Azilsartan medoxomil: opportunities and prospects in diabetes mellitus

Current data on the prevalence of hypertension and diabetes mellitus (DM) are presented. Concomitant DM complicates the course of cardiac diseases, affecting the effectiveness of antihypertensive therapy. Along with high blood pressure, lipid and carbohydrate metabolism parameters should be corrected. Nephroprotection is also important in these patients. These goals are achievable due to the pleiotropic effects of some drugs. The analytical paper reviews the pleiotropic organoprotective effects of the antihypertensive drug azilsartan medoxomil. The data on its antihypertensive efficacy versus other angiotensin II receptor blockers are presented. In addition, the results of clinical trials in patients with various components of the metabolic syndrome (obesity, dyslipidemia, hyperglycemia) and DM are described.

Triple fixed-dose combination in the treatment of hypertension: the results of the Russian observational study TRICOLOR

The article presents the main results of the Russian post-marketing multicenter open-label program TRICOLOR (Triple fixed-dose combination in the treatment of hypertension).Aim. To evaluate the antihypertensive efficacy and tolerability of the triple amlodipine/indapamide/perindopril fixed-dose combination, as well as the adherence of hypertensive (HTN) patients to this therapy in actual clinical practice.Material and methods. The program enrolled 1247 outpatients aged 18 to 79 of both sexes with essential HTN. All patients included in the study receive amlodipine/ indapamide/perindopril fixed-dose combination. The patient’s condition was assessed according to four visits: visit 1 — at inclusion, visit 2 — after 2 weeks, visit 3 — after 4 weeks, visit 4 — after 12 weeks of follow-up. At each visit, the achievement of the target blood pressure (BP) <140/90 mm Hg and <130/80 mm Hg. At enrollment and visit 4, quality of life was analyzed using the SF-36 questionnaire and adherence to therapy using a validated 6-question questionnaire.Results. After 12 weeks, a significant decrease in systolic and diastolic BP was recorded — by 33,5 and 14,3 mm Hg, respectively (p<0,001). Target BP <140/90 mm Hg after 12-week follow-up was achieved by the overwhelming majority (93,4%) of patients. After 12 weeks, the proportion of patients with good medical adherence increased from 18,8% to 49,0%, while the proportion of patients with low adherence, on the contrary, decreased from 46,3% to 5,1%.Conclusion. The results of the TRICOLOR program demonstrate a high antihypertensive efficacy, good tolerance and medical adherence of triple amlodipine/indapamide/perindopril fixed-dose combination in patients with essential HTN in actual clinical practice in Russia.

Renal denervation: where do we stand and what is the relevance to the nephrologist?

Catheter-based renal denervation to reduce high blood pressure (BP) has received well-deserved attention after a recent series of sham-controlled trials reported significant antihypertensive efficacy and very favourable tolerability and safety of the intervention. This emerging treatment option is of high relevance to nephrologists. Patients with chronic kidney disease (CKD) are at elevated risk of cardiovascular adverse events and often present with hypertension, which is very difficult to control with medication. Renal denervation promises a new tool to reduce BP and to prevent loss of renal function in this population. The current review considers the role of the kidney and neurohormonal activation in the development of hypertension and the rationale for renal denervation. The current state of the evidence for the effectiveness and tolerability of the procedure is considered from the nephrologists’ perspective, with a focus on the potential future role of renal denervation in the management of CKD patients with hypertension.