Abstract
Aim. To evaluate different tactics of initial antihypertensive therapy. Material and Methods. 120 patients with mild-to-moderate arterial hypertension were included and randomized into three groups: “A”, “B”, and “C”. 5 drugs from the main antihypertensive classes were used: indapamide, bisoprolol, amlodipine, fosinopril, and rilmenidine as well as fixed drug combination of fosinopril and hydrochlorothiazide. Patients included in group “A” received initial therapy according to individual leading pathogenic variant of hypertension. Patients from group “B” received standard stepped antihypertensive therapy with gradual dose increase and further addition of second (third) drug. Patients in group “C” were immediately administrated fixed drug combination and later added other drugs. Visits were scheduled after 2, 4, 6, 8, 10, etc weeks of treatment up to achievement of target blood pressure (BP). Results. In group “A” 33 patients (82,5%) achieved target BP after 6 visits, in group “B” - 37 patients (92,5%) after 8 visits and in group “C” - 100% of patents after 6 visits. Thus, in group “C” there was less number of visits and respectively lower number of therapy changes in order to achieve target BP. No significant discrepancies between group “A” and “B” were observed. Conclusion. Tactics of initial antihypertensive therapy with usage of fixed drug combination results in more effective and fast achievement of target BP.
Highlights
Другим подходом является ступенчатое назначение лечения, при котором в случае недостаточной эффективности одного из препаратов, после увеличения его дозы добавляют другой препарат, затем третий до достижения целевых значений артериального давления (АД)
8. Stergiou GS, Karotsis AK, Symeonidis A, Vassilopoulou VA.Aggressive blood pressure control in general practice (ABC-GP) study: can the new targets be reached?
Summary
В исследование было включено 120 пациентов с мягкой и умеренной артериальной гипертензией, которые были рандомизированы в группы «А», «В» и «С». Пациенты группы «В» получали ступенчатую антигипертензивную терапию с титрованием препарата до максимальной дозы и последующим добавлением второго (третьего) препарата при неэффективности терапии. В группе «В», целевое АД было достигнуто у 37 пациентов (92,5%) за 8 визитов Тактика комбинированной терапии с использованием фиксированных комбинаций (тактика лечения в группе «С») приводит к наилучшему результату по снижению уровня АД за меньшее число визитов. Tactics of initial antihypertensive therapy with usage of fixed drug combination results in more effective and fast achievement of target BP. Быстрое наступление эффекта улучшает приверженность пациентов к лечению, тогда как большое количество визитов к врачу и последовательных изменений в терапии, напротив, приводит к отказам от лечения [2].
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