cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-2160Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONГипотензивный эффект небиволола у пациентов с артериальной гипертензией и сахарным диабетом 2 типа. Исследование YESTONOBlood pressure-lowering effect of nebivolol in hypertensive patients with type 2 diabetes mellitus. The YESTONO StudyШмидтА. К.SchmidtA. C.

Department of Internal Medicine

Department of Internal Medicine

GrafCh.GrafCh.

Department of Molecular and Cellular Sport Medicine

Department of Molecular and Cellular Sport Medicine

BrixiusK.BrixiusK.

Department of Molecular and Cellular Sport Medicine

Department of Molecular and Cellular Sport Medicine

ScholzeJ.ScholzeJ.

Department of Molecular and Cellular Sport Medicine

Department of Molecular and Cellular Sport Medicine

Charite-Universitaetsmedizin Berlin, Outpatient Clinic, BerlinCharite-Universitaetsmedizin Berlin, Outpatient Clinic, BerlinInstitute of Cardiology and Sport Medicine, German Sport University Cologne, CologneInstitute of Cardiology and Sport Medicine, German Sport University Cologne, Cologne201001011970973340Copyright © Шмидт А.К., Graf C., Brixius K., Scholze J., 19701970Шмидт А.К., Graf C., Brixius K., Scholze J.Schmidt A.C., Graf C., Brixius K., Scholze J.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/2160

Актуальность проблемы. Эффективная антигипертензивная ттерапия – наиболее действенное лечебное вмешательство при сахарном диабете (СД). Небиволол широко используется для лечения артериальной гипертензии (АГ), однако до настоящего времени отсутствуют исследования по применению этого препарата у большой популяции пациентов с сочетанием АГ и СД 2 типа (СД-2). Методы. В многоцентровое, постмаркетиноговое, проспективное, открытое исследование вошли 2838 пациентов с АГ, требующей лечения, и сопутствующим СД-2, а также с наличием другой патологии либо без нее. Небиволол назначали как в виде монотерапии, так и в сочетании с другими антигипертензивными препаратами, на протяжении не < 3 мес. Основной конечной точкой было достижение целевого уровня артериального давления (АД) — систолического АД (САД) ≤140 мм рт.ст. и диастолического АД (ДАД) ≤90 мм рт.ст. Дополнительными конечными точками были изменение метаболических параметров, влияние на физическую работоспособность и переносимость терапии. Статистический анализ выполнялся с учетом проспективного дизайна исследования и характера назначенной терапии. Результаты. За время лечения средний уровень АД снизился со 156 (стандартное отклонение 15,3) / 92 (9,4) мм рт.ст. до 135 (11)/81 (6,6) мм рт.ст., частота сердечных сокращений – с 79 (10) до 71 (7) уд/мин. Выраженное снижение АД сопровождалось улучшением большинства метаболических параметров, в т.ч. липидного профиля, уровня гликозилированного гемоглобина и микроальбуминурии. Физическая работоспособность также несколько увеличилась. Большинство пациентов (85 %) получали небиволол в дозе 5 мг/сут. Заключение. На фоне приема небиволола в дозе 5 мг/сут. удалось добиться существенного снижения АД у большинства больных АГ, СД-2 и другой сопутствующей патологией или без нее. Антигипертензивное действие небиволола сочеталось с улучшением большинства метаболических параметров и повышением физической работоспособности.

Background: Effective blood pressure (BP) lowering therapy is regarded as the most important intervention in diabetes mellitus (DM). Nebivolol is commonly used for the treatment of hypertension (AH), but to date there has been no study of its use in a large population of hypertensive patients with type 2 diabetes mellitus (DM-2). Methods: A prospective, open-label, multicentre, post-marketing surveillance study was conducted in 2838 patients with AH requiring intervention and concomitant DM-2, with or without other diseases. The therapeutic agent was nebivolol, either as monotherapy or as add-on therapy to other antihypertensive agents, over a minimum period of 3 months, with the primary endpoint being achievement of target BP, that is, systolic BP ≤140 mm Hg and diastolic BP ≤90 mm Hg. Other endpoints were changes in metabolic parameters, effects on physical capability and tolerability during treatment. Statistical analysis was prospectively planned and conducted on an intention-totreat basis. Results: Mean (SD) BP decreased from 156 (15,3)/92 (9,4) mm Hg to 135 (11)/81 (6,6) mm Hg during the treatment period, while mean (SD) heart rate decreased from 79 (10) to 71 (7) beats/min. Strict reduction of BP was associated with improvements in most metabolic parameters, including lipid levels, glycosylated haemoglobin (HbA1c), and microalbuminuria. Maximum physical capability improved modestly. Most patients (85%) received nebivolol 5 mg/day. Conclusions: Strict BP reduction in AH patients with DM-2, with or without other concomitant diseases, is achieved with nebivolol 5 mg/day in most patients. The benefits of lowering BP with use of nebivolol are associated with improvements in most metabolic parameters and in maximum physical capability.

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