Preview

Кардиоваскулярная терапия и профилактика

Расширенный поиск

Роль вазодилатирующих β-адреноблокаторов в контроле артериальной гипертензии и снижении риска сердечнососудистых и цереброваскулярных осложнений

Полный текст:

Аннотация

На протяжении нескольких десятилетий β-адреноблокаторы (β-АБ) продолжают играть ключевую роль в терапии артериальной гипертензии (АГ) и связанных с ней сердечно-сосудистых заболеваний (ССЗ). Согласно современным национальным рекомендациям, эти препараты остаются основой антигипертензивной терапии. По последним данным, терапия β-АБ ассоциируется с менее выраженным снижением общей смертности, смертности от ССЗ и частоты сердечно-сосудистых событий, по сравнению с лечением ингибиторами ренин-ангиотензиновой системы или антагонистами кальция. Следует отметить, что класс β-АБ включает в себя широкий спектр препаратов, и опасения о соотношении риска и пользы при приеме этих лекарственных средств могут не распространяться на вазодилатирующие β-АБ последнего поколения, такие как карведилол и небиволол. Постоянно растет число исследований, подтверждающих клиническую эффективность и безопасность вазодилатирующих β-АБ при АГ. Согласно результатам исследований конечных точек, эти препараты могут играть важную роль в снижении суммарного риска ССЗ у пациентов с сердечной недостаточностью — гипертензивного либо ишемического генеза.

Об авторе

Я. Н. Базиль
Программа сердечно-сосудистого здоровья Seinsheimer, Медицинский университет Южной Каролины и медицинский центр Ralph H. Johnson VA
Соединённые Штаты Америки
Чарлестон, Южная Каролина



Список литературы

1. Chobanian AV, Bakris GL, Black HR, et al, for the National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and the National High Blood Pressure Education Program Coordinating Committee. 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: 2560-72.

2. Dahlöf B, Devereux RB, Kjeldsen SE, et al, for the LIFE Study Group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002; 359: 995-1003.

3. Dahlöf B, Sever PS, Poulter NR, et al, for the ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOTBPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895-906.

4. Messerli FH, Bangalore S, Julius S. Risk/benefit assessment of β-blockers and diuretics precludes their use as first-line therapy in hypertension. Circulation 2008; 117: 2706-15.

5. Carlberg B, Samuelsson O, Lindholm LH. Atenolol in hypertension: is it a wise choice? Lancet 2004; 364: 1684-9.

6. Sarafidis PA, Bakris GL. Metabolic effects of β-blockers: importance of dissociating newer from conventional agents. J Hypertens 2007; 25: 249-52.

7. Pedersen ME, Cockcroft JR. The vasodilatory beta-blockers. Curr Hypertens Rep 2007; 9: 269-77.

8. Weiss RJ, Weber MA, Carr AA, Sullivan WA. A randomized, doubleblind, placebo-controlled parallel-group study to assess the efficacy and safety of nebivolol, a novel beta-blocker, in patients with mild to moderate hypertension. J Clin Hypertens (Greenwich) 2007; 9: 667-76.

9. Saunders E, Smith WB, DeSalvo KB, Sullivan WA. The efficacy and tolerability of nebivolol in hypertensive African American patients. J Clin Hypertens (Greenwich) 2007; 9: 866-75.

10. Greathouse M. Nebivolol efficacy and safety in patients with stage I-II hypertension. Clin Cardiol 2010; 33: E20-7.

11. Carr AA, Weiss RJ. Significant blood pressure-lowering responses in nebivolol-treated patients assessed using stringent, clinically relevant criteria. J Clin Hypertens (Greenwich) 2008; 10(suppl A): A117-8.

12. Papademetriou V. Long-term efficacy of the highly cardioselective vasodilating β1-blocker nebivolol in patients without an initial response. J Clin Hypertens (Greenwich) 2008; 10(suppl A): A124-5.

13. Gradman AH. Safety and tolerability of nebivolol: a pooled safety analysis comparing typical β-blocker-associated adverse events with those of placebo. J Clin Hypertens (Greenwich) 2008; 10(suppl A): A120.

14. Sowers J, Whaley-Connell A. Long-term effects of the novel β-blocker, nebivolol, on blood glucose in hypertensive patients. South Med J 2008; 101: 863.

15. Giles T. Glucose control in hypertensive patients treated with the vasodilating, selective β-blocker, nebivolol. South Med J 2008; 101: 863.

16. Bakris GL, Fonseca V, Katholi RE, et al, for the GEMINI Investigators. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. JAMA 2004; 292: 2227-36.

17. Flather MD, Shibata MC, Coats AJS, et al, for the SENIORS Investigators. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005; 26: 215-25.

18. Packer M, Coats AJS, Fowler MB, et al, for the Carvedilol Prospective Randomized Cumulative Survival Study Group. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 2001; 344: 1651-8.

19. Rosamond W, Flegal K, Friday G, et al, for the American Heart Association Statistics Committee and Stroke Statistics Committee. Heart disease and stroke statistics-2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2007; 115: e69-171.

20. MRC Working Party. Medical Research Council trial of treatment of hypertension in older adults: principal results. BMJ 1992; 304: 405-12.

21. Messerli FH, Grossman E, Goldbourt U. Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 1998; 279: 1903-7.

22. Lindholm LH, Carlberg B, Samuelsson O. Should β-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 366: 1545-53.

23. Williams B, Lacy PS, Thom SM, et al, for the CAFE Investigators, the Anglo-Scandinavian Cardiac Outcomes Trial Investigators, and the CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213-25.

24. Wiysonge CS, Bradley H, Mayosi BM, et al. Beta-blockers for hypertension. Cochrane Database Syst Rev 2007; (1): CD002003.

25. Cutler JA, Davis BR. Thiazide-type diuretics and β-adrenergic blockers as first-line drug treatments for hypertension. Circulation 2008; 117: 2691-705.

26. Kamp O, Sieswerda GT, Visser CA. Comparison of effects on systolic and diastolic left ventricular function of nebivolol versus atenolol in patients with uncomplicated essential hypertension. Am J Cardiol 2003; 92: 344-8.

27. Bristow MR, Nelson P, Minobe W, Johnson C. Characterization of β1-adrenergic receptor selectivity of nebivolol and various other β-blockers in human myocardium. Am J Hypertens. 2005; 18 (suppl 4s): 51A-2.

28. Brixius K, Bundkirchen A, Bölck B, et al. Nebivolol, bucindolol, metoprolol and carvedilol are devoid of intrinsic sympathomimetic activity in human myocardium. Br J Pharmacol 2001; 133: 1330-8.

29. Mason RP, Kalinowski L, Jacob RF, et al. Nebivolol reduces nitroxidative stress and restores nitric oxide bioavailability in endothelium of black Americans. Circulation 2005; 112: 3795-801.

30. Ignarro LJ. Experimental activity of nitric oxide-dependent vasodilatory activity of nebivolol, a third generation β-blocker. Blood Press Suppl 2004; 1: 3-17.

31. Taylor AA, Bakris GL. The role of vasodilating β-blockers in patients with hypertension and the cardiometabolic syndrome. Am J Med 2010;123(suppl): S21-6.

32. Giles TD. The role of vasodilating β-blockers in patients with complicated hypertension: focus on nebivolol. Am J Med 2010; 123(suppl): S16-20.

33. Cushman WC, Ford CE, Cutler JA, et al, for the ALLHAT Collaborative Research Group. Success and predictors of blood pressure control in diverse North American settings: the Antihypertensive and Lipid-lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Clin Hypertens (Greenwich) 2002; 4: 393-404.

34. Neutel JM, Smith DH, Gradman AH. Adding nebivolol to ongoing antihypertensive therapy improves blood pressure and response rates in patients with uncontrolled stage I-II hypertension. J Hum Hypertens 2010; 24: 64-73.

35. Lacourcière Y, Lefebvre J, Poirier L, et al. A double-blind crossover comparison of nebivolol and lisinopril in the treatment of ambulatory hypertension. Am J Ther 1994; 1: 74-80.

36. Lacourcière Y, Poirier L, Lefebvre J, et al. Comparative effects of a new cardioselective beta-blocker nebivolol and nifedipine sustained-release on 24-hour ambulatory blood pressure and plasma lipoproteins. J Clin Pharmacol 1992; 32: 660-6.

37. Uhlir O, Fejfusa M, Havranek K, et al. Nebivolol vs metoprolol in the treatment of hypertension. Drug Invest. 1991;3(suppl 1): 107-10.

38. Brixius K, Middeke M, Lichtenthal A, et al. Nitric oxide, erectile dysfunction and beta-blocker treatment (MR NOED study): benefit of nebivolol versus metoprolol in hypertensive men. Clin Exp Pharmacol Physiol 2007; 34: 327-31.

39. Celik T, Iyisoy A, Kursaklioglu H, et al. Comparative effects of nebivolol and metoprolol on oxidative stress, insulin resistance, plasma adiponectin and soluble P-selectin levels in hypertensive patients. J Hypertens 2006; 24: 591-6.


Для цитирования:


Базиль Я.Н. Роль вазодилатирующих β-адреноблокаторов в контроле артериальной гипертензии и снижении риска сердечнососудистых и цереброваскулярных осложнений. Кардиоваскулярная терапия и профилактика. 2011;10(3):97-102.

For citation:


Basile J.N. The role of vasodilating β-blockers in controlling arterial hypertension as a means of reducing cardiovascular and stroke risk. Cardiovascular Therapy and Prevention. 2011;10(3):97-102. (In Russ.)

Просмотров: 33


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)