The place of a new fixed combination Valsacor® INDA (valsartan and indapamide) in the treatment of patients with various phenotypes of arterial hypertension (resolution of the Council of Experts)
I. E. Chazova,
O.. L. Barbarash,
O. A. Kislyak,
T. V. Martynyuk,
S. V. Nedogoda,
O. N. Tkacheva,
O. Iu. Trushina https://doi.org/10.38109/2075-082X-2025-3-43-47
Abstract
On May 23, 2025, an expert council was held to discuss the place of a fixed combination of valsartan and indapamide Valsacor® INDA in the treatment of patients with arterial hypertension in various clinical situations – in patients with diabetes mellitus and metabolic disorders, the elderly, the ones with high cardiovascular risk, target organ damage (left ventricular hypertrophy, chronic kidney disease, cognitive impairment).
About the Authors
I. E. Chazova
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Irina E. Chazova, Academician of RAS, Professor, Dr. of Sci. (Med.), Deputy General Director for Scientific and Expert Work, Head of Hypertension Department
St. Academician Chazova, 15 a, Moscow 121552
tel: +7(495) 415-52-05
O.. L. Barbarash
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Olga L. Barbarash, Academician of RAS, Professor, Dr. of Sci. (Med.), Director of the Federal State Budgetary Scientific Institution “Research Institute of KPSSZ” of the Ministry of Science and Higher Education of the Russian Federation
Academician L.S. Barbarash Boulevard, 6, Kemerovo 650002
O. A. Kislyak
Pirogov Russian Federation National Research Medical University
Russian Federation
Russian Federation
Oxana A. Kislyak, Dr. of Sci. (Med.), Professor, Professor of the Department of Faculty Therapy Institute of Clinical Medicine
1 Ostrovityanova street, Moscow 117997
T. V. Martynyuk
E.I. Chazov National Medical Research Center of Cardiology;
Pirogov Russian Federation National Research Medical University
Russian Federation
Russian Federation
Tamila V. Martynyuk, Dr. of Sci. (Med.), Professor, Head of the Department of Pulmonary Hypertension and Heart Diseases, Professor of the Department of Cardiology
St. Academician Chazova, 15 a, Moscow 121552
1 Ostrovityanova street, Moscow 117997
S. V. Nedogoda
Volgograd State Medical University
Russian Federation
Russian Federation
Sergey V. Nedogoda, Dr. of Sci. (Med.), Professor, Vice-Rector for Regional Healthcare Development and Clinical Work, Head of the Department of Internal Medicine
Fallen Fighters Square, 1, Volgograd 400066
O. N. Tkacheva
Pirogov Russian Federation National Research Medical University
Russian Federation
Russian Federation
Olga N. Tkacheva, Corresponding Member of RAS, Dr. of Sci. (Med.), Professor, Head of the Department of Aging-Related Diseases, Faculty of Continuing Professional Education, Director
1 Ostrovityanova street, Moscow 117997
O. Iu. Trushina
N.V. Sklifosovsky Institute of Clinical Medicine
Russian Federation
Russian Federation
Olga Iu. Trushina, Dr. of Sci. (Med.), Professor, Chair of Faculty Therapy №1
Bolshaya Pirogovskaya St., 6, building 1, Moscow 119435
References
1. Chazova I.E., Solntseva T.D., Sivakova O.A., Ageev F.T., Fofanova T.V., Bragina A.E., Trushina O.I. Russian Medical Society for Arterial Hypertension expert consensus. Arterial hypertension and adherence to antihypertensive therapy. Systemic Hypertension. 2024;21(2):7-17. (In Russ.) https://doi.org/10.38109/2075-082X-2024-2-5-15
2. Chazova I.E., Chikhladze N.M., Blinova N.V., Aksenova A.V., Alekseeva T.A., Ambatiello L.G., Balanova Yu.A., Bragina A.E., Danilov N.M., Drapkina O.M., Drozdova L.Yu., Ezhov M.V., Elfimova E.M., Zhernakova Yu.V., Zhirov I.V., Kislyak O.A., Litvin A.Yu., Nebieridze D.V., Ostroumova O.D., Podzolkov V.I., Sergienko I.V., Sivakova O.A., Starodubova A.V., Stryuk R.I., Tereshchenko S.N., Trushina O.Yu., Shchelkova G.V. Clinical guidelines of the Russian Medical Society on arterial Hypertension (RSH) and the Eurasian association of Cardiologists (EaC) for the diagnosis and treatment of arterial hypertension (2024). Systemic Hypertension. 2024;21(4):5-110. (In Russ.) https://doi.org/10.38109/2075-082X-2024-4-5-109
3. Oganov R.G., Simanenkov V.I., Bakulin I.G., Bakulina N.V., Barbarash O.L., Boytsov S.A., Boldueva S.A., Garganeeva N.P., Doshchitsin V.L., Karateev A.E., Kotovskaya Yu.V., Lila A.M., Lukyanov M.M., Morozova T.E., Pereverzev A.P., Petrova M.M., Pozdnyakov Yu.M., Syrov A.V., Tarasov A.V., Tkacheva O.N., Shalnova S.A. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Cardiovascular Therapy and Prevention. 2019;18(1):5-66. (In Russ.) https://doi.org/10.15829/1728-8800-2019-1-5-66
4. Zhou B., Carrillo-Larco R.M., Danaei G., Riley L.M., Paciorek C.J., Stevens G.A., Gregg E.W., Bennett J.E., Solomon B., Singleton R.K., Sophiea M.K. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. The lancet. 2021 Sep 11;398(10304):957-80. https://doi.org/10.1016/s0140-6736(21)01330-1
5. Kisliak O.A., Zhernakova J.V., Aksenova A.V., Chazova I.E. Russian medical society expert consensus on arterial hypertension: use of fixed combinations in the treatment of patients with arterial hypertension. Systemic Hypertension. 2024;21(1):5-13. (In Russ.) https://doi.org/10.38109/2075-082X-2024-1-5-13
6. Götzinger F, Kieble M, Daudí AE, Kunz M, Lauder L, Böhm M, Laufs U, Mahfoud F, Schulz M. Use of fixeddose combinations for cardiovascular indications from 2018 to 2023: a nationwide population-based study. Journal of Hypertension. 2024 Oct 1;42(10):1720-1727. https://doi.org/10.1097/hjh.0000000000003789
7. Jamerson K. A., Bakris G. L., Wun C. C., Dahlöf B., Lefkowitz M., Manfreda S., et al. Rationale and design of the Avoiding Cardiovascular events through COMbination therapy in Patients LIving with Systolic Hypertension (ACCOMPLISH) Trial. Am J Hypertens 2004; 17: 793–801. https://doi.org/10.1016/j.amjhyper.2004.05.004
8. Julius S, Weber MA, Kjeldsen SE, McInnes GT, Zanchetti A, Brunner HR, Laragh J, Schork MA, Hua TA, Amerena J, Balazovjech I. The valsartan antihypertensive long-term use evaluation (VALUE) trial: outcomes in patients receiving monotherapy. Hypertension. 2006 Sep 1;48(3):385-391. https://doi.org/10.1161/01.hyp.0000236119.96301.f2
9. Maggioni AP, Latini R, Carson PE, Singh SN, Barlera S, Glazer R, Masson S, Cerè E, Tognoni G, Cohn JN, Val-HeFT Investigators. Valsartan reduces the incidence of atrial fibrillation in patients with heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT). American heart journal. 2005 Mar 1;149(3):548-57. https://doi.org/10.1016/j.ahj.2004.09.033
10. Viberti G, Wheeldon NM. Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus: a blood pressure–independent effect. Circulation. 2002 Aug 6;106(6):672-8. https://doi.org/10.1161/01.cir.0000024416.33113.0a
11. Black HR, Bailey J, Zappe D, Samuel R. Valsartan: more than a decade of experience. Drugs. 2009 Dec;69(17):2393-414. https://doi.org/10.2165/11319460-000000000-00000
12. Califf RM, Boolell M, Haffner SM, et al. Prevention of diabetes and cardiovascular disease in patients with impaired glucose tolerance: rationale and design of the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Am Heart J 2008 Oct; 156: 623–632. https://doi.org/10.1016/j.ahj.2008.05.017
13. Ridker PM, Danielson E, Rifai N, Glynn RJ. Valsartan, blood pressure reduction, and C-reactive protein: primary report of the Val-MARC trial. Hypertension. 2006 Jul 1;48(1):73-79. https://doi.org/10.1161/01.hyp.0000226046.58883.32
14. Chazova I.E., Martynyuk T.V., Accetto R., Sirenko Yu., Vincelj J., J.widimsky J., Barbič-Žagar B., Arhipov M.V., Grinshtein Yu.I., Ostroumova O.D., Galjavich A.S., Rotar' O.P., Haisheva L.A., Nedogoda S.V. The results of the international clinical study VICTORY: efficacy and safety of antihypertensive monotherapy with valsartan (Valsacor®) and its fixed combination with hydrochlorothiazide (Valsacor® H) in routine clinical practice in patients with grade 1 and grade 2 hypertension. Systemic Hypertension. 2017;14(2):80-89. (In Russ.)
15. Chazova I.E., Martynyuk T.V., Rodnenkov V.O., Gorieva B.Sh., Rogoza A.N., Arkhipov M.V., Grinshtein Yu.I., Ostroumova O.D., Galiavich A.S., Rotar’ O.P., Haisheva L.A., Kameneva T.R. First results of Russian multicenter prospective clinical study VICTORY II: Vamloset® and Co-Vamloset effectiveness and safety in patients with stage 2 and 3 arterial hypertension. Systemic Hypertension. 2020;17(2):36-47. (In Russ.) https://doi.org/10.26442/2075082X.2020.2.200123
16. Chazova E..., Martyniuk T.V. The first results of an international clinical trial VICTORY:the efficacy and safety of antihypertensive valsartan monotherapy and the fixed combination of valsartan and hydrochlorothiazide usingdifferent dosage regimens in patients with 1-2 degree arterial hypertension. Systemic Hypertension. 2015;12(2):71-82. (In Russ.)
17. Düsing RJ. Effect of the angiotensin II antagonist valsartan on sexual function in hypertensive men. Blood Pressure. 2003 Jan 1;12(sup2):29-34. https://doi.org/10.1080/08038020310021967
18. De Wildt DJ, Hillen FC. A comparative study on possible calcium antagonistic properties of indapamide and other drugs potentially interfering with calcium transport in isolated vascular smooth muscle. European journal of pharmacology. 1984 Jul 20;102(3-4):401-10. https://doi.org/10.1016/0014-2999(84)90559-4
19. Zempel G, Ditlevsen J, Hoch M, Emerich U, Heinle H, Schiavi P, Dubois F, Lang F. Effects of indapamide on Ca2+ entry into vascular smooth muscle cells. Nephron. 1997 Dec 23;76(4):460-5. https://doi.org/10.1159/000190229
20. Chaffman M, Heel RC, Brogden RN, Speight TM, Avery GS. Indapamide: a review of its pharmacodynamic properties and therapeutic efficacy in hypertension. Drugs. 1984 Sep;28(3):189-235. https://doi.org/10.2165/00003495-198428030-00001
21. Nishioku T, Takata F, Yamauchi A, Sumi N, Yamamoto I, Fujino A, Naito M, Tsuruo T, Shuto H, Kataoka Y. Protective action of indapamide, a thiazide-like diuretic, on ischemia-induced injury and barrier dysfunction in mouse brain microvascular endothelial cells. Journal of pharmacological sciences. 2007 Jan 1;103(3):323-7. https://doi.org/10.1254/jphs.sc0060222
22. National Clinical Guideline Centre (UK). Hypertension: The Clinical Management of Primary Hypertension in Adults: Update of Clinical Guidelines 18 and 34 [Internet. London: Royal College of Physicians (UK); 2011 Aug. PMID: 22855971.
23. Leung AA, Daskalopoulou SS, Dasgupta K, McBrien K, Butalia S, Zarnke KB, et al. Hypertension Canada. Hypertension Canada's 2017 Guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults. Can J Cardiol 2017;33:557-576. https://doi.org/10.1016/j.cjca.2017.03.005
24. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/ AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018;71:1269-1324. https://doi.org/10.1161/hyp.0000000000000065
25. Burnier, Michel; Bakris, George; Williams, Bryan. Redefining diuretics use in hypertension: why select a thiazide-like diuretic? Journal of Hypertension. 2019 Aug;37(8):1574-1586. https://doi.org/10.1097/hjh.0000000000002088
26. Task Force of the Latin American Society of Hypertension. Guidelines on the management of arterial hypertension and related comorbidities in Latin America. J Hypertens 2017;35:1529-1545. https://doi.org/10.1097/hjh.0000000000001418
27. Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008;358:1887-1898. https://doi.org/10.1056/nejmoa0801369
28. Beckett N, Peters R, Tuomilehto J, Swift C, Sever P, Potter J, et al. Immediate and late benefits of treating very elderly people with hypertension: results from active treatment extension to Hypertension in the Very Elderly randomised controlled trial. BMJ 2012;344:d7541. https://doi.org/10.1136/bmj.d7541
29. Zhou MS, Schulman IH, Jaimes EA, Raij L. Thiazide diuretics, endothelial function, and vascular oxidative stress. J Hypertens 2008;26:494-500. https://doi.org/10.1097/hjh.0b013e3282f3e39d
30. Vergely C, Walker MK, Zeller M, Rademakers JR, Maupoil V, Schiavi P, et al. Antioxidant properties of indapamide, 5-OH indapamide and hydrochlorothiazide evaluated by oxygen-radical absorbing capacity and electron paramagnetic resonance. Mol Cell Biochem 1998;178:151-155. https://doi.org/10.1023/a:1006845612499
31. Ma F, Lin F, Chen C, Cheng J, Zeldin DC, Wang Y, Wang DW. Indapamide lowers blood pressure by increasing production of epoxyeicosatrienoic acids in the kidney. Mol Pharmacol 2013;84:286-295. https://doi.org/10.1124/mol.113.085878
32. Thuillez C, Richard V. Targeting endothelial dysfunction in hypertensive subjects. J Hum Hypertens 2005;19 (Suppl 1):S21-S25. https://doi.org/10.1038/sj.jhh.1001889
33. Gosse P, Sheridan DJ, Zannad F, Dubourg O, Guéret P, Karpov Y, de Leeuw PW, Palma-Gamiz JL, Pessina A, Motz W, Degaute JP. Regression of left ventricular hypertrophy in hypertensive patients treated with indapamide SR 1.5 mg versus enalapril 20 mg: the LIVE study. Journal of hypertension. 2000 Oct 1;18(10):1465-75. https://doi.org/10.1097/00004872-200018100-00015
34. Mychka V.B., Chazova I.E. Rossiyskaya dokazatel'naya meditsina – programma MINOTAVR: preimushchestva retardnoy formy indapamida pri lechenii metabolicheskogo sindroma. Consilium Medicum 2006;8(5):46-50. (In Russ.)
35. Yan VK, Ju C, MacDonald TM, Mackenzie IS, Flynn R, Williams B, Chen Y, Chan EW, George J, Wei L. Comparative effectiveness and prescribing trends of modified release versus immediate release indapamide in patients with hypertension: cohort study. BMJ medicine. 2025 Feb 25;4(1):e000857. https://doi.org/10.1136/bmjmed-2024-000857
36. Chazova I.E., Kislyak O.A., Podzolkov V.I., Bragina A.E., Sivakova O.A., Solntseva T.D., Elfimova E.M., Valieva Z.S., Fomin V.V., Mironova O.I. Arterial hypertension and chronic kidney disease: consensus statement on patient management. Systemic Hypertension. 2023;20(1):5-19. (In Russ.) https://doi.org/10.38109/2075-082X-2023-1-5-19
Review
For citations:
Chazova I.E., Barbarash O.L., Kislyak O.A., Martynyuk T.V., Nedogoda S.V., Tkacheva O.N., Trushina O.I. The place of a new fixed combination Valsacor® INDA (valsartan and indapamide) in the treatment of patients with various phenotypes of arterial hypertension (resolution of the Council of Experts). Systemic Hypertension. 2025;22(3):43-47. (In Russ.) https://doi.org/10.38109/2075-082X-2025-3-43-47
Views:
45
Email this article 