Antihypertensive therapy in obese patients with arterial hypertension
Abstract
Obesity (O) is one of the main risk factors of arterial hypertension (AH). Clinicians face increasing numbers of patients with a combination of AH and O and the problem of correct choice of antihypertensive therapy, which should effectively control blood pressure, provide cardio- and nephroprotection, and be metabolically neutral. At the present, a fixed-dose combined medication is available, which has all the characteristics required — a combination of a non-dihydropyridine calcium antagonist verapamil in its retard form and an ACE inhibitor trandolapril. This combination could be a medication of choice in patients with AH, O, diabetes mellitus and nephropathy.
About the Authors
О. M. DrapkinaRussian Federation
Yu. V. Dubolazova
Russian Federation
References
1. www.euro.who.int/obesity
2. Haftenberger M, Lahmann P, Panico S, et al. Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Pub Health Nutr 2002; 5: 1147-62.
3. Kim MH. Prevalence of the Metabolic Syndrome and its Association with Cardiovascular Diseases in Korea. J Korean Med Sci 2004; 19: 195-201.
4. Рекомендации по лечению артериальной гипертонии Европейского Общества Гипертонии и Европейского Общества Кардиологов 2007г.
5. Sharma SK, Ruggenenti P, Remuzzi G. Managing hypertension in diabetic patients — focus on trandolapril/verapamil combination. Vasc Health Risk Manag 2007; 3(4): 453—65.
6. Маколкин В.И. Комбинированная терапия артериальной гипертонии: фокус на сочетание антагониста кальция и ингибитора ангиотензин-превращающего фермента. www.medi.ru
7. Bakris G, Molitch M, Hewkin A, et al.; STAR Investigators. Differences in glucose tolerance between fixed-dose antihypertensive drug combinations in people with metabolic syndrome. Diabetes Care 2006; 29(12): 2592—7.
8. Nakou E, Filippatos TD, Liberopoulos EN, et al. Effects ofsibutramine plus verapamil sustained release/trandolapril combination on blood pressure and metabolic variables in obese hypertensive patients. Expert Opin Pharmacother 2008; 9(10): 1629—39.
9. Моисеев В.С., Мухин Н.А., Кобалава Ж.Д. и др. Основные положения Проекта Рекомендаций Всероссийского научного общества кардиологов и Научного общества нефрологов России по оценке функционального состояния почек у больных с сердечно-сосудистыми заболеваниями или повышенным риском их развития. Кардиоваск тер профил 2008; 7(4): 8—20.
10. Рекомендации по профилактике, диагностике и лечению артериальной гипертензии. Российские рекомендации (второй пересмотр). Кардиоваск тер профил 2004; 4 (Приложение).
11. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105—87.
12. Sandeep N, Pepine CJ, Bakris GL. Calcium Antagonists: Effects on Cardio-Renal Risk in Hypertensive Patients. Hypertension 2005; 46(4): 637—42.
13. Widimsky J. The fixed combination of verapamil SR/trandolapril. Expert Opin Pharmacother 2000; 1(3): 515—35.
14. Pepine CJ, Handberg EM, Cooper-DeHoff RM, et al.; INVEST Investigators. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA 2003; 290(21): 2805—16.
15. Ruggenenti P, Fassi A, Ilieva AP, et al., for the Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) Investigators. Preventing Microalbuminuria in Type 2 Diabetes. NEJM 2004; 351(19):1941—51.
16. Bangalore S, Messerli FH, Cohen JD, et al.; INVEST Investigators. Verapamil-sustained release-based treatment strategy is equivalent to atenolol-based treatment strategy at reducing cardiovascular events in patients with prior myocardial infarction: an INternational VErapamil SR-Trandolapril (INVEST) substudy. Am Heart J 2008; 156(2): 241—7.
17. Widimsky J. The fixed combination of verapamil SR/trandolapril. Expert Opin Pharmacother 2000; 1(3): 515—35.
18. Karlberg BE, Andrup M, Oden A. Efficacy and safety of a new long-acting drug combination, trandolapril/verapamil as compared to monotherapy in primary hypertension. Swedish TARKA trialists. Blood Press 2000; 9(2—3): 140—5.
19. Rubio-Guerra AF, Lozano-Nuevo JJ, Vargas-Ayala G, et al. Efficacy of a fixed-dose combination of trandolapril-verapamil in obese hypertensive patients resistant to monotherapy. Clin Exp Hypertens 2006; 28(7): 619—24.
Review
For citations:
Drapkina О.M., Dubolazova Yu.V. Antihypertensive therapy in obese patients with arterial hypertension. Cardiovascular Therapy and Prevention. 2009;8(4):93-97. (In Russ.)