cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2012-1-36-40cardiovascular-1666Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONАнтигипертензивные и метаболические эффекты комбинации лерканидипина с различными антигипертензивными препаратами в условиях повседневной клинической практикиBlood Pressure and Metabolic Effect of a Combination of Lercanidipine with Different Antihypertensive Drugs in Clinical PracticeЧичероА. Ф.CiceroArrigo F.G.ГерокарниБ.GerocarniBeatriceРостиччиМ.RosticciMartinaБоргиК.BorghClaudioУнивеситет Болоньи, БолоньяDepartment of Internal Medicine, Aging and Kidney Diseases, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna2012200220121113640Copyright © Чичеро А.Ф., Герокарни Б., Ростиччи М., Борги К., 20122012Чичеро А.Ф., Герокарни Б., Ростиччи М., Борги К.Cicero A.F., Gerocarni B., Rosticci M., Borgh C.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1666

Целью исследования была оценка антигипертензивных и метаболических эффектов лерканидипина в сочетании с различными антигипертензивными препаратами (АГП) первой линии в условиях повседневной клинической практики. В исследование были последовательно включены 162 пациента с неосложненной первичной гипертензией (АГ), которые частично отвечали на монотерапию лерканидипином в течение предшествующих 24 мес. Всем участникам назначался лерканидипин (10-20 мг/сут.) в сочетании с β-блокаторами, диуретиками, ингибиторами ангиотензин-превращающего фермента (ИАПФ) либо блокаторами рецепторов ангиотензина II (БРА), в соответствии с клиническими рекомендациями Европейского общества по изучению гипертензии и Европейского общества кардиологов. Все участники полностью выполнили протокол исследования. За весь период наблюдения не было зарегистрировано побочных эффектов (ПЭ), связанных с приемом изучаемых препаратов. Сочетание лерканидипина с иными АГП приводило к дополнительному снижению систолического либо диастолического артериального давления (АД), независимо от класса дополнительно назначаемых препаратов (р<0,05 для всех сравнений). Степень снижения АД в различных группах комбинированной терапии достоверно не различалась. Дополнительное назначение иных АГП не оказывало существенного влияния на сывороточные уровни общего холестерина, холестерина липопротеидов низкой плотности и холестерина липопротеидов высокой плотности (р>0,05 для всех сравнений). На фоне комбинированной терапии лерканидипином и ИАПФ либо БРА наблюдалось достоверное снижение уровня глюкозы плазмы натощак и сывороточной концентрации триглицеридов (ТГ). Таким образом, данное исследование продемонстрировало хорошую переносимость и высокую антигипертензивную эффективность комбинированной терапии лерканидипином. Прием лерканидипина в сочетании с препаратами, блокирующими эффекты ренин-ангиотензиновой системы, сочетался с достоверным снижением уровней ТГ и глюкозы плазмы натощак.

The aim of this study is to assess the blood pressure (BP) and metabolic effects of lercanidipine when combined with other classes of first-line antihypertensive drugs in day-to-day clinical practice. For this study, we consecutively enrolled 162 patients with uncomplicated primary hypertension, who are partial responders to the treatment with lercanidipine over a period of 24 months. Patients were then allocated to the combination of lercanidipine (10–20 mg/day) with β-blockers, diuretics, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers according to compelling indications (if any) and/or suggestions of European Society of Hypertension–European Society of Cardiology (ESH–ESC) guidelines. All the enrolled patients completed the study and no adverse drug reaction was registered during the research period. The association of a second drug with lercanidipine determined an additional BP decrease of either systolic BP or diastolic BP independently from the type of drug added (P always <0.05). The additional effect of lercanidipine appears widely distributed with no significant differences in the size of BP decrease. From the metabolic point of view, the addition of a second drug did not determine a significant variation in the serum levels of total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (P always >0.05). Conversely, a significant decrease in fasting plasma glucose and serum levels of triglycerides has been observed in patients where lercanidipine has been combined with an angiotensin-converting enzyme inhibitor or an angiotensin-II receptor blocker. In conclusion, in our study we observed that lercanidipine-based protocols are well tolerated and efficacious in reducing BP. Moreover, the association of lercanidipine with renin–angiotensin system blockers is also associated with significant improvements in triglycerides and fasting plasma glucose.

лерканидипингипертензияметаболические эффектымонотерапиякомбинированная терапияlercanidipinehypertensionmetabolic effectmonotherapycombination therapyReferencesBlood 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; 36(7653):1121-3.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; 36(7653):1121-3.Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 2010; 303(20): 2043-50.Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 2010; 303(20): 2043-50.Kotseva K, Wood D, De Backer G, et al. EUROASPIRE III. Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries. Eur J Cardiovasc Prev Rehabil 2010; 17(5): 530-40.Kotseva K, Wood D, De Backer G, et al. EUROASPIRE III. Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries. Eur J Cardiovasc Prev Rehabil 2010; 17(5): 530-40.Viera AJ, Schmid D, Bostrom S, et al. Level of blood pressure above goal and clinical inertia in a Medicaid population. J Am Soc Hypertens 2010; 4(5): 244-54.Viera AJ, Schmid D, Bostrom S, et al. Level of blood pressure above goal and clinical inertia in a Medicaid population. J Am Soc Hypertens 2010; 4(5): 244-54.Webb AJ, Fischer U, Mehta Z, Rothwell PM. Effects of antihypertensivedrug class on interindividual variation in blood pressure and risk of stroke: a systematic review and meta-analysis. Lancet 2010; 375(9718): 906-15.Webb AJ, Fischer U, Mehta Z, Rothwell PM. Effects of antihypertensivedrug class on interindividual variation in blood pressure and risk of stroke: a systematic review and meta-analysis. Lancet 2010; 375(9718): 906-15.Burnier M, Pruijm M, Wuerzner G. Treatment of essential hypertension with calcium channel blockers: what is the place of lercanidipine? Expert Opin Drug Metab Toxicol 2009; 5(8): 981-7.Burnier M, Pruijm M, Wuerzner G. Treatment of essential hypertension with calcium channel blockers: what is the place of lercanidipine? Expert Opin Drug Metab Toxicol 2009; 5(8): 981-7.Makarounas-Kirchmann K, Glover-Koudounas S, Ferrari P. Results of a meta-analysis comparing the tolerability of lercanidipine and other dihydropyridine calcium channel blockers. Clin Ther 2009; 31(8):1652-63.Makarounas-Kirchmann K, Glover-Koudounas S, Ferrari P. Results of a meta-analysis comparing the tolerability of lercanidipine and other dihydropyridine calcium channel blockers. Clin Ther 2009; 31(8):1652-63.Mancia G, De Backer G, Dominiczak A, et al. 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC task force on the management of arterial hypertension. J Hypertens 2007; 25(9):1751-62.Mancia G, De Backer G, Dominiczak A, et al. 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC task force on the management of arterial hypertension. J Hypertens 2007; 25(9):1751-62.Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation 2005; 111(5): 697-716.Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation 2005; 111(5): 697-716.Borghi C, Veronesi M, Cosentino E, et al. Interaction between serum cholesterol levels and the renin-angiotensin system on the new onset of arterial hypertension in subjects with highnormal blood pressure. J Hypertens 2007; 25(10): 2051-7.Borghi C, Veronesi M, Cosentino E, et al. Interaction between serum cholesterol levels and the renin-angiotensin system on the new onset of arterial hypertension in subjects with highnormal blood pressure. J Hypertens 2007; 25(10): 2051-7.Israili ZH, Lyoussi B, Herníndez-Herníndez R, Velasco M. Metabolic syndrome: treatment of hypertensive patients. Am J Ther 2007; 14(4): 386-402.Israili ZH, Lyoussi B, Herníndez-Herníndez R, Velasco M. Metabolic syndrome: treatment of hypertensive patients. Am J Ther 2007; 14(4): 386-402.Wu JR, Liou SF, Lin SW, et al. Lercanidipine inhibits vascular smooth muscle cell proliferation and neointimal formation via reducing intracellular reactive oxygen species and inactivating Ras-ERK1/2 signaling. Pharmacol Res 2009; 59(1): 48-56.Wu JR, Liou SF, Lin SW, et al. Lercanidipine inhibits vascular smooth muscle cell proliferation and neointimal formation via reducing intracellular reactive oxygen species and inactivating Ras-ERK1/2 signaling. Pharmacol Res 2009; 59(1): 48-56.Taddei S, Virdis A, Ghiadoni L, et al. Calcium antagonist treatment by lercanidipine prevents hyperpolarization in essential hypertension. Hypertension 2003; 41(4): 950-5.Taddei S, Virdis A, Ghiadoni L, et al. Calcium antagonist treatment by lercanidipine prevents hyperpolarization in essential hypertension. Hypertension 2003; 41(4): 950-5.Hopps E, Noto D, Caimi G, Averna MR. A novel component of the metabolic syndrome: the oxidative stress. Nutr Metab Cardiovasc Dis 2010; 20(1): 72-7.Hopps E, Noto D, Caimi G, Averna MR. A novel component of the metabolic syndrome: the oxidative stress. Nutr Metab Cardiovasc Dis 2010; 20(1): 72-7.Viviani GL. Lercanidipine in type II diabetic patients with mild to moderate arterial hypertension. J Cardiovasc Pharmacol 2002; 40(1): 133-9.Viviani GL. Lercanidipine in type II diabetic patients with mild to moderate arterial hypertension. J Cardiovasc Pharmacol 2002; 40(1): 133-9.Duvnjak L, Duvnjak M. The metabolic syndrome – an ongoing story. J Physiol Pharmacol 2009; 60(Suppl. 7): 19-24.Duvnjak L, Duvnjak M. The metabolic syndrome – an ongoing story. J Physiol Pharmacol 2009; 60(Suppl. 7): 19-24.Robles NR, Romero B, de Vinuesa EG, Sínchez-Casado E, Cubero JJ. Treatment of proteinuria with lercanidipine associated with renin-angiotensin axis-blocking drugs. Ren Fail 2010; 32(2):192-7.Robles NR, Romero B, de Vinuesa EG, Sínchez-Casado E, Cubero JJ. Treatment of proteinuria with lercanidipine associated with renin-angiotensin axis-blocking drugs. Ren Fail 2010; 32(2):192-7.Borghi C, Cicero AFG. Rationale for the use of fixed-dose combination in the anagement of hypertension: efficacy and tolerability of lercanidipine plus enalapril. Clin Drug Invest 2010; 30(12): 843-54.Borghi C, Cicero AFG. Rationale for the use of fixed-dose combination in the anagement of hypertension: efficacy and tolerability of lercanidipine plus enalapril. Clin Drug Invest 2010; 30(12): 843-54.Prandin MG, Cicero AF, Veronesi M, et al. Persistence on treatment and blood pressure control with different first-line antihypertensive treatments: a prospective evaluation. Clin Exp Hypertens 2007; 29(8): 553-62.Prandin MG, Cicero AF, Veronesi M, et al. Persistence on treatment and blood pressure control with different first-line antihypertensive treatments: a prospective evaluation. Clin Exp Hypertens 2007; 29(8): 553-62.Simons LA, Ortiz M, Calcino G. Persistence with antihypertensive medication: Australia-wide experience, 2004-2006. Med J Aust 2008; 188(4): 224-7.Simons LA, Ortiz M, Calcino G. Persistence with antihypertensive medication: Australia-wide experience, 2004-2006. Med J Aust 2008; 188(4): 224-7.

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