Preview

Systemic Hypertension

Advanced search

Priorities for choosing diuretics in the treatment of hypertensive disease: Evidence-based medicine, recommendation documents, and real clinical practice

Abstract

Reorganization of the drug supply is one of the most important parts of the Russian health care reform. Pharmacoepidemiology is one of the sections of clinical pharmacology, the study of the results of the application and effects of drugs in large groups. The aim of the study was the analysis of pharmacoepidemiological and validity purpose diuretic therapy in patients with hypertension and chronic heart failure in clinical practice. A comparative analysis of retrospective pharmacoepidemiological diuretic in the hospital according to the sources of primary medical records for 2010-2012. - Continuous sampling histories hospital regional center and district hospitals in Krasnodar Krai (435 patients). The results of our study showed an active and relevant guidance documents use of diuretics doctors practical medicine. There have been no use of diuretics is the testimony and in the presence of contraindications, revealed no excess doses and irrational combinations. Can be considered a positive increase in the activity of torasemide destination due to the impact of the drug on the prognosis of the disease, which can be realized through antialdosterone effect and influence on depozitsiyu collagen. Analysis of contemporary domestic and foreign recommendations GB and CHF, as well as evidence-based data suggests that the use of diuretics is a stable long-term trends in the pharmacotherapy of cardiac disease, so you need to continue to assess the quality of the clinical use of pharmacological agents, to raise awareness doctors about clinical situations with the need to connect with spironolactone and acetazolamide, as well as a new indication and especially the appointment of torasemide in patients with chronic heart failure, hypertension, as reflected in clinical guidelines and "standards of primary health care workers in essential hypertension (hypertension) "Health Ministry.

About the Authors

O. G. Kompaniets
Кубанский государственный медицинский университет
Russian Federation


E. E. Averin
ГБОУ ВПО Российский национальный исследовательский университет им. Н.И.Пирогова Минздрава РФ
Russian Federation


References

1. Фармакоэкономика и фармакоэпидемиология – практика приемлемых решений. Под ред. В.Б.Герасимова, А.Л.Хохлова, О.И.Карпова. М.: Медицина, 2005.

2. International Society for Pharmacoepidemiology (Международное сообщество по фармакоэпидемиологии). http://www.pharmacoepi.org/index.cfm

3. Coca A. Effect of torasemide in monotherapy or associated to other antihypertensive drugs on pulse pressure in essential hypertension. Amer J Hypertens 2002; 15 (113–114а): 231.

4. Reyes A.J., Chiesa P.D., Santucci M.R. et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmacotherapy in eldery patient: randomized and double - blind study. In: Progress in pharmacology and clinical pharmacology. Gustav-Fischer-Verfag. Stuttgart 1990; 8: 183–209.

5. Veeraveedu P.T., Watanabe K, Ma M. et al. Comparative effects of torasemide and furosemide in rats with heart failure. Biochem Pharmacol 2007; 23: 143–8.

6. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertention. Drug Res 1988; 38 (1): 190–3.

7. Преображенский Д.В., Некрасова Н.И., Хосева Е.Н. и др. Торасемид – эффективный петлевой диуретик для длительной терапии артериальной гипертензии. Кардиология. 2011; 51 (4): 67–73.

8. Аверин Е.Е. Влияние торасемида на гипертрофию миокарда левого желудочка. Журн. сердечная недостаточность. 2012; 13 (3): 158–63.

9. Kasama S. Effects of torasemide on cardiac sympathetic nerve activity and left ventricular remodelling in patients with congestive heart failure. Heart 2006; 92: 1434–40.

10. Государственный реестр лекарственных средств. http://grls.rosminzdrav.ru

11. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Europ Heart J 2012; 33: 1787–847.

12. Российское кардиологическое общество. http://www.scardio.ru

13. Гендлин Г.Е., Борисов С.Н., Мелехов А.В. Ингибиторы АПФ и сартаны – современные методы влияния на ренин - ангиотензин - альдостероновую систему. Сердце: журнал для практикующих врачей. 2012; 11 (4): 230–4.

14. Оганов Р.Г. Национальные рекомендации. Под ред. Р.Г.Оганова. 3-е изд. М.: Силицея-Полиграф, 2010.

15. Yamato M, Sasaki T, Honda K et al. Effects of torasemide in left ventricular function and neurohumoral factors in patients with chronic heart failure. Circ J 2003; 67 (5): 384–90.

16. Mуller K, Gamba G, Jaquet F, Hess B. Torasemide vs furosemide in primary care patients with chronic heart failure NYHA II to IV – efficacy and quality of life. Eur J Heart Fail 2003; 5 (6): 793–801.

17. Fortuno А. The loop diuretic torasemide interferes with endothelin 1 actions in the aorta of hypertensive rats. Nephrol Dial Transplant 2001; 16 (Suppl. 1): 18–21.

18. Bolke T, Achhammer I. Torasemid: review of its pharmacology and therapeutic use. Drugs Today 1994; 8: 1–28.

19. Pitt B, Zannad F, Remme W.J. et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999; 341: 709–17.

20. Сайт Министерства здравоохранения РФ. http://www.rosminzdrav.ru

21. Cosín J, Díez J. TORIC investigators. Torasemide in chronic heart failure: results of the TORIC study. Eur J Heart Fail 2002; 4 (4): 507–13.


Review

For citations:


Kompaniets O.G., Averin E.E. Priorities for choosing diuretics in the treatment of hypertensive disease: Evidence-based medicine, recommendation documents, and real clinical practice. Systemic Hypertension. 2013;10(1):62-65.

Views: 110


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2075-082X (Print)
ISSN 2542-2189 (Online)