Med. praxi. 2022;19(5):377-384

AT1 blokátory nejen v léčbě hypertenze

MUDr. Zuzana Zafarová

7. října 2022 uspořádala společnost Zentiva na XXXIX. konferenci České společnosti pro hypertenzi sympozium věnované sartanům. Profesor Zelinka v úvodu sympozia připomněl nepříznivé důsledky nonadherence k preventivní kardiovaskulární léčbě, včetně zvýšeného výskytu cévních mozkových příhod či zvýšené mortality. Rozebral možné příčiny nedodržování léčby a na základě klinických důkazů doporučil především pravidelnou kontrolu adherence pacientů k předepsané léčbě, používání fixních kombinací a předepisování přípravků s minimem nežádoucích účinků. Jak ukázal, z antihypertenziv vykazují nejnižší riziko vysazení léčby z důvodu nežádoucích účinků AT1 blokátory. Docent Petrák připomněl mechanismus účinku AT1 blokátorů a rozdílné charakteristiky jednotlivých přípravků z této třídy antihypertenziv. Zaměřil se na jejich porovnání s ACEI a doložil, že AT1 blokátory poskytují stejnou KV ochranu a účinné snížení krevního tlaku, ovšem s nižším rizikem přerušení léčby. Poukázal na postavení AT1 blokátorů v současných českých, evropských i mezinárodních doporučeních pro léčbu hypertenze, kde figurují jako 1. volba bez ohledu na průvodní choroby pacientů, jako je chronické onemocnění ledvin, ICHS, srdeční selhání či fibrilace síní. Profesor Widimský se věnoval přínosu AT1 blokátorů u dalších onemocnění. Ukázal, že je lze využít u pacientů se srdečním selháním se sníženou i zachovanou ejekční frakcí, jako prevenci vzniku nebo recidivy fibrilace síní, jako doporučenou léčbu u pacientů s hypertenzí a chronickou obstrukční plicní nemocí, u hypertoniků s chronickým onemocněním ledvin, kde vykazují dobrou antihypertenzní účinnost i renoprotektivitu, a upozornil na příznivé metabolické účinky telmisartanu u pacientů s diabetem 2. typu a metabolickým syndromem. Přinášíme souhrn celého sympozia.

Published: November 29, 2022  Show citation

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Zafarová Z. AT1 blokátory nejen v léčbě hypertenze. Med. praxi. 2022;19(5):377-384.
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