Консенсус экспертов Российского медицинского общества по артериальной гипертонии: применение фиксированных комбинаций в лечении больных артериальной гипертонией

Несмотря на большой арсенал антигипертензивных средств, контроль АД, как в Европе, так и в России по-прежнему остается на низком уровне, более 50% пациентов не достигают целевых уровней АД. Вместе с тем, данные результатов крупных РКИ демонстрируют, что достижение целевых значений АД возможно у большинства пациентов, резистентность к антигипертензивной терапии имеют не более 5-10% больных. Накоплено достаточно данных о том, что низкая приверженность к лечению остается фундаментальным фактором, способствующим недостаточному контролю АД. Получены доказательства того, что приверженность к лечению тесно коррелирует со сложным режимом дозирования препаратов и количеством принимаемых таблеток.

Доказано, что низкая приверженность связана с повышенным риском развития сердечно-сосудистых осложнений. Кроме того, фактические данные свидетельствуют о том, что медицинская инерция способствует неэффективности лечения у пациентов, остающихся на монотерапии или получающих неадекватную субоптимальную терапию. Использование комбинированной терапии, в том числе с применением фиксированных комбинаций у большинства пациентов может способствовать решению обеих этих проблем. Настоящий консенсус посвящен различным вопросам, связанным с назначением комбинированной терапии в виде фиксированных комбинаций и полипилл.

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