systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.26442/2075082X.2019.4.190733systhiper-596Research ArticleКАРДИОЛОГИЯCARDIOLOGYРоль фиксированных комбинаций в современной терапии артериальной гипертензии: новое или хорошо забытое старое?Role of fixed combinations in modern treatment of arterial hypertension: new or well overlooked old?https://orcid.org/0000-0002-3763-8994АдашеваТ. В.AdashevaT. V.adashtv@mail.ruhttps://orcid.org/0000-0002-8912-1348СаморуковаЕ. И.SamorukovaE. I.noemail@neicon.ruЗадионченкоВ. С.ZadionchenkoV. S.z7vladimir@bk.ruЛаричеваК. А.LarichevaK. A.pochtakyti@mail.ruФГБОУ ВО «МГМСУ им. А.И. Евдокимова»РоссияYevdokimov Moscow State University of Medicine and DentistryRussian Federation2019231220221643337Copyright © Адашева Т.В., Саморукова Е.И., Задионченко В.С., Ларичева К.А., 20222022Адашева Т.В., Саморукова Е.И., Задионченко В.С., Ларичева К.А.Adasheva T.V., Samorukova E.I., Zadionchenko V.S., Laricheva K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/596

В статье обсуждаются изменения в терапевтической тактике и алгоритмы терапии артериальной гипертензии (АГ), принятые в последних рекомендациях Европейского общества по артериальной гипертензии и Европейского общества кардиологов (ESH/ESC 2018). Анализируются причины неэффективности терапевтических стратегий: терапевтическая инерция, недостаточное использование комбинированной терапии, проблемы приверженности пациентов терапии, «сложность» применяемых терапевтических стратегий. Описаны этапы истории комбинированной терапии АГ и ренессанс терапии фиксированными комбинациями в 1990-е годы. Особое внимание уделяется трехкомпонентным фиксированным комбинациям лечения АГ. Обосновывается терапевтическая стратегия быстрого перехода к тройной антигипертензивной терапии при неэффективности двухкомпонентных схем. Приводятся последние экспертные консенсусы, метаанализы, исследования, обосновывающие основные положения повышения контроля АГ в популяции. Анализируются механизмы повышения приверженности терапии АГ. Отдельно анализируются результаты недавнего исследования по эффективности, безопасности и приверженности терапии при применении фиксированной комбинации амлодипин/индапамид/периндоприл.

The article discusses therapeutic tactics changes and arterial hypertension (AH) treatment algorithms stated in latest European Society of Hypertension and European Society of Cardiology guidelines (ESH/ESC 2018). Causes of therapeutic strategies ineffectiveness are analyzed: therapeutical persistency, insufficient use of combined therapy, treatment adherence problems, and “complexity” of therapeutic strategies used. Stages of combined AH therapy history and treatment with fixed combinations renaissance in the 1990s are described. Special attention is given to triple-component fixed combination for AH treatment. Therapeutic strategy of rapid change to triple-component antihypertensive therapy in case of double-component schemes non-effectiveness is explained. The latest expert consensus, mataanalyses, and studies explaining fundamental principles of AH control increase in population are presented. Mechanisms of AH treatment adherence increase are analyzed. Results of the latest study of amlodipine/indapamide/perindopril fixed combination use effectiveness, safety, and treatment adherence are analyzed independently.

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