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯTHE FEATURES OF ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH METABOLIC SYNDROMEОСОБЕННОСТИ АНТИГИПЕРТЕНЗИВНОЙ ТЕРАПИИ У БОЛЬНЫХ МЕТАБОЛИЧЕСКИМ СИНДРОМОМКремневаЛ. В.KremnevaL. V.

Кремнева Людмила Викторовна – доктор медицинских наук, ведущий научный сотрудник

nbabushkina@tokb.ruАбатуроваО. В.AbaturovaO. V.

Абатурова Ольга Викторовна – доктор медицинских наук, ведущий научный сотрудник Тюменского института терапии; профессор кафедры кардиологии факультета повышения квалификации и профессиональной переподготовки специалистов Тюменской государственной медицинской академии

nbabushkina@tokb.ruШалаевС. В.ShalaevS. V.

Шалаев Сергей Васильевич – доктор медицинских наук, профессор, гл.научный сотрудник Тюменского института терапии; зав. кафедрой кардиологии факультета повышения квалификации и профессиональной переподготовки специалистов Тюменской государственной медицинской академии

nbabushkina@tokb.ruТюменский институт терапииРоссияTyumen Institute of TherapyRussian FederationТюменский институт терапии; Тюменская государственная медицинская академияРоссияTyumen Institute of Therapy; Tyumen State Medical AcademyRussian Federation201419092015102212219Copyright © Kremneva L.V., Abaturova O.V., Shalaev S.V., 20152015Кремнева Л.В., Абатурова О.В., Шалаев С.В.Kremneva L.V., Abaturova O.V., Shalaev S.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.rpcardio.online/jour/article/view/26

Arterial hypertension (HT) in patients with metabolic syndrome has features (early damage of target organ, a predisposition to thrombosis, refractory to standard antihypertensive therapy, high cardiovascular risk). The aim of HT treatment in patients with metabolic syndrome includes not only the achievement of target blood pressure, but also a reduction of target organ damage, correction of modifiable risk factors and associated clinical conditions. Results of multicenter studies on assessment of clinical efficacy of groups of antihypertensive drugs, their effects on metabolic parameters, the ability to prevent the development of cardiovascular events, diabetes mellitus, and renal dysfunction are presented.

Течение артериальной гипертензии (АГ) у больных метаболическим синдромом имеет особенности, заключающиеся в раннем поражении органов-мишеней, предрасположенности  к тромбообразованию, рефрактерности к проводимой антигипертензивной терапии, высоком риске развития сердечно-сосудистых осложнений. В задачи лечения АГ у больных метаболическим синдромом входит не только достижение целевых уровней артериального давления, но и замедление поражения органов-мишеней, коррекция модифицируемых факторов риска и ассоциированных клинических состояний – компонентов метаболического синдрома, ишемической болезни сердца и др. Представлены результаты многоцентровых исследований по оценке клинической эффективности отдельных групп антигипертензивных препаратов, их влиянии на показатели метаболизма: инсулинорезистентность, уровни гликемии, мочевой кислоты, липидный спектр крови, способность предупреждать развитие кардиоваскулярных событий, сахарного диабета, почечной дисфункции.

метаболический синдроминсулинорезистентностьартериальная гипертензияантигипертензивная терапиямногоцентровые исследованияmetabolic syndromeinsulin resistancearterial hypertensionantihypertensive therapymulticenter studiesReferencesKrasil'nikova EI, Supportive Y.,AABystrov et al.Adiposopathy – a key element ofthe state of development of insulin resistance. ArterialHypertension 2012; 18 (2): 164-76. Russian (Красильникова Е.И., Благосклонная Я.В., Быстрова А.А. и др. Адипозопатия – ключевое звено развития состояния инсулинорезистентности. Артериальная Гипертензия 2012; 18(2): 164-76).Krasil'nikova EI, Supportive Y.,AABystrov et al.Adiposopathy – a key element ofthe state of development of insulin resistance. ArterialHypertension 2012; 18 (2): 164-76. Russian (Красильникова Е.И., Благосклонная Я.В., Быстрова А.А. и др. Адипозопатия – ключевое звено развития состояния инсулинорезистентности. Артериальная Гипертензия 2012; 18(2): 164-76).Alessi M.C.,Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. ThrombHaemost 2008; 99 (6): 995-1000.Alessi M.C.,Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. ThrombHaemost 2008; 99 (6): 995-1000.Chazova IE, Sliver VB Gornostaev VV etc. Cerebrovascular complications in patients with hypertension: primary and secondary prevention. Consilium Medicum 2003; 5 (2): 61-4. Russian (Чазова И.Е., Мычка В.Б., Горностаев В.В. и др. Цереброваскулярные осложнения у больных артериальной гипертонией: первичная и вторичная профилактика. Consilium Medicum 2003; 5 (2): 61-4).Chazova IE, Sliver VB Gornostaev VV etc. Cerebrovascular complications in patients with hypertension: primary and secondary prevention. Consilium Medicum 2003; 5 (2): 61-4. Russian (Чазова И.Е., Мычка В.Б., Горностаев В.В. и др. Цереброваскулярные осложнения у больных артериальной гипертонией: первичная и вторичная профилактика. Consilium Medicum 2003; 5 (2): 61-4).Praskurnichy EA, Zhukov VA, Savelyev SA et al Clinical evaluation of the effects of antihypertensive drugs in relation to carbohydrate metabolism disorders and metabolic syndrome. Heart 2012; 1 (63): 449. Russian (Праскурничий Е.А., Жукова В.А., Савельева С.А. и др. Клиническая оценка эффектов антигипертензивных средств в отношении нарушений углеводного обмена при метаболическом синдроме. Сердце 2012; 1 (63): 44-9).Praskurnichy EA, Zhukov VA, Savelyev SA et al Clinical evaluation of the effects of antihypertensive drugs in relation to carbohydrate metabolism disorders and metabolic syndrome. Heart 2012; 1 (63): 449. Russian (Праскурничий Е.А., Жукова В.А., Савельева С.А. и др. Клиническая оценка эффектов антигипертензивных средств в отношении нарушений углеводного обмена при метаболическом синдроме. Сердце 2012; 1 (63): 44-9).The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991; 325: 293-302.The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991; 325: 293-302.Dahlof B., Sever P.S., Poulter N.R., for the ASCOT investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial. Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentrerandomised controlled trial. Lancet 2005; 366: 895-906.Dahlof B., Sever P.S., Poulter N.R., for the ASCOT investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial. Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentrerandomised controlled trial. Lancet 2005; 366: 895-906.Yusuf S., Sleight P., Pogue J. et al. Effects of an angiotensin-converting –enzyme inhibitor, ramipril, on cardiovascular events in high – risk patients. The Heart Outcomes Prevention Evaluation study investigators. N Engl J Med 2000; 342: 145-53.Yusuf S., Sleight P., Pogue J. et al. Effects of an angiotensin-converting –enzyme inhibitor, ramipril, on cardiovascular events in high – risk patients. The Heart Outcomes Prevention Evaluation study investigators. N Engl J Med 2000; 342: 145-53.Ball S.G., Hall A.S., Murray G.D. ACE inhibition, atherosclerosis and myocardial infarction – the AIRE study. Eur Heart J 1994; 15 Suppl B: 20-5.Ball S.G., Hall A.S., Murray G.D. ACE inhibition, atherosclerosis and myocardial infarction – the AIRE study. Eur Heart J 1994; 15 Suppl B: 20-5.Ramipril Efficacy In Nephropathy study investigators. Lancet 1999; 345: 359-64.Ramipril Efficacy In Nephropathy study investigators. Lancet 1999; 345: 359-64.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.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.ADVANCE Collaborative Group.Action inDiabetes and VascularDisease: patientrecruitment and characteristics of the study population at baseline. Diabet Med 2005; 22: 882-8.ADVANCE Collaborative Group.Action inDiabetes and VascularDisease: patientrecruitment and characteristics of the study population at baseline. Diabet Med 2005; 22: 882-8.Zancetti A., Crepaldi G., Bond M.G. et al. Systolic and pulse blood pressure (but not diastolic blood pressure and serum cholesterol) are associated with alterations in carotid intima – media thickness in the moderately hypercholesterolaemic hypertensive patients of the Plaque Hypertension Lipid Lowering Italian Study. J Hypertens 2001: 19: 79-88.Zancetti A., Crepaldi G., Bond M.G. et al. Systolic and pulse blood pressure (but not diastolic blood pressure and serum cholesterol) are associated with alterations in carotid intima – media thickness in the moderately hypercholesterolaemic hypertensive patients of the Plaque Hypertension Lipid Lowering Italian Study. J Hypertens 2001: 19: 79-88.Lonn E.M., Yusuf S., Dzavik V. et al. Effects of ramipril and vitamin E on atherosclerosis. Circulation 2001; 103: 919-25.Lonn E.M., Yusuf S., Dzavik V. et al. Effects of ramipril and vitamin E on atherosclerosis. Circulation 2001; 103: 919-25.The European trial on reduction of cardiac events with perindopril in stable coronary artery investigators. On reduction of cardiac events with perindopril in stable coronary artery disease investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease. Randomised, double – blind, placebo – controlled, multicentre trial (the EUROPA study). Lancet 2003; 362: 782-8.The European trial on reduction of cardiac events with perindopril in stable coronary artery investigators. On reduction of cardiac events with perindopril in stable coronary artery disease investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease. Randomised, double – blind, placebo – controlled, multicentre trial (the EUROPA study). Lancet 2003; 362: 782-8.Fosinopril versus amlodipine Cardiovascular Events Trial. Diadetes Care 1998: 21: 597-603.Fosinopril versus amlodipine Cardiovascular Events Trial. Diadetes Care 1998: 21: 597-603.Wing L.M., Reid C.M., Ryan P. et al. A comparison of outcomes with angiotensin – converting enzime inhibitors and diuretic for hypertension in the erderly. N Engl J Med 2003; 348 (7): 583-92.Wing L.M., Reid C.M., Ryan P. et al. A comparison of outcomes with angiotensin – converting enzime inhibitors and diuretic for hypertension in the erderly. N Engl J Med 2003; 348 (7): 583-92.Dahlof B., Devereux R.B., Kjeldsen S.E. et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995-1003.Dahlof B., Devereux R.B., Kjeldsen S.E. et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995-1003.Lindholm L.H., Persson M., Alaupovic P. et al. Metabolic outcome during 1 jearin newly detected hypertensives: results of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Efficacy Evaluation (ALPIN study). J Hypertens 2003; 21; 1563-74.Lindholm L.H., Persson M., Alaupovic P. et al. Metabolic outcome during 1 jearin newly detected hypertensives: results of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Efficacy Evaluation (ALPIN study). J Hypertens 2003; 21; 1563-74.Julius S., Kjeldsen S.E., Weber M. et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022-31.Julius S., Kjeldsen S.E., Weber M. et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022-31.Parving H.H. Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria study Group. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 345: 870-8.Parving H.H. Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria study Group. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 345: 870-8.Lewis E.J. Renoprotective effect of the angiotensin – receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345: 851-60.Lewis E.J. Renoprotective effect of the angiotensin – receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345: 851-60.Pfeffer M.A. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM – Overall programme. Lancet 2003; 362: 759-66.Pfeffer M.A. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM – Overall programme. Lancet 2003; 362: 759-66.Mann I.F., Schmieder R.E., McQueen M. et al. Renal outcomes with telmisartan, ramipril, or both, in people at high vascularrisk (the ONTARGET study): a multicentre,randomised, double – blind, controlled trial. Lancet 2008; 372 (9638): 547-53.Mann I.F., Schmieder R.E., McQueen M. et al. Renal outcomes with telmisartan, ramipril, or both, in people at high vascularrisk (the ONTARGET study): a multicentre,randomised, double – blind, controlled trial. Lancet 2008; 372 (9638): 547-53.Brenner B.M., Cooper M.E., de Zeeuw D. et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345: 861-9.Brenner B.M., Cooper M.E., de Zeeuw D. et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345: 861-9.Zillich A.J., Garg J., Basu S. et al. Thiazide diuretics, potassium, and the development of diabetes: a quantitave review. Hypertension 2006; 48 (2): 219-24.Zillich A.J., Garg J., Basu S. et al. Thiazide diuretics, potassium, and the development of diabetes: a quantitave review. Hypertension 2006; 48 (2): 219-24.Gress T.W., Nieto F.J., Shahar E. et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000; 342 (13): 905-12.Gress T.W., Nieto F.J., Shahar E. et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000; 342 (13): 905-12.Nedogoda S.V. Opportunities arifon retard in the treatment of hypertension in patients with metabolic syndrome. Actual Questions ArterialHypertension 2008; 15: 10-3. Russian (Недогода С.В. Возможности арифона-ретард в лечении артериальной гипертензии у пациентов с метаболическим синдромом. Актуальные Вопросы Артериальной Гипертензии 2008; 15: 10-3).Nedogoda S.V. Opportunities arifon retard in the treatment of hypertension in patients with metabolic syndrome. Actual Questions ArterialHypertension 2008; 15: 10-3. Russian (Недогода С.В. Возможности арифона-ретард в лечении артериальной гипертензии у пациентов с метаболическим синдромом. Актуальные Вопросы Артериальной Гипертензии 2008; 15: 10-3).Marre M., Puig J.G., Kokot F. et al. Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes: the NESTOR study. J Hypertens 2004: 22: 1613-22.Marre M., Puig J.G., Kokot F. et al. Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes: the NESTOR study. J Hypertens 2004: 22: 1613-22.Cosin J., Diez J. Torasemide in chronic heart failure: Results of the TORIC Study. Eur J Heart Fail 2002; 4 (4): 507-13.Cosin J., Diez J. Torasemide in chronic heart failure: Results of the TORIC Study. Eur J Heart Fail 2002; 4 (4): 507-13.Prichard B., Cruickshank J., Graham B. Beta – adrenergic blocking drugs in the treatment of hypertension. Blood Pressure 2001; 10: 366-86.Prichard B., Cruickshank J., Graham B. Beta – adrenergic blocking drugs in the treatment of hypertension. Blood Pressure 2001; 10: 366-86.Hansson L., Lindholm L., Ekbom T. et al. Randomised trial of old and new antihypertensive drugs in elderly patients cardiovascular mortality and morbidity the Swedish trial in old patients with hypertension 2 study. Lancet 1999; 345: 1751-6.Hansson L., Lindholm L., Ekbom T. et al. Randomised trial of old and new antihypertensive drugs in elderly patients cardiovascular mortality and morbidity the Swedish trial in old patients with hypertension 2 study. Lancet 1999; 345: 1751-6.UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complication in type 2 diabetes: UKPDS. Br Med J 1998; 317: 703-13.UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complication in type 2 diabetes: UKPDS. Br Med J 1998; 317: 703-13.Shalnova SA, Martsevich SYu,DeevADet al. The firstresults of a multicenterrandomized clinicaltrial on the drug Akridilol in combination therapy in patients with hypertension and obesity or type 2 diabetes (ACCORD). Cardiology 2008; 48:8: 28-33. Russian (Шальнова С.А., Марцевич С.Ю., Деев А.Д. и др. Первыерезультатымногоцентровогорандомизированногоклиническогоисследования поприменению препарата Акридилол в комбинированной терапии у больных артериальной гипертонией и ожирением или сахарным диабетом 2 типа (АККОРД).Кардиология 2008; 48:8: 28-33).Shalnova SA, Martsevich SYu,DeevADet al. The firstresults of a multicenterrandomized clinicaltrial on the drug Akridilol in combination therapy in patients with hypertension and obesity or type 2 diabetes (ACCORD). Cardiology 2008; 48:8: 28-33. Russian (Шальнова С.А., Марцевич С.Ю., Деев А.Д. и др. Первыерезультатымногоцентровогорандомизированногоклиническогоисследования поприменению препарата Акридилол в комбинированной терапии у больных артериальной гипертонией и ожирением или сахарным диабетом 2 типа (АККОРД).Кардиология 2008; 48:8: 28-33).Martsevich SY, Kutishenko KM, Shilova EA, et al. on behalf ofthe working group on the "Kamellia" study. Comparison therapy based on carvedilol or metoprolol in patients with hypertension and overweight / obesity. First results of KAMELIA. Ration Pharmacother Cardiol 2009; (1): 23-7. Russian (Марцевич С.Ю., Кутишенко К.М., Шилова Е.В. и др. от имени рабочей группы по проведению исследования «Камелия». Сравнение терапии, основанной на карведилоле или метопрололе, у больных артериальной гипертонией и избыточной массой тела/ожирением.Первые результатыисследования КАМЕЛИЯ. Рациональная Фармакотерапия в Кардиологии 2009; (1): 23-7).Martsevich SY, Kutishenko KM, Shilova EA, et al. on behalf ofthe working group on the "Kamellia" study. Comparison therapy based on carvedilol or metoprolol in patients with hypertension and overweight / obesity. First results of KAMELIA. Ration Pharmacother Cardiol 2009; (1): 23-7. Russian (Марцевич С.Ю., Кутишенко К.М., Шилова Е.В. и др. от имени рабочей группы по проведению исследования «Камелия». Сравнение терапии, основанной на карведилоле или метопрололе, у больных артериальной гипертонией и избыточной массой тела/ожирением.Первые результатыисследования КАМЕЛИЯ. Рациональная Фармакотерапия в Кардиологии 2009; (1): 23-7).Martsevich SY, Tolpygina SN, on behalf of the working group on the KABRIOLET study. Compared the effects of long-term therapy based on carvedilol or bisoprolol on metabolic parameters in patients with arterial hypertension and overweight or obese. Results of a randomized open parallel study CONVERTIBLE step (part 1). Ration Pharmacother Cardiol 2012; (4): 488-99. Russian (Марцевич С.Ю., Толпыгина С.Н. от имени рабочей группыпо проведению исследования КАБРИОЛЕТ. Сравнение влияния длительной терапии, основанной на карведилоле или бисопрололе, на метаболические параметры у больных артериальной гипертонией и избыточной массой тела или ожирением. Результатырандомизированного открытого параллельного ступенчатого исследованияКАБРИОЛЕТ (часть 1). Рациональная Фармакотерапия в Кардиологии 2012; (4): 488-99).Martsevich SY, Tolpygina SN, on behalf of the working group on the KABRIOLET study. Compared the effects of long-term therapy based on carvedilol or bisoprolol on metabolic parameters in patients with arterial hypertension and overweight or obese. Results of a randomized open parallel study CONVERTIBLE step (part 1). Ration Pharmacother Cardiol 2012; (4): 488-99. Russian (Марцевич С.Ю., Толпыгина С.Н. от имени рабочей группыпо проведению исследования КАБРИОЛЕТ. Сравнение влияния длительной терапии, основанной на карведилоле или бисопрололе, на метаболические параметры у больных артериальной гипертонией и избыточной массой тела или ожирением. Результатырандомизированного открытого параллельного ступенчатого исследованияКАБРИОЛЕТ (часть 1). Рациональная Фармакотерапия в Кардиологии 2012; (4): 488-99).FlatherM.D., ShibataM.C., CoatsA.J. etal. Randomised trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005; 26 (3): 215-25.FlatherM.D., ShibataM.C., CoatsA.J. etal. Randomised trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005; 26 (3): 215-25.Torp-Pedersen C., Metra M., Charlesworth A. et al. COMET investigators. Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: data from the Carvedilol Or Metoprolol European Trial (COMET). Heart 2007; 93: 8: 968-73.Torp-Pedersen C., Metra M., Charlesworth A. et al. COMET investigators. Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: data from the Carvedilol Or Metoprolol European Trial (COMET). Heart 2007; 93: 8: 968-73.Pepine C., Handberg E.M., Cooper-de Hoff R.M. et al. A calcium antagonist vs a treatment strategy for patients with coronary artery disease. The international Verapamil-Trandolapril study (INVEST): a randomised controlled trial. JAMA 2003; 290: 2805-16.Pepine C., Handberg E.M., Cooper-de Hoff R.M. et al. A calcium antagonist vs a treatment strategy for patients with coronary artery disease. The international Verapamil-Trandolapril study (INVEST): a randomised controlled trial. JAMA 2003; 290: 2805-16.Elliot W.J., Meyer P.M. Incident diabetes in clinical trials of antihypertensive drugs: a net work metaanalysis. Lancet 2007; 369: 201-7.Elliot W.J., Meyer P.M. Incident diabetes in clinical trials of antihypertensive drugs: a net work metaanalysis. Lancet 2007; 369: 201-7.Deanfield J., Detry J.M., Lichtlen P.R. Amlodipine reduced transient myocardial ischemia in patients with coronary artery disease: double – blind circadian anti – ischemia program in Europe (CAPE Trial). J Am CollCardiol 1999; 24: 1460-7.Deanfield J., Detry J.M., Lichtlen P.R. Amlodipine reduced transient myocardial ischemia in patients with coronary artery disease: double – blind circadian anti – ischemia program in Europe (CAPE Trial). J Am CollCardiol 1999; 24: 1460-7.Pitt B. Effect of amlodipine on progression of atherosclerosis and the occurrence of clinical events. PREVENT investigators. Circulation 2000; 102 (13): 1503-10.Pitt B. Effect of amlodipine on progression of atherosclerosis and the occurrence of clinical events. PREVENT investigators. Circulation 2000; 102 (13): 1503-10.Hansson L. The Hypertension Optimal Treatment Study (the HOT Study). Blood Press 1993; 2: 62-8.Hansson L. The Hypertension Optimal Treatment Study (the HOT Study). Blood Press 1993; 2: 62-8.Hansson L., Lindholm L.H., Ekbom T. et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension – 2 study. Lancet 1999; 345: 1751-6.Hansson L., Lindholm L.H., Ekbom T. et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension – 2 study. Lancet 1999; 345: 1751-6.Sanjuliani A.F., Genelhu de Abreu V., Ueleres B.J. et al. Effects of moxonidine on the sympathetic nervous system, blood pressure, plasma rennin activity, plasma aldosterone, leptin, and metabolic profile in obese hypertensive patients. J Clin Basic Cardiol 2004; 7: 19-25.Sanjuliani A.F., Genelhu de Abreu V., Ueleres B.J. et al. Effects of moxonidine on the sympathetic nervous system, blood pressure, plasma rennin activity, plasma aldosterone, leptin, and metabolic profile in obese hypertensive patients. J Clin Basic Cardiol 2004; 7: 19-25.Chazova EI, Michka VB, Silence EV et al. Place imidazoline receptor agonist moxonidine in the treatment of hypertensive patients with metabolic syndrome. Results of the study MERSY in Russia. Systemic Hypertension 2009; (3); 22-4. Russian (Чазова Е.И., Мычка В.Б., Тишина Е.В. и др. Место агонистовимидазолиновых рецепторов моксонидина в лечении больных артериальной гипертензией и метаболическим синдромом. Результатыисследования MERSY в России. Системные Гипертензии 2009; (3); 22-4).Chazova EI, Michka VB, Silence EV et al. Place imidazoline receptor agonist moxonidine in the treatment of hypertensive patients with metabolic syndrome. Results of the study MERSY in Russia. Systemic Hypertension 2009; (3); 22-4. Russian (Чазова Е.И., Мычка В.Б., Тишина Е.В. и др. Место агонистовимидазолиновых рецепторов моксонидина в лечении больных артериальной гипертензией и метаболическим синдромом. Результатыисследования MERSY в России. Системные Гипертензии 2009; (3); 22-4).ChazovaI.E., Almazov V.A., Shlyakhto E.V. Moxonidine improves glycaemic control in mildly hypertensive, overweight patients: a comparisonwith metformin (ALMAZ).Diabetes, Obesity andMetabolism 2006; 8; 456-65.ChazovaI.E., Almazov V.A., Shlyakhto E.V. Moxonidine improves glycaemic control in mildly hypertensive, overweight patients: a comparisonwith metformin (ALMAZ).Diabetes, Obesity andMetabolism 2006; 8; 456-65.Martynov AI, Ostroumova OD, Korsakov NK, et al. Effect of the moxonidine on cardiovascular system and brain in elderly patients with hypertension. Russian Journal of Cardiology 2002; (4): 59-63. Russian (Мартынов А.И., Остроумова О.Д., Корсакова Н.К. и др. Влияние препарата моксонидин на состояние сердечно-сосудистой системы и головного мозга у пожилых больных с артериальной гипертонией. Российский Кардиологический Журнал 2002; (4): 59-63).Martynov AI, Ostroumova OD, Korsakov NK, et al. Effect of the moxonidine on cardiovascular system and brain in elderly patients with hypertension. Russian Journal of Cardiology 2002; (4): 59-63. Russian (Мартынов А.И., Остроумова О.Д., Корсакова Н.К. и др. Влияние препарата моксонидин на состояние сердечно-сосудистой системы и головного мозга у пожилых больных с артериальной гипертонией. Российский Кардиологический Журнал 2002; (4): 59-63).Imanishi T., TsujokaH., SkejimaH. et al. Renin inhibitor aliskiren improves impaired nitric oxide bioavailability and protects against atherosclerotic changes. Hypertension 2008; 52 (3): 563-72.Imanishi T., TsujokaH., SkejimaH. et al. Renin inhibitor aliskiren improves impaired nitric oxide bioavailability and protects against atherosclerotic changes. Hypertension 2008; 52 (3): 563-72.Rutherford J.D., Pfeffer M.A., Moye L.A. et al. Effect of captopril on ischemic events after myocardial infarction. Results of the Survival and Ventricular Enlargement trial. Circulation 1994; 90: 1731-8.Rutherford J.D., Pfeffer M.A., Moye L.A. et al. Effect of captopril on ischemic events after myocardial infarction. Results of the Survival and Ventricular Enlargement trial. Circulation 1994; 90: 1731-8.Cohn J.N., Tognoni G. A randomised trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001; 345: 1667-75. 51. Parving H.H., Persson F., Lewis J.B. et al. Aliskiren Combined with Losartan in Type 2 Diabetes and Nephropathy. N Engl J Med 2008; 358: 2433-46.Cohn J.N., Tognoni G. A randomised trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001; 345: 1667-75. 51. Parving H.H., Persson F., Lewis J.B. et al. Aliskiren Combined with Losartan in Type 2 Diabetes and Nephropathy. N Engl J Med 2008; 358: 2433-46.HabibiJ., Whaley-Connell A.,Hayden M.R. et al. Renin intibition attenuates insulin resistance, oxidative stress, and pancreatic remodeling in the transgenic Ren 2 rat. Endocrinology 2008; 149 (11): 5643-53.HabibiJ., Whaley-Connell A.,Hayden M.R. et al. Renin intibition attenuates insulin resistance, oxidative stress, and pancreatic remodeling in the transgenic Ren 2 rat. Endocrinology 2008; 149 (11): 5643-53.Mukhin NA, Fomin VV. Plasma renin activity an independent risk factor and target of antihypertensive therapy: the role of aliskiren. Consilium Medicum 2010; (7): 38-44. Russian (Мухин Н.А., Фомин В.В. Активность ренина плазмы – фактор риска и самостоятельная мишень антигипертензивной терапии: роль алискирена. Consilium Medicum2010; (7): 38-44).Mukhin NA, Fomin VV. Plasma renin activity an independent risk factor and target of antihypertensive therapy: the role of aliskiren. Consilium Medicum 2010; (7): 38-44. Russian (Мухин Н.А., Фомин В.В. Активность ренина плазмы – фактор риска и самостоятельная мишень антигипертензивной терапии: роль алискирена. Consilium Medicum2010; (7): 38-44).Bax L., Mali W.P.T.M., Buskens E. et al. The benefit of stent placement and blood pressure and lipidlowering for the prevention of progression ofrenal dysfunction caused by Atherosclerotic ostial stenosis of the Renal artery. J Nephrol 2003; 16: 807-12.Bax L., Mali W.P.T.M., Buskens E. et al. The benefit of stent placement and blood pressure and lipidlowering for the prevention of progression ofrenal dysfunction caused by Atherosclerotic ostial stenosis of the Renal artery. J Nephrol 2003; 16: 807-12.Blood pressure normalization by fixed perindopril/ indapamide combination in hypertensive patients with or without associate metabolic syndrome: results of the OPTIMAX 2 study. VascHlth Risk Manag 2008; 4 (2): 443-51.Blood pressure normalization by fixed perindopril/ indapamide combination in hypertensive patients with or without associate metabolic syndrome: results of the OPTIMAX 2 study. VascHlth Risk Manag 2008; 4 (2): 443-51.Mankovsky BN, Ivanov DD Effect of antihypertensive therapy on renal function in patients with type 2 diabetes: a prospective study "SKIF-2." Liki of Ukraine 2010; 8 (144): 28-32. Ukrainian (Маньковский Б.Н., Иванов Д.Д. Влияние антигипертензивной терапии на функцию почек у больных сахарным диабетом 2 типа: результаты проспективного исследования «СКИФ-2». Лiки України 2010; 8 (144): 28-32).Mankovsky BN, Ivanov DD Effect of antihypertensive therapy on renal function in patients with type 2 diabetes: a prospective study "SKIF-2." Liki of Ukraine 2010; 8 (144): 28-32. Ukrainian (Маньковский Б.Н., Иванов Д.Д. Влияние антигипертензивной терапии на функцию почек у больных сахарным диабетом 2 типа: результаты проспективного исследования «СКИФ-2». Лiки України 2010; 8 (144): 28-32).Dahlof B., Gosse P., Gueret P. et al. Perindopril/ indapamide combination more effective than enalapril in reducing blood pressure and left ventricular mass: the PICXEL study. J Hypertens 2005; 23: 2063-70.Dahlof B., Gosse P., Gueret P. et al. Perindopril/ indapamide combination more effective than enalapril in reducing blood pressure and left ventricular mass: the PICXEL study. J Hypertens 2005; 23: 2063-70.Mogensen C.E., Viberti G.,Halimi S. et al. Preterax in Albuminuria Regression (PREMIER) Study Group. Effect of low-dose perindopril / indapamide on albuminuria in diabetes. Preterax in Albuminuria Regression: PREMIER. Hypertension 2003; 41: 1063-71.Mogensen C.E., Viberti G.,Halimi S. et al. Preterax in Albuminuria Regression (PREMIER) Study Group. Effect of low-dose perindopril / indapamide on albuminuria in diabetes. Preterax in Albuminuria Regression: PREMIER. Hypertension 2003; 41: 1063-71.Council Conclusions of Experts. Optimizing statin treatment of patients at high and very high risk. Cardiosomatics 2012; 2 (4): 80-6. Russian (Заключение Совета экспертов. Оптимизация терапии статинами пациентов высокого и очень высокого риска. Кардиосоматика 2012; 2 (4): 80-6).Council Conclusions of Experts. Optimizing statin treatment of patients at high and very high risk. Cardiosomatics 2012; 2 (4): 80-6. Russian (Заключение Совета экспертов. Оптимизация терапии статинами пациентов высокого и очень высокого риска. Кардиосоматика 2012; 2 (4): 80-6).SchwartzG.G., OliverM.F., EzekowitzM.D. etal. Rationale and design of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study that evaluates atorvastatin in unstable angina pectoris and in non-Q-wave acute myocardial infarction. Am J Cardiol 1998; 81: 578-81.SchwartzG.G., OliverM.F., EzekowitzM.D. etal. Rationale and design of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study that evaluates atorvastatin in unstable angina pectoris and in non-Q-wave acute myocardial infarction. Am J Cardiol 1998; 81: 578-81.Cannon C.P., Braunwald E., McCabe C.H. et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 2004; 350: 1495-504.Cannon C.P., Braunwald E., McCabe C.H. et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 2004; 350: 1495-504.LaRosa J.C., Grundy S.M., Waters D.D. et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352: 1425-35.LaRosa J.C., Grundy S.M., Waters D.D. et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352: 1425-35.Nissen S.E. Effect of intensive lipid lowering on progression of coronary atherosclerosis: evidence for an early benefit from the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial. Am J Cardiol 2005; 96 Suppl: 61F-68F.Nissen S.E. Effect of intensive lipid lowering on progression of coronary atherosclerosis: evidence for an early benefit from the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial. Am J Cardiol 2005; 96 Suppl: 61F-68F.

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