Цель. Определить гиполипидемическую и плейотропную эффективность дже-нерического розувастатина (Розукарда) в сравнении с аторвастатином у боль-ных артериальной гипертонией (АГ) с высоким и очень высоким сердечно-сосудистым риском (ССР) при длительном применении в условиях амбулатор-ного наблюдения. Материал и методы. Исследование выполнено на 114 больных (58,2±3,11 лет) АГ II-III степени с высоким или очень высоким ССР по SCORE, получающих гипотензивную терапию метопрололом, индапамидом, эналаприлом в эффек-тивных дозах, у которых предшествующий прием в течение 1 года аторваста-тина (20 мг/сут.) не сопровождался достижением целевого уровня холесте-рина (ХС). Аторвастатин был заменен на розувастатин 10 мг/сут. в течение 1,5 лет. Если указанная доза не приводила ХС и ХС липопротеидов низкой плотно-сти (ХС ЛНП) к целевым значениям в течение 6 нед, доза розувастатина увели-чивалась до 20 мг/сут., а при недостижении целевых значений ХС в течение последующих 6 недель увеличивалась до 40 мг/сут. Результаты. Включение розувастатина в комплексную терапию сопровожда-лось дальнейшим снижением атерогенных липидов: ХС на 24%, ХС ЛНП на 53% и сочеталось с уменьшением параметров жесткости сосудистой стенки -снижением CAVI на 12%, индекса аугментации на 17%, улучшением вазодилатирующей функции сосудистого эндотелия на 24%. Заключение. Розукард обладает, наряду с гиполипидемическим эффектом, плейотропными свойствами, превышающими таковые аторвастатина, что позволяет использовать препарат у больных АГ с высоким и очень высоким ССР для профилактики сердечно-сосудистых осложнений в амбулаторной практике. Aim. To evaluate the pleiotropical and hypolipidepmic efficacy of generic rosuvastatin (Rosucard) comparing with atorvastatin in arterial hypertension patients (AH) with high and very high cardiovascular risk (CVR) during the long-term usage in outpatient circumstances. Material and methods. Totally, 114 patients studied (age 58,2±3,11 y. o.) with AH of II-III grades and with high or very high CVR by SCORE, taking antihypertension treatment with metoprolol, indapaminde, enalapril in effective dosages, who, during the previous 1 year of atorvastatin treatment (20 mg/day) did not reach the target level of cholesterol. Atorvastatin was replaced by rosuvastatin 10 mg/day for 1,5 year. If the mentioned dosage did not reach cholesterol and low-density lipoproteides (CLDL) to target levels by 6 weeks, dosage was increased to 20 mg/day, and then if again not achieved during next 6 weeks, to 40 mg/day. Results. Introduction of rosuvastatin to the complex treatment was followed by further decrease of atherogenic lipids: cholesterol by 24%, CLDL by 53% and was followed with the decrease of vessel wall stiffness -decreased CAVI by 12%, augmentation index by 17%, improvement of the vasodilation endothelium function by 24%. ГИПОЛИПИДЕМИЧЕСКАЯ И ПЛЕЙОТРОПНАЯ ЭФФЕКТИВНОСТЬ РОЗУВАСТАТИНА У БОЛЬНЫХ АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ С ВЫСОКИМ СЕРДЕЧНО-СОСУДИСТЫМ РИСКОМ В УСЛОВИЯХ ДЛИТЕЛЬНОГО АМБУЛАТОРНОГО НАБЛЮДЕНИЯ Conclusion.Rosucard has, together with hyp...
Objective. To determine the comparative effectiveness of atorvastatin and rosuvastatin in relation to individual biochemical and functional markers of vascular wall remodeling in patients with arterial hypertension of high cardiovascular risk. Materials and methods. The study included 140 patients with stage II of arterial hypertension (AH), II-III degree of severity with the duration of the disease from 5 to 12 years, who, against the background of antihypertensive therapy (enalapril 20-40 mg/day, indapamide retard 1.5 mg, metoprolol 100-150 mg/days) received atorvastatin 20 mg/day for 1 year, subsequently it was replaced by rosuvastatin 10, 20, 40 mg / day. The dose regimen was determined by achieving the target level of cholesterol (CS) and low density lipoprotein cholesterol (LDL-C). Results. Taking atorvastatin for 1 year was accompanied by a decrease in the value of the cardio-ankle vascular index (CAVI) by 14.4%, the augmentation index (AI) - by 10.3%. The replacement of atorvastatin with rosuvastatin was accompanied by a further decrease in the R-CAVI value: by 10.8% (20 mg/day) and 14.4% (40 mg/day). The use of atorvastatin for 1 year was accompanied by a decrease in both C-reactive protein (CRP) (by 26.0%) and osteopontin (OP) (by 22.8%). A further decrease in the concentration of CRP by 18 months of rosuvastatin therapy is recorded when using mean and high doses (20-40 mg/day). Differences in the severity of changes in CRP level between the groups were significant (p<0.05). The level of OP in comparison with the beginning of rosuvastatin decreased by 32.9%. Differences in the degree of reduction of OP when taking rosuvastatin between the groups were significant (P<0.05). Conclusion. Rosuvastatin in various dosage regimens with long-term use in patients with arterial hypertension with a high vascular risk reduces the content of CRP and OP in blood, reduces the CAVI and the AI, and is more effective than 20 mg atorvastatin a day.
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