Статья
Тиазидные и тиазидоподобные диуретики: как правильно сделать выбор?
Для достижения целевого уровня артериального давления большинству пациентов с артериальной гипертензией (АГ) требуется назначение комбинированной терапии. При этом, согласно отечественным и зарубежным клиническим рекомендациям по лечению пациентов с АГ, комбинировать можно различные антигипертензивные препараты, тем не менее не все их сочетания имеют одинаковый профиль безопасности и клинической эффективности. В этом контексте особое внимание отводится комбинации ингибиторов ренин–ангиотензин–альдостероновой системы и тиазидных (гидрохлоротиазид) или тиазидоподобных (хлорталидон, индапамид) диуретиков. Между диуретиками также существуют различия по механизмам действия, наличию плейотропных эффектов и органопротективных свойств, влиянию на прогноз, а также по доказательной базе. В данном обзоре литературы обсуждается место тиазидных и тиазидоподобных диуретиков в лечении пациентов с АГ, дается оценка основных различий, как в фармакологических, так и клинических эффектах препаратов, входящих в класс диуретиков.
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