FEATURES OF MANAGEMENT OF PATIENTS WITH HYPERTENSION IN COMBINATION WITH ISCHEMIC HEART DISEASE: MODERN APPROACHES

Abstract

The main positions of the American guidelines on management of patients with hypertension and concomitant ischemic heart disease (2015) are discussed in the article. Questions about the target blood pressure levels and the choice of the main classes of antihypertensive drugs, depending on the history of myocardial infarction, diabetes mellitus, and chronic kidney disease are presented. The principles of management of hypertensive patients with stable angina and acute coronary syndrome are discussed separately. The place of amlodipine in the therapy of patients with hypertension and ischemic heart disease is also being considered. Analysis of the large number of patients presented in the VALUE, CAMELOT and PREVENT studies allows one to more reliably talk about the pleiotropic effects of amlodipine and to determine its place in the antihypertensive therapy of patients with subclinical and symptomatic atherosclerosis. Possible potentiating effect of angiotensin converting enzyme inhibitors and amlodipine is also discussed in the article. This allows us to consider amlodipine as one of the key components of antihypertensive therapy in patients with ischemic heart disease, which contributes not only to accelerated normalization of blood pressure but also to a decrease in cardiovascular risk.

Keywords

• hypertension
• ischemic heart disease
• calcium channel blockers
• amlodipine