Статья
Клинические особенности артериальной гипертонии в пожилом и старческом возрасте и обоснование применения комбинации амлодипин/индапамид ретард
Доля пожилых лиц в популяции неуклонно растет, при этом % лиц старше 65 лет страдают артериальной гипертонией (АГ). С возрастом наблюдается существенный рост частоты развития изолированной систолической АГ Взаимосвязь между повышением пульсового давления, артериальной жесткостью и процессами старения неоднократно подтверждена в популяционных эпидемиологических исследованиях. Накоплены определенные доказательства того, что лечение АГ у пожилых сопровождается снижением риска сердечно-сосудистых заболеваний. Целевые уровни артериального давления (АД) у пожилых лиц с АГ моложе 80 лет, а также старше 80 лет при удовлетворительном физическом и когнитивном статусе с систолического АД >160 мм рт. ст. рекомендуется снижать до 140-150 мм рт. ст. С целью эффективного снижения сердечно-сосудистых осложнений в лечении АГ у пожилых к препаратам первой линии относят низкие дозы тиазидных/тиазидоподобных диуретиков и длительно действующие антагонисты кальциевых каналов (преимущественно дигидропиридиновые), их назначение в виде фиксированной комбинации является оптимальным решением при неэффективности монотерапии.
1. Yoon S. S., Fryar C. D., Carroll M. D. Hypertension Prevalence and Control among Adults: United States, 2011-2014. NCHS Data Brief no. 220. Hyattsville, MD: National Center for Health Statistics; 2015.
2. Mozaffarian D., Benjamin E.J., Go A. S. et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics - 2015 Update. Circulation 2015;131: e29-e322.
3. Шальнова С. А., Деев А. Д., Оганов Р. Г. и др. Роль систолического и диастолического артериального давления для прогноза смертности от сердечно-сосудистых заболеваний. Кардиоваскулярная терапия и профилактика 2002; 1:10-15
4. Вишневский А., Андреев Е., Тимонин С. Смертность от болезнеий системы кровообращения и продолжительность жизни в России. Демографическое обозрение 2016; 3 (1): 6-34
5. Lewington S., Clarke R., Qizilbash N. et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-1913.
6. Egan B. M., Zhao Y., Axon R. N. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 2010;303:2043.
7. Aronow W. S., Fleg J. L., Pepine C.J. et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation 2011;123 (21):2434-506.
8. Кобалава Ж. Д., Котовская Ю. В., Асеева О. А. и др. Клинико-демографические характеристики различных вариантов артериальной гипертонии у пожилых пациентов (по результатам Российской научно-практической программы АРГУС). Терапевтический архив 2002;2:47-51
9. Nilsson P. M., Olsen M. H., Laurent S. Early Vascular Aging (EVA): New Directions in Cardiovascular Protection. Elsevier, 2015, 343 p. English.
10. Kannel W. B. Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA 1996; 275:1571.
11. Franklin S. S., Pio J. R., Wong N. D. et al. Predictors of new-onset diastolic and systolic hypertension: the Framingham Heart Study. Circulation 2005;111:1121-7.
12. Franklin S. S., Gustin W.4th, Wong N. D. et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997;96:308-15.
13. Falaschetti E., Mindell J., Knott C. et al. Hypertension management in England: a serial cross-sectional study from 1994 to 2011 Lancet 2014;383:1912-1919.
14. ESH/ESC Guidelines for the management of arterial hypertension. European Heart Journal 2013;34:2159-2219.
15. Chobanian A. V. Clinical practice. Isolated systolic hypertension in the elderly. N Engl J Med 2007;357:789.
16. Mitchell G. F., Wang N., Palmisano J. N. et al. Hemodynamic correlates of blood pressure across the adult age spectrum: noninvasive evaluation in the Framingham Heart Study. Circulation 2010;122:1379-86.
17. Kaess B. M., Rong J., Larson M. G. et al. Aortic stiffness, blood pressure progression, and incident hypertension. JAMA 2012;308:875-81.
18. Franklin S. S., Larson M. G., Khan S. A. et al. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation 2001;103:1245.
19. Izzo J. L. Jr, Levy D., Black H. R. Clinical Advisory Statement. Importance of systolic blood pressure in older Americans. Hypertension 2000;35:1021.
20. Young J. H., Klag M. J., Muntner P. et al. Blood pressure and decline in kidney function: findings from the Systolic Hypertension in the Elderly Program (SHEP). J Am Soc Nephrol 2002;13:2776.
21. Диагностика и лечение артериальной гипертонии. Российские рекомендации (четвертый пересмотр). М., 2010
22. Neaton J. D., Wentworth D. Serum cholesterol, blood pressure, cigarette smoking, and death from coronary heart disease. Overall findings and differences by age for 316,099 white men. Multiple Risk Factor Intervention Trial Research Group. Arch Intern Med 1992;152:56.
23. Protogerou A. D., Safar M. E., Iaria P. et al. Diastolic blood pressure and mortality in the elderly with cardiovascular disease. Hypertension 2007; 50:172.
24. Prevention ofstroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991;265:3255.
25. Beckett N., Peters R., Fletcher A. et al. the HYVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008;358:1887-98.
26. Somes G. W., Pahor M., Shorr R. I. et al. The role of diastolic blood pressure when treating isolated systolic hypertension. Arch Intern Med 1999;159:2004.
27. Voko Z., Bots M. L,. Hofman A. et al. J-shaped relation between blood pressure and stroke in treated hypertensives. Hypertension 1999;34:1181.
28. Messerli F. H., Mancia G., Conti C. R. et al. Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann Intern Med 2006;144:884.
29. Boutitie F., Gueyffier F., Pocock S. et al. J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Ann Intern Med 2002;136:438.
30. Mulatero P., Verhovez A., Morello F., Veglio F. Diagnosis and treatment of low-renin hypertension. Clin Endocrinol (Oxf) 2007;67:324-34.
31. Laragh J. Laragh's lessons in pathophysiology and clinical pearls for treating hypertension. Am J. Hypertens 2001;14:733-742.
32. Кобалава Ж. Д., Котовская Ю. В., Моисеев В. С. Артериальная гипертония. Ключи к диагностике и лечению. М.: Гэотар-Медиа. 2009. - 864 с.
33. Alderman M. H., Cohen H. W., Sealey J. E. et al. Pressor responses to antihypertensive drug types. AmJ Hypertens 2010;23 (9):1033-37.
34. Furberg C. D. Renin-guided treatment of hypertension: time for action. Am J. Hypertens 2010;23 (9):929-930.
35. Brown M. J. Heterogeneity of blood pressure response to therapy. Am J. Hypertens 2010; 2:926-928.
36. Krusell L. R., Jespersen L. T., Christensen C. K. et al. Acute natriuresis induced by inhibition of proximal tubular reabsorption of sodium and water in hypertensives following acute calcium entry blockade with nifedipine. J. Cardiovasc Pharmacol 1987;10 (Suppl 10):162-163.
37. Yokoyama S., Kaburagi T. Clinical effects of intravenous nifedipine on renal function. J. Cardiovasc Pharmacol 1983;5:67-71.
38. Laragh J. H., Sealey J. E. The plasma renin test reveals the contribution of body sodium-volume content (V) and renin - angiotensin (R) vasoconstriction to long- term blood pressure. Am J. Hypertens 2011;24: 1164-1180.
39. Turner S. T., Schwartz G. L., Chapman A. B. et al. Plasma renin activity predicts blood pressure responses to betablocker and thiazide diuretics as monotherapy and add-on for hypertension. Am J. Hypertens 2010; 23 (9):1014-22.
40. Chobanian A. V., Bakris G. L., Black H. R. et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 Report. JAMA 2003;289:2560-2572.
41. Neal B., MacMahon S., Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Lancet 2000;356:1955-1964.
42. Psaty B. M., Smith N. L., Siscovick D. S. et al. Health outcomes associated with antihypertensive therapies used as first-line agents: asystematic review and meta-analysis. JAMA 1997;277:739-745.
43. Gentil A., Bejot Y., Lorgis L. et al. Comparative epidemiology of stroke and acute myocardial infarction: the Dijon Vascular project (Diva). J. Neurol Neurosurg Psychiatry 2009;80:1006-1010.
44. Whelton P. K., Appel L.J., Espeland M. A. et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA 1998; 279:839.
45. Appel L.J., Espeland M. A., Easter L. et al. Effects of reduced sodium intake on hypertension control in older individuals: results from the Trial of Nonpharmacologic Interventions in the Elderly (TONE). Arch Intern Med 2001;161:685.
46. Staessen J. A., Gasowski J., Wang J. G. et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet 2000;355:865.
47. Burney B., Bakris G. Hypertension and its management in the elderly. Semin Nephrol 2009;29:604.
48. Chaudhry S. I., Krumholz H. M., Foody J. M. Systolic hypertension in older persons. JAMA 2004;292:1074.
49. SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N. Engl J. Med 2015;373:2103 --2116.
50. Vanhanen H., Thijs L., Birkenhager W. et al. Associations of orthostatic blood pressure fall in older patients with isolated systolic hypertension. Syst-Eur Investigators. J. Hypertens 1996;14:943.
51. Tinetti M. E., Han L., Lee D. S. et al. Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med 2014;174:588.
52. Butt D. A., Mamdani M., Austin P. C. et al. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch Intern Med 2012; 172:1739.
53. Benetos A., Labat C., Rossignol P. et al. Treatment With Multiple Blood Pressure Medications, Achieved Blood Pressure, and Mortality in Older Nursing Home Residents: The PARTAGE Study. JAMA Intern Med 2015;175:989.
54. Odden M. C., Peralta C. A., Haan M. N. et al. Rethinking the association of high blood pressure with mortality in elderly adults: the impact of frailty. Arch Intern Med 2012;172:1162.
55. Lithell H., Hansson L., Skoog I. et al., SCOPE Study Group. The study on cognition and prognosis in the elderly (SCOPE). Principal results of a randomised double-blind intervention trial. J. Hypertens 2003;21:875-86.
56. James P. A., Oparil S., Carter B. L. et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311:507.
57. NICE guidelines. Hypertension: Clinical management of primary hypertension in adults. Published August 2011. Updated 2016. https://www.nice.org.uk/guidance/cg127/chap-ter/Introduction.
58. Blood Pressure Lowering Treatment Trialists' Collaboration, Turnbull F., Neal B. et al. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials. BMJ 2008;336:1121.
59. Law M. R., Morris J. K., Wald N.J. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 2009; 338: b1665.
60. Wassertheil-Smoller S., Anderson G., Psaty B. M. et al. Hypertension and Its Treatment in Postmenopausal Women Baseline Data from the Women's Health Initiative. Hypertension 2000;36:780-789.
61. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288:2981.
62. Staessen J. A., Fagard R., Thijs L. et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 1997;350:757.
63. Hansson L., Lindholm L. H., 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;354:1751.
64. Liu L., Wang J. G., Gong L. et al. Comparison of active treatment and placebo in older Chinese patients with isolated systolic hypertension. Systolic Hypertension in China (Syst-China) Collaborative Group. J. Hypertens 1998;16:1823.
65. Jamerson K., Weber M. A., Bakris G. L. et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N. Engl J. Med 2008;359:2417.
66. Baguet J. P., Legallicier B., Auquier P. et al. Updated meta-analytical approach to efficacy of antihypertensive drugs in reducing blood pressure. Clinical Drug Invest 2007;27:735-753.
67. Chen G. J., Yang M. S. The effects of calcium channel blockers in the prevention of stroke in adults with hypertension: a metaanalysis of data from 273,543 participants in 31 randomized controlled trials. PLoS One 2013;8 (3):e57854.
68. Mukete B. N., Cassidy M., Ferdinand K. C. et al. Long-term antihypertensive therapy and stroke prevention. A Meta-analysis. Am J. Cardiovasc Drugs 2015;15 (4):243-257.
69. Liu L., Zhang Y. et al. The Felodipine Event Reduction (FEVER) Study: a randomized long-term placebo-controlled trial in Chinese hypertensive patients.Journal of Hypertension 2005;23 (12):2157-72.
70. Rimoldi S. F., Messerli F. H., Chavez P. et al. Efficacy and Safety of Calcium Channel Blocker/Diuretics Combination Therapy in Hypertensive Patients: A Meta-Analysis. J. Clin Hypertens 2015;17:193-199.
71. Mancia G., Facchetti R., Parati G. et al. Visit-to-Visit Blood Pressure Variability, Carotid Atherosclerosis, and Cardiovascular Events in the European Lacidipine Study on Atherosclerosis. Circulation 2012;126:569-578.
72. Jadhav U., Hiremath J., Namjoshi D.J. et al. Blood Pressure Control with a Single-Pill Combination of Indapamide Sustained-Release and Amlodipine in Patients with Hypertension: The EFFICIENT Study. PLoS ONE 2014;9 (4):e92955.
73. Hanon O., Boully C., Caillard L. et al. Treatment of Hypertensive Patients With Diabetes and Microalbuminuria With Combination Indapamide SR/Amlodipine: Retrospective Analysis of NESTOR. Am J. Hypertens 2015;28 (8):1064-7.