Öz
Abstract
Hypertension is a worldwide common cardiovascular risk factor associated with highmortality and morbidity unless it is treated well. According to current hypertension studies and guidelines, the benefit of antihypertensive medication is not associated with thetype of medication and is dependent on the decreasing of blood pressure itself. Therefore, all available guidelines agree with that the initial drug selection is any of the 4 groups of drugs listed below, or a combination of the two of them. These are angiotensin converting enzyme inhibitors or angiotensin receptor blockers, calcium channel blockers, diuretics, beta blockers. Guidelines recommend combination therapy in patients withstage 2 and 3 hypertension and in individuals with high cardiovascular risk. In combination therapy; fixed-dose combinations should be preferred instead of free-dose combinations in terms of patient compliance and cost effectiveness.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1.Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M,Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M,Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Ma-nolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sle-ight P, Viigimaa M, Waeber B, Zannad F. 2013 ESH/ESC Guideli-nes for the management of arterial hypertension— The Task Forcefor the management of arterial hypertension of the European Soci-ety of Hypertension (ESH) and of the European Society of Cardio-logy (ESC). 2.Weber MA, Schiff rin EL, White WB, et al. Clinical practice guide-lines for the management of hypertension in the community. A sta-tement by the American Society of Hypertension and the Internatio-nal Society of Hypertension. J Hypertens 2014; 32: 3–15 3.National Institute for Health and Clinical Excellence. Hypertensi-on: clinical management of primary hypertension in adults (upda-te). (Clinical guideline 127). 2011. Accessed Aug 2011 4.James PA, Oparil S, Carter BL, et al. 2014 evidence-based guide-line for the management of high blood pressure in adults: report fromthe panel members appointed to the Eighth Joint National Commit-tee (JNC 8). JAMA 2014; 311: 507–20. 5.Corrao G, Nicotra F, Parodi A, Zambon A, Heiman F, Merlino L,Fortino I, Cesana G, Mancia G. Cardiovascular protection by ini-tial and subsequent combination of antihypertensive drugs in dailylife practice. Hypertension. 2011;58(4):566–72 6.Gradman AH, Parise´ H, Lefebvre P, et al. Initial combination the-rapy reduces the risk of cardiovascular events in hypertensive pa-tients: a matched cohort study. Hypertension. 2013;61:309–18. 7.Taddei S. Combination Therapy in Hypertension: What Are the BestOptions According to Clinical Pharmacology Principles and Con-trolled Clinical Trial Evidence? Am J Cardiovasc Drugs. 2015Jun;15(3):185-94 8.Kaplan NM, Flynn JT. Kaplan’s clinical hypertension. 9th ed. Phi-ladelphia: Lippincot Williams & Wilkins; 2006. p. 1–518. 9.Paz MA1, de-La-Sierra A, Sáez M, Barceló MA, Rodríguez JJ, Cas-tro S, Lagarón C, Garrido JM, Vera P, Coll-de-Tuero G. Treatmentefficacy of anti-hypertensive drugs in monotherapy or combinationATOM systematic review and meta-analysis of randomized clinicaltrials according to PRISMA statement. Medicine (Baltimore). 2016Jul;95(30) 10.Dahlo¨f B, Sever PS, Poulter NR, ASCOT Investigators, et al. Pre-vention of cardiovascular events with an antihypertensive regimenof amlodipine adding perindopril as required versus atenolol addingbendroflumethiazide as required, in the Anglo- Scandinavian Car-diac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet.2005;366:895–906. 11.Jamerson K, Weber MA, Bakris GL, Dahlo B, Pitt B, Shi V, HesterA, Gupte J, Gatlin M, Velazquez EJ, ACCOMPLISH Trial Investi-gators. Benazepril plus amlodipine or hydrochlorothiazide forhypertension in high-risk patients. N Engl J Med. 2008;359:2417–28. 12.Bertrand ME, Ferrari R, Remme WJ, Simoons ML, Deckers JW, FoxKM, EUROPA Investigators. Clinical synergy of perindopril and cal-cium-channel blocker in the prevention of cardiac events and mor-tality in patients with coronary artery disease. Post hoc analysis ofthe EUROPA study. Am Heart J. 2010;159:795–802.
Öz
Öz
Hipertansiyon tüm dünyada ve ülkemizde oldukça yaygın görülen ve tedavi edilmediği takdirde yüksek mortalite ve morbidite ile ilişkili bir kardiyovasküler risk faktörüdür. Güncel hipertansiyon çalışmaları ve kılavuzlarına göre antihipertansif ilaç tedavisinin faydası kullanılan ilacın cinsinden bağımsız olup büyük ölçüde düşen kan basıncının kendisine aittir. Bu yüzden mevcut tüm kılavuzlar başlangıç ilaç seçimi konusun-da hemfikir olup aşağıda verilen 4 grup ilaçtan herhangi birinin veya bunların ikili kombinasyonunun seçilebileceğini önermektedir. Bu ilaçlar anjiotensin dönüştürücü enzimin hibitörleri veya anjiotensin reseptör blokerleri, kalsiyum kanal blokerleri, diüretikler ve beta blokerlerdir. İlaç seçiminde özel hasta gruplarında zorlayıcı endikasyonlar ve kontrendikasyonlara dikkat edilmelidir. Kılavuzlar evre 2 ve 3 hipertansiyonda ve yüksek kardiyovasküler riske sahip bireylerde kombinasyon tedavisi önermektedir. Kombinasyontedavisinde sabit doz kombinasyonlar hasta uyumu, tedavi başarısı ve maliyet açısından serbest doz kombinasyonlara tercih edilmelidir.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1.Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M,Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M,Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Ma-nolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sle-ight P, Viigimaa M, Waeber B, Zannad F. 2013 ESH/ESC Guideli-nes for the management of arterial hypertension— The Task Forcefor the management of arterial hypertension of the European Soci-ety of Hypertension (ESH) and of the European Society of Cardio-logy (ESC). 2.Weber MA, Schiff rin EL, White WB, et al. Clinical practice guide-lines for the management of hypertension in the community. A sta-tement by the American Society of Hypertension and the Internatio-nal Society of Hypertension. J Hypertens 2014; 32: 3–15 3.National Institute for Health and Clinical Excellence. Hypertensi-on: clinical management of primary hypertension in adults (upda-te). (Clinical guideline 127). 2011. Accessed Aug 2011 4.James PA, Oparil S, Carter BL, et al. 2014 evidence-based guide-line for the management of high blood pressure in adults: report fromthe panel members appointed to the Eighth Joint National Commit-tee (JNC 8). JAMA 2014; 311: 507–20. 5.Corrao G, Nicotra F, Parodi A, Zambon A, Heiman F, Merlino L,Fortino I, Cesana G, Mancia G. Cardiovascular protection by ini-tial and subsequent combination of antihypertensive drugs in dailylife practice. Hypertension. 2011;58(4):566–72 6.Gradman AH, Parise´ H, Lefebvre P, et al. Initial combination the-rapy reduces the risk of cardiovascular events in hypertensive pa-tients: a matched cohort study. Hypertension. 2013;61:309–18. 7.Taddei S. Combination Therapy in Hypertension: What Are the BestOptions According to Clinical Pharmacology Principles and Con-trolled Clinical Trial Evidence? Am J Cardiovasc Drugs. 2015Jun;15(3):185-94 8.Kaplan NM, Flynn JT. Kaplan’s clinical hypertension. 9th ed. Phi-ladelphia: Lippincot Williams & Wilkins; 2006. p. 1–518. 9.Paz MA1, de-La-Sierra A, Sáez M, Barceló MA, Rodríguez JJ, Cas-tro S, Lagarón C, Garrido JM, Vera P, Coll-de-Tuero G. Treatmentefficacy of anti-hypertensive drugs in monotherapy or combinationATOM systematic review and meta-analysis of randomized clinicaltrials according to PRISMA statement. Medicine (Baltimore). 2016Jul;95(30) 10.Dahlo¨f B, Sever PS, Poulter NR, ASCOT Investigators, et al. Pre-vention of cardiovascular events with an antihypertensive regimenof amlodipine adding perindopril as required versus atenolol addingbendroflumethiazide as required, in the Anglo- Scandinavian Car-diac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet.2005;366:895–906. 11.Jamerson K, Weber MA, Bakris GL, Dahlo B, Pitt B, Shi V, HesterA, Gupte J, Gatlin M, Velazquez EJ, ACCOMPLISH Trial Investi-gators. Benazepril plus amlodipine or hydrochlorothiazide forhypertension in high-risk patients. N Engl J Med. 2008;359:2417–28. 12.Bertrand ME, Ferrari R, Remme WJ, Simoons ML, Deckers JW, FoxKM, EUROPA Investigators. Clinical synergy of perindopril and cal-cium-channel blocker in the prevention of cardiac events and mor-tality in patients with coronary artery disease. Post hoc analysis ofthe EUROPA study. Am Heart J. 2010;159:795–802.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Makaleler 1 |
| Yazarlar | |
| Yayımlanma Tarihi | 4 Mayıs 2017 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 5 Sayı: 5 |
