Usage of the fixed-doses combinations for drug therapy of arterial hypertension in northern regions of the Far Eastern Federal district

Aim. To analyze the usage of the fixed-doses combinations for treatment of arterial hypertension in three northern regions of the Far Eastern Federal District.

Material and methods. The pharmacoepidemiological study of realization of antihypertensive drugs in the pharmaceutical organizations of the Magadan region, Kamchatka Krai, the Sakha Republic (Yakutia). The studied period was 2013-2017. Total sales were calculated based on the amount of drugs and defined daily doses, acquired by patients. The range of international nonproprietary names has been divided into therapeutic classes. Further calculation of indicators in group for each combination was carried out. The analysis was performed with usage of Microsoft Office of Excel 2015.

Results. In a therapeutic class of combinations β-blockers with diuretics or calcium channel blockers the combination atenolol+сhlortalidone remained the leader in three regions. Shares of sales of other international nonproprietary names were insignificant, and did not exceed totally 10%. Valsartan+amlodipin had the greatest indicators of realization in the therapeutic class of аngiotensin II antagonists with calcium channel blockers. Among combinations of аngiotensin II antagonists and diuretics, the combination of losartan+hydrochlorothiazide had more than a half of the acquired defined daily doses. Since 2017 in the Sakha Republic (Yakutia) were more actively used valsartan+hydrochlorothiazide, azilsartan medoxomil+chlortalidone. In a therapeutic class of angiotensin-converting-enzyme inhibitors with calcium channel blockers in the Magadan region and in the Sakha Republic (Yakutia) the leader of the market was the combination of lisinopril+amlodipine, in Kamchatka Krai - perindopril+amlodipine. Acquisition of the drugs containing ramipril and amlodipine has increased in all three regions. In a therapeutic class of combinations of angiotensinconverting-enzyme inhibitor with diuretics, the redistribution of preferences from drugs containing enalapril+hydrochlorothiazide in favor of perindopril+indapamid was observed. The combinations lisinopril+hydrochlorothiazide had the considerable share of sales in the Sakha Republic (Yakutia). Usage of a combination of hydrochlorothiazide+triamterene and drugs of a reserpine is characteristic of the Magadan region and Kamchatka Krai. In the Sakha Republic (Yakutia), in comparison with other explored regions, triple-component drugs are more actively applied.

Conclusions. The greatest part of realization of the defined daily doses of the modern antihypertensive fixed-doses combinations was the share of only seven international nonproprietary names, on condition of presence in the pharmaceutical market of 43 variants. Current situation proves expediency of prescription of the applied schemes of drugs therapy, taking into account the available range of drugs in the pharmaceutical organizations of regions.

1. Bojcov S.A. Assessment of the possibility of comparing mortality rates from diseases of the circulatory system in the United States and Russia / S.A. Bojcov, E.M. Andreev, I.V. Samorodskaya // Cardiology. – 2017. – Vol.57(1). – P. 5-16. DOI: 10.18565/cardio.2017.1.5-16.

2. Villeval’de S.V. Guideline for management an arterial hypertension of the European Society of Cardiology and European society about an arterial hypertension of 2018 / S.V. Villeval’de, Yu.V. Kotovskaya, Ya.A. Orlova / Electronic source URL: http://rgnkc.ru/novosti/new-novyeevropejskie-rekomendatsii-po-arterialnojgipertonii-2018-goda (Date of the address 8/8/2018).

3. Amlodipine, indapamide and perindopril fixed combination in patients with uncontrolled hypertension / S.V. Nedogoda, E.V. Chumachek, A.A. Ledyaeva [et al] // Cardiology. – 2017. – Vol.57(6). – P. 29-32. DOI: 10.18565/cardio.2017.6.29-32.

4. Incidence of all population of Russia in 2016. Statistical materials. Part I. Ministry of Health of the Russian Federation. Department of monitoring, analysis and strategic development of health care. Federal State Budgetary Institution Central Research and Development Institute of the Organization and Informatization of Health Care of the Russian Ministry of Health. – M., 2017. – Р. 67-68. Electronic source URL: https://www.rosminzdrav.ru/ministry/61/22/stranitsa-979/statisticheskie-i-informatsionnyematerialy/statisticheskiy-sbornik-2016-god (Date of the address 2/11/2018).

5. Kravchenko A.Ya. Efficacy evaluation of the transition to fixed combination drug prestance in patients with insufficient control of blood pressure by other antihypertensive medications or combinations: regional program objective / A.Ya. Kravchenko, Z.Z. Alimhanova // Cardiovascular Therapy and Prevention. – 2018. – Vol.17(2). – P. 10-16. https://doi.org/10.15829/1728-8800-2018-2-10-16.

6. Krivoshapova K.E. Prevalence, awareness and adherence to treatment of arterial hypertension: myths and reality / K.E. Krivoshapova, D.P. Cygankova, O.L. Barbarash // Systemic hypertension. – 2018. – Vol.15(1). – P. 63–67. DOI: 10.26442/2075-082X_15.1.63-67

7. Novel combination of the angiotensin converting enzyme inhibitor perindopril and highly selective β-adrenoblocker bisoprolol: prime among the equal / O.D. Ostroumova, A.I. Kochetkov, A.V. Starodubova [et al.] // Cardiovascular Therapy and Prevention. – 2018. – Vol.17(3). – P. 85-95. https://doi.org/10.15829/1728-8800-2018-3-85- 95.

8. Optimization of control of blood pressure, metabolic disorders and target organs protection with fixed perindopril and indapamide combination in treated patients with arterial hypertension / S.V. Nedogoda, E.V. Chumachek, A.A. Ledyaeva [et al.] // Cardiology. – 2017. – Vol.57(2). – P. 5-11. DOI: 10.18565/cardio.2017.2.5-11.

9. Specifics of antihypertension therapy in hypertensives of various cardiovascular risk (by the registry of chronic non-communicable diseases in Tyumenskaya oblast) / A.Yu. Efanov, Yu.A. Vyalkina, Yu.A. Petrova [et al.] // Cardiovascular Therapy and Prevention. – 2018. – Vol.17(3). – P.4-10. https://doi.org/10.15829/1728-8800-2018-3-4-10.

10. Ostroumova O.D. Fixed combination of amlodipine and lisinopril effectiveness in hypertensive smokers / O.D. Ostroumova, A.I. Kochetkov // Systemic hypertension. – 2018. – Vol.15(1). – P. 23–31. DOI: 10.26442/2075-082X_15.1.23-31.

11. Assessment of efficacy of combined pharmacotherapy with fixed perindopril/amlodipine combination in patients with combined cardiovascular pathology in outpatient practice / E.I. Bezuglova, YuV. Luneva, A.A. Kornilov [et al.] // Cardiology. – 2018. – Vol.58(3). – P. 37-42. DOI:10.18087/cardio.2018.3.10097.

12. Clinical guidelines for Diagnostics and treatment of arterial hypertension / I.E. Chazova, E.V. Oshchepkova, Yu.V. Zhernakova [et al.] // Сardiological messenger. – 2015. – Vol.1. – P.5-30.

13. Stacenko M.E. Organoprotective properties of therapy by fixed combination of perindoprile and amlodipine in patients with arterial hypertension and diabetes mellitus type 2 / M.E. Stacenko, S.V. Turkina, M.N. Titarenko // Systemic hypertension. – 2018. – Vol.15(1). – P. 51–55. DOI: 10.26442/2075-082X_15.1.51-55.

14. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology / P.K. Whelton, R.M. Carey, W.S. Aronow [et al.] / American Heart Association Task Force on Clinical Practice Guidelines // J Am Coll Cardiol. – 2018. – Vol. 71. – P. e127-e248. DOI: 10.1016/j.jacc.2017.11.006.

15. DDD. Definition and general considerations. Electronic resource URL: https://www.whocc.no/ddd/definition_and_general_considera/#ddds2 (Date of the address 08/08/2018).