medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2020-21-19-28medalphabet-1661Research ArticleСтатьиВыбор фиксированной комбинации у пациентов с артериальной гипертонией: фокус на антигипертензивные и нефропротективные свойства фиксированной комбинации лизиноприла и амлодипина (клинический пример)Fixed combination in patients with arterial hypertension: focus on antihypertensive and nephroprotective properties of fixed combination of lisinopril and amlodipine (clinical example)ЭбзееваЕ. Ю.EbzeevaE. Yu.

к.м.н., доцент, доцент кафедры терапии и полиморбидной патологии

г. Москва

Moscow

ОстроумоваО. Д.OstroumovaO. D.

д.м.н., проф., зав. кафедрой терапии и полиморбидной патологии

г. Москва

Moscow

ДолдоН. М.DoldoN. M.

зав. терапевтическим отделением

г. Москва

Moscow

ПавлееваЕ. Е.PavleevaE. E.

к.м.н., ассистент кафедры пропедевтики внутренних болезней и гастроэнтерологии

г. Москва

Moscow

ФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава РоссииРоссияRussian Medical Academy for Postgraduate Continuous EducationRussian FederationЧУЗ «Центральная клиническая больница „РЖД-Медицина“РоссияCentral Clinical Hospital ‘Russian Railways – Medicine’Russian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова» Минздрава РоссииРоссияMoscow State University of Medicine and Dentistry n.a. A.I. EvdokimovRussian Federation202013102020021Современная поликлиника (2)1928Copyright © Эбзеева Е.Ю., Остроумова О.Д., Долдо Н.М., Павлеева Е.Е., 20202020Эбзеева Е.Ю., Остроумова О.Д., Долдо Н.М., Павлеева Е.Е.Ebzeeva E.Y., Ostroumova O.D., Doldo N.M., Pavleeva E.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1661

Артериальная гипертензия (АГ) остается одной из самых значимых медико-социальных проблем в мире, ее распространенность среди взрослого населения составляет 30–45%. Наряду с этим современное население характеризуется высокой заболеваемостью хронической болезнью почек (ХБП), в том числе за счет их вторичного поражения в рамках АГ. В свою очередь, ХБП является важным независимым фактором риска развития и прогрессирования сердечно-сосудистых заболеваний, в том числе фатальных. Использование при лечении пациентов с АГ имеющихся подходов к нефропротекции позволит существенно улучшить прогноз как у больных с факторами риска развития почечной дисфункции, так и у пациентов с уже имеющимся заболеванием почек. Согласно современным рекомендациям по АГ в таких клинических ситуациях следует начинать терапию с фиксированных комбинаций антигипертензивных препаратов. Наибольшую эффективность, согласно данным доказательной медицины у больных с АГ высокого риска, в том числе и с позиций нефропротекции, продемонстрировала комбинация ингибитора ангиотензинпревращающего фермента (ИАПФ) и дигидропиридинового блокатора кальциевых каналов (БКК). В представленном клиническом случае описано успешное применение фиксированной комбинации ИАПФ и БКК у пациента с АГ и микроальбуминурией.

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.

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