ВВЕДЕНИЕ О микоплазменной инфекции за прошедшие деся-тилетия написано несколько монографий и множе-ство статей. На протяжении многих лет и в России, и за рубежом интерес к этой проблеме не ослабева-ет. Это прежде всего связано с тем, что существуют периоды подъема (эпидемии) заболеваемости мико-плазменной инфекцией (один раз в 5-8 лет), которые влекут за собой увеличение числа больных с пневмо-нией, бронхитами, острыми респираторными забо-леваниями.Однако, несмотря на определенные успехи, достигну-тые в диагностике этого заболевания, открытии важных патогенетических звеньев, получении данных о фор-мировании аутоиммунных заболеваний, до сих пор существуют недостаточно изученные вопросы о продол-жительности курса лечения, в особенности серопозитив-ных лиц, и т. д.
Аim. To study the efficacy, tolerability and safety of using a fixed dose combination of an ACE inhibitor lisinopril with a prolonged-action diuretic indapamide in patients with degree 1-2 hypertension.Material and methods. Patients (n = 32) with uncontrolled 1-2 degrees hypertension, moderate or high cardiovascular risk, without severe comorbid diseases, who were prescribed a fixed dose combination of lisinopril (5, 10 or 20 mg) and indapamide (1.5 mg) were included in the observational study. All patients had home monitoring of blood pressure and diuresis, as well as assessment of subjective tolerance of treatment and registration of adverse events within 3 months of observation. Assessment of changes in circadian fluctuations in blood pressure and diuresis, the frequency of achieving the target blood pressure at the outpatient stage, as well as the subjective tolerance of treatment and adverse events during a three-month follow-up.Results. Target blood pressure was achieved in 44.5% of patients taking the fixed dose combination of lisinopril 5 mg + prolonged-acting indapamide1.5 mg; 76.9% – in patients taking the combination of lisinopril 10 mg + indapamide 1.5 mg; 78,6% – in patients taking the combination of lisinopril 20 mg + indapamide 1.5 mg. The achieved antihypertensive effect was characterized by daily circadian stability, accompanied by an improvement in the initially impaired day and night diuretic profile (increase in the share of daytime diuresis by 29.6% and 22.3% with a decrease in the share of nighttime diuresis by 35% and 49% when using a combination with lisinopril 5 and 10 mg, respectively). The treatment was well tolerated by patients and did not cause the development of serious adverse events. Reported adverse events (non-intense dry cough, headache, general weakness) were transient and did not require correction or withdrawal of treatment.Conclusion. The fixed dose combination of the ACE inhibitor lisinopril (5, 10 or 20 mg) and the long-acting thiazide-like diuretic indapamide (1.5 mg) had good antihypertensive efficacy with improved circadian blood pressure and diuresis profiles, acceptable tolerance and safety of treatment, as well as a simple choice of doses of the drug components.
The novel coronavirus infection (COVID-19) caused by the b-coronavirus SARS-CoV-2, and leads to acute respiratory distress-syndrome, has affected more than nineteen million people worldwide, resulting in 0.7 million deaths as of August 2020. The fact that the virus uses angiotensin-converting enzyme 2 as a receptor for entering the target cell, and the high prevalence of hypertension and other cardiovascular diseases among patients with COVID-19, have caused serious discussions on the management of such patients. This consensus of experts from the Russian Medical Society for Arterial Hypertension analyzed the existing data on the relationship between COVID-19 and hypertension, the pathophysiological aspects of the penetration of the virus into target cells and the use of renin-angiotensin-aldosterone system inhibitors in patients with hypertension and COVID-19.
Aim. To study the prevalence of comorbidity affecting the choice of antihypertensive treatment, as well as the efficacy and safety of the application of a single pill combination of lysinopril, amlodipine and rosuvastatin (SPC LAR) in hypertensive patients.Material and methods. Observational epidemiological study with the participation of 626 doctors and 13037 hypertensive patients with high cardiovascular risk and dyslipidemia treated with SPC LAR were held in 24 cities of Russia from November 2020 to March 2021. Prevalence and types of comorbidity, changes of blood pressure (BP), of total cholesterol (TC) and blood glucose levels and adverse events were studied during observation. Patients had 3 visits – initially, after 4 and 12 weeks. The obtained data was recorded by doctors through a web portal.Results. Concominant cardiovascular diseases found in all patients (in 38.7% of cases – from 2 to 5 diseases). The most commonly diseases were coronary artery disease (43.1%), metabolic syndrome (36.6%), diabetes (25.2%), chronic heart failure (24.9%), cerebrovascular diseases (12.3%) and chronic obstructive pulmonary disease (0.5%). SPC LAR with minimal doses of components (in 41.1% of patients) or with reinforced antihypertensive or hypocholesterolemic effects, based on the experience of treatment, the patient was prescribed as starting treatment with doctors. Reducing the level of systolic and diastolic BP, as well as the level Tc, respectively, by 20.9%, 16.9% and 29.7% found during the study. Target levels of systolic BP were achieved in 97.6% of patients, diastolic BP – in 99.6%, and target levels TC ≤5 mmol/l, ≤4 mmol/l and ≤3 mmol/l were achieved, respectively, in 94.5%, 68.6% and 23.5% patients. No significant dynamics of the level of glycemia were not found. The treatment was well tolerated by patients. Side effects found in 0.53% of patients (more often there was a dry cough, feet edema and headache). Commitment to treatment was 92.7%.Conclusion. The modern hypertension phenotype has cardiovascular atherosclerosis-associated diseases, which justifies the need to combine antihypertensive and hypolipidemic therapy. Triple SPC LAR, which effectively controlled the blood pressure and improved the violation of lipid metabolism was prescribed to patients in this observational study. The low frequency of side effects and good tolerance of treatment was accompanied by a high adherence of patients to treatment.
The paper presents the indications and main differences of frequently used rectal suppositories containing interferon alpha-2b.The features and differences in the contained excipients are highlighted. A range of diseases in children's practice is presented, in which candles are shown VIFERON®, Kipferon®, Genferon light®
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