cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2013-4-62-66cardiovascular-215Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESИСПОЛЬЗОВАНИЕ КОМБИНИРОВАННОЙ ТЕРАПИИ НА ОСНОВЕ ДИУРЕТИКОВ У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ. РЕЗУЛЬТАТЫ РОССИЙСКОГО ИССЛЕДОВАНИЯ ТРАСТDIURETIC-BASED COMBINATION THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION: RESULTS OF THE RUSSIAN TRUST STUDYГавриловаН. Е.GavrilovaN. E.

к. м.н., с. н.с. отдела клинической кардиологии и молекулярной генетики

Тел.: +7 (495) 623-86-36; факс: +7 (495) 621-01-22 

tel.: +7 (495) 623-86-36; факс: +7 (495) 621-01-22

ngavrilova@gnicpm.ruОгановР. Г.OganovR. G.

д. м.н., академик РАМН, главный научный сотрудник, руководитель отдела профилактики коморбидных состояний

ФГБУ “Государственный научно-исследовательский центр профилактической медицины Минздрава России”, МоскваState Research Centre for Preventive Medicine, Moscow2013200820131246266Copyright © Гаврилова Н.Е., Оганов Р.Г., 20132013Гаврилова Н.Е., Оганов Р.Г.Gavrilova N.E., Oganov R.G.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/215

Артериальная гипертензия (АГ) является одной из важнейших проблем современной медицины, что связано, прежде всего, с чрезвычайно высокой распространенностью этой нозологии. В работе освещается вопрос об эффективности и безопасности применения комбинированной терапии на основе диуретиков у пациентов с АГ. Обследованы 4495 пациентов в возрасте >18 лет (1476 мужчин, 2989 женщин) с установленным клиническим диагнозом АГ 1–3 ст. Пациенты получали фиксированную комбинированную терапию атенолол/хлорталидон. По результатам исследования ТРАСТ подтверждена безопасность и эффективность фиксированной комбинации атенолол/хлорталидон. 

Arterial hypertension (AH) is one of the most important problems of the modern medicine, due to its exceptionally high prevalence. This study focused on effectiveness and safety of the diuretic-based combination therapy among patients aged >18 years (1476 men and 2989 women) with a clinical diagnosis of Stage 1–3 AH. All patients received fixed-dose combination therapy with atenolol and chlorthalidone. The findings from the TRUST study have confirmed safety and effectiveness of the fixed-dose combination of atenolol and chlorthalidone. 

артериальная гипертензиядиуретикибета-адреноблокаторыкомбинированная терапияarterial hypertensiondiureticsbeta-adrenoblockerscombination therapyReferencesShalnova S, Kukushkin S, Manoshkina E, et al. Arterial hypertension and commitment of therapy. Doctor 2009; 12: 39–42. Russian (Шальнова С., Кукушкин С., Маношкина Е. и др. Артериальная гипертензия и приверженность терапии. Врач 2009; 12: 39–42).Shalnova S, Kukushkin S, Manoshkina E, et al. Arterial hypertension and commitment of therapy. Doctor 2009; 12: 39–42. Russian (Шальнова С., Кукушкин С., Маношкина Е. и др. Артериальная гипертензия и приверженность терапии. Врач 2009; 12: 39–42).Karpov AYu. The combined hypotensive therapy – a way to achievement of target level of arterial pressure at patients with arterial hypertension. Atmosphere. Cardiology news 2013; 1: 22–6. Russian (Карпов А. Ю. Комбинированная гипотензивная терапия – путь к достижению целевого уровня артериального давления у пациентов с артериальной гипертензией. Атмосфера. Новости кардиологии 2013; 1: 22–6).Karpov AYu. The combined hypotensive therapy – a way to achievement of target level of arterial pressure at patients with arterial hypertension. Atmosphere. Cardiology news 2013; 1: 22–6. Russian (Карпов А. Ю. Комбинированная гипотензивная терапия – путь к достижению целевого уровня артериального давления у пациентов с артериальной гипертензией. Атмосфера. Новости кардиологии 2013; 1: 22–6).Moser M, Hebert P, Hennekens CR. An overview of the meta analysis of the hypertension treatment trials. Arch Intern Med 1991; 151: 1277–9.Moser M, Hebert P, Hennekens CR. An overview of the meta analysis of the hypertension treatment trials. Arch Intern Med 1991; 151: 1277–9.Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hy-pertension in middle-aged women and men: the Framingham Heart Study. JAMA 2002; 287: 1003–10.Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hy-pertension in middle-aged women and men: the Framingham Heart Study. JAMA 2002; 287: 1003–10.Chobanian AN, Bakris GL, Black HR, 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: 2560–71.Chobanian AN, Bakris GL, Black HR, 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: 2560–71.Elliott WJ, Grimm RH Jr. Using diuretics in practice: one opinion. J Clin Hypertens (Greenwich) 2008; 10: 856–62.Elliott WJ, Grimm RH Jr. Using diuretics in practice: one opinion. J Clin Hypertens (Greenwich) 2008; 10: 856–62.Ernst ME, Carter BL, Basile JN. All thiazide-like diuretics are not chlorthalidone: putting the ACCOMPLISH study into perspective. J Clin Hypertens (Greenwich) 2009; 11: 5–10.Ernst ME, Carter BL, Basile JN. All thiazide-like diuretics are not chlorthalidone: putting the ACCOMPLISH study into perspective. J Clin Hypertens (Greenwich) 2009; 11: 5–10.Kaplan NM. The choice of thiazide diuretics: why chlorthalidone may replace hydrochlorothiazide. Hypertension 2009; 54: 951–3.Kaplan NM. The choice of thiazide diuretics: why chlorthalidone may replace hydrochlorothiazide. Hypertension 2009; 54: 951–3.Sica DA. Chlorthalidone: a renaissance in use? Expert Opin Pharma-cother 2009; 10: 2037–203.Sica DA. Chlorthalidone: a renaissance in use? Expert Opin Pharma-cother 2009; 10: 2037–203.Mitka M. Experts argue not all diuretics the same. JAMA 2007; 298: 31.Mitka M. Experts argue not all diuretics the same. JAMA 2007; 298: 31.Taler SJ. Should chlorthalidone be the diuretic of choice for antihypertensive therapy? Curr Hypertens Rep 2008; 10: 293–7. 12. Saklayen MG. Which diuretic should be used for the treatment of hypertension? Am Fam Physician 2008; 78: 444, 446.Taler SJ. Should chlorthalidone be the diuretic of choice for antihypertensive therapy? Curr Hypertens Rep 2008; 10: 293–7. 12. Saklayen MG. Which diuretic should be used for the treatment of hypertension? Am Fam Physician 2008; 78: 444, 446.Ernst ME, Moser M. Use of diuretics in patients with hypertension. N Engl J Med 2009; 361: 2153–64.Ernst ME, Moser M. Use of diuretics in patients with hypertension. N Engl J Med 2009; 361: 2153–64.The Multiple Risk Factor Intervention Trial Research Group (MRFIT). Mortality rates after 10.5 years for hypertensive participants in the Multiple Risk Factor Intervention Trial. Circulation 1990; 82: 1616–28.The Multiple Risk Factor Intervention Trial Research Group (MRFIT). Mortality rates after 10.5 years for hypertensive participants in the Multiple Risk Factor Intervention Trial. Circulation 1990; 82: 1616–28.Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the Hypertension Detection and Follow-up Program I. JAMA 1979; 242: 2562–71.Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the Hypertension Detection and Follow-up Program I. JAMA 1979; 242: 2562–71.Kaplan N, Victor R. Treatment of hypertension: drug therapy. Kaplan’s Clinical Hypertension. 10th ed. Philadelphia, PA: Lippincott and Wilkins; 2010.Kaplan N, Victor R. Treatment of hypertension: drug therapy. Kaplan’s Clinical Hypertension. 10th ed. Philadelphia, PA: Lippincott and Wilkins; 2010.Pitt B. The role of chlorthalidone in patients with high-risk hypertension. J Clin Hypertens (Greenwich) 2009; 11: 460–1.Pitt B. The role of chlorthalidone in patients with high-risk hypertension. J Clin Hypertens (Greenwich) 2009; 11: 460–1.Ernst ME, Carter BL, Zheng S, et al. Meta-analysis of dose-response characteristics of hydrochlorothiazide and chlorthalidone: effects on systolic blood pressure and potassium. Am J Hypertens 2010; 23: 440–6.Ernst ME, Carter BL, Zheng S, et al. Meta-analysis of dose-response characteristics of hydrochlorothiazide and chlorthalidone: effects on systolic blood pressure and potassium. Am J Hypertens 2010; 23: 440–6.ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high risk 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: 2981–97.ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high risk 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: 2981–97.Wright JT Jr, Dunn JK, Cutler JA, et al, for the ALLHAT Collaborative Research Group. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA 2005; 293: 1595–608.Wright JT Jr, Dunn JK, Cutler JA, et al, for the ALLHAT Collaborative Research Group. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA 2005; 293: 1595–608.Psaty BM, Lumley T, Furberg CD, et al. Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA 2003; 289: 2534–44.Psaty BM, Lumley T, Furberg CD, et al. Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA 2003; 289: 2534–44.Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the Hypertension Detection and Follow-up Program I. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 1979; 242: 2562–71.Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the Hypertension Detection and Follow-up Program I. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 1979; 242: 2562–71.SHEP Cooperative Research Group. Prevention of stroke by antihyper￾tensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265: 3255–64.SHEP Cooperative Research Group. Prevention of stroke by antihyper￾tensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265: 3255–64.Neaton JD, Grimm RH Jr, Prineas RJ, et al, for the Treatment of Mild Hypertension Study Research Group. Treatment of mild hypertension study. Final results. Treatment of Mild Hypertension Study Research Group. JAMA 1993; 270: 713–24.Neaton JD, Grimm RH Jr, Prineas RJ, et al, for the Treatment of Mild Hypertension Study Research Group. Treatment of mild hypertension study. Final results. Treatment of Mild Hypertension Study Research Group. JAMA 1993; 270: 713–24.Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The seventh report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). JAMA 2003; 289: 2560–72.Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The seventh report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). JAMA 2003; 289: 2560–72.Amery A, Birkenhger W, Brixko P, et al. Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly Trial. The Lancet 1985; 1: 1349–54.Amery A, Birkenhger W, Brixko P, et al. Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly Trial. The Lancet 1985; 1: 1349–54.Multiple Risk Factor Intervention Trial Research Group. Baseline rest electrocardiographic abnormalities, antihypertensive treatment, and mortality in the multiple risk factor intervention trial. Am J Cardiol 1985; 55: 1–15.Multiple Risk Factor Intervention Trial Research Group. Baseline rest electrocardiographic abnormalities, antihypertensive treatment, and mortality in the multiple risk factor intervention trial. Am J Cardiol 1985; 55: 1–15.MRC working party. Medical research council trial of treatment of hyper-tension in older adults: principal results. BMJ 1992; 304: 405–12.MRC working party. Medical research council trial of treatment of hyper-tension in older adults: principal results. BMJ 1992; 304: 405–12.Jamerson K, Weber M, Bakris G, et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359: 2417–28.Jamerson K, Weber M, Bakris G, et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359: 2417–28.Multiple Risk Factor Intervention Trial Research Group. Coronary heart disease death, nonfatal acute myocardial infarction and other clinical outcomes in the multiple risk factor intervention trial. Am J Cardiol 1986; 58: 1–13.Multiple Risk Factor Intervention Trial Research Group. Coronary heart disease death, nonfatal acute myocardial infarction and other clinical outcomes in the multiple risk factor intervention trial. Am J Cardiol 1986; 58: 1–13.Ernst ME, Carter BL, Goerdt CJ, et al. Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure. Hypertension 2006; 47: 352–8.Ernst ME, Carter BL, Goerdt CJ, et al. Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure. Hypertension 2006; 47: 352–8.Kostis JB, Cabrera J, Cheng JQ, et al. Association between chlorthalidone treatment of systolic hypertension and long-term survival. JAMA 2011; 306 (23): 2588–93.Kostis JB, Cabrera J, Cheng JQ, et al. Association between chlorthalidone treatment of systolic hypertension and long-term survival. JAMA 2011; 306 (23): 2588–93.Chazova IE, Ratova LG. Diagnostics and treatment of arterial hypertension. Syst Hypert 2010; No. 10: 5–27. Russian (Чазова И. Е., Ратова Л. Г. Диагностика и лечение артериальной гипертензии. Системные гипертензии 2010; 10: 5–27).Chazova IE, Ratova LG. Diagnostics and treatment of arterial hypertension. Syst Hypert 2010; No. 10: 5–27. Russian (Чазова И. Е., Ратова Л. Г. Диагностика и лечение артериальной гипертензии. Системные гипертензии 2010; 10: 5–27).Casiglia E, Spolaore P, Mazza A, et al. Effect of two different therapeutic approaches on total and cardiovascular mortality in a Cardiovascular Study in the Elderly (CASTEL). Jpn Heart J 1994; 35 (5): 589–600.Casiglia E, Spolaore P, Mazza A, et al. Effect of two different therapeutic approaches on total and cardiovascular mortality in a Cardiovascular Study in the Elderly (CASTEL). Jpn Heart J 1994; 35 (5): 589–600.Asanov EO. Application of the fixed combination of a selective beta-blocker and thiazide diuretic at elderly patients with arterial hypertension. Arter Hypert 2011; 5: 31–5. Russian (Асанов Э. О. Применение фиксированной комбинации селективного бета-блокатора и тиазидного диуретика у пожилых больных гипертонической болезнью. Артериальная гипертония 2011; 5: 31–5).Asanov EO. Application of the fixed combination of a selective beta-blocker and thiazide diuretic at elderly patients with arterial hypertension. Arter Hypert 2011; 5: 31–5. Russian (Асанов Э. О. Применение фиксированной комбинации селективного бета-блокатора и тиазидного диуретика у пожилых больных гипертонической болезнью. Артериальная гипертония 2011; 5: 31–5).Curry RC Jr, Schwartz KM, Urban PL. Atenolol and chlorthalidone therapy for hypertension: a double-blind comparison. South Med J 1988; 81 (11): 1401–6, 1411.Curry RC Jr, Schwartz KM, Urban PL. Atenolol and chlorthalidone therapy for hypertension: a double-blind comparison. South Med J 1988; 81 (11): 1401–6, 1411.

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