Optimization of anti-hypertensive treatment regimen in therapeutic practice: focus on free indapamide combinations


DOI: https://dx.doi.org/10.18565/therapy.2020.4.168-180

Pereverzev A.P., Ostroumova O.D., Golovina O.V.

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia
Key point of new clinical guidelines for hypertension patients management is an active start with fixed combinations of antihypertensive medicines. At the same time, in the Russian recommendations of 2020, it is noted that, although fixed combinations increase adherence to treatment, they are not always included in the dosage formularies of many medical institutions and lists of essential drugs. Therefore, if the patient has reached the target level of blood pressure within the established values and there is a good adherence to treatment, then there is no need to transfer him from a free to a fixed combination. Free combinations can be used also for organizational reasons, in particular, in order to maintain the availability of medicinrs for the patient. In this article, the authors illustrate this point with a series of clinical examples based on the results of large, double-blind, randomized trials and meta-analyzes proving the high antihypertensive efficacy of indapamide in monotherapy and combined antihypertensive therapy, as well as the organoprotective properties of this thiazide-like diuretic.
The appearance on the Russian pharmaceutical market of indapamide 2,5 mg in 4 equal parts-divided tablets with a special division line contributes to the prevention of dose-dependent adverse reactions, as it allows the dose to be titrated more slowly and to individualize the selection of the minimum effective indapamide dosage. This is especially actual for patients of elder age groups with the presence of hemodynamically significant stenoses of brachiocephalic arteries who have suffered a stroke or transient ischemic attack.
Keywords: arterial hypertension, antihypertensive medicines, indapamide, elderly and senile age, stroke, cognitive disorders, dementia
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About the Autors

Anton P. Pereverzev, PhD, associate professor of the Department of therapy and polymorbid pathology of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 125284, Moscow, 5 2nd Botkinsky Lane. Tel.: +7 (499) 728-81-97. E-mail: acchirurg@mail.ru. ORCID: https://orcid.org/0000-0001-7168-3636
Olga D. Ostroumova, MD, professor, head of the Department of therapy and polymorbid pathology of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 125284, Moscow, 5 2nd Botkinsky Lane. Tel.: +7 (499) 728-81-97. E-mail: terapia_polimorbid@rmapo.ru. ORCID: https://orcid.org/0000-0002-0795-8225
Olga V. Golovina, PhD, associate professor, associate professor of the Department of therapy and polymorbid pathology of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 125284, Moscow, 5 2nd Botkinsky Lane. Tel.: +7 (499) 728-81-97. E-mail: terapia_polimorbid@rmapo.ru. ORCID: https://orcid.org/0000-0002-0795-8225

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