Personalized medicine: for whom, when and how?

28 березня 2024
553
УДК:  616.12-008.331.1
Резюме

The article presents modern approaches to antihypertensive therapy, describes the causes of poor blood pressure control in patients with arterial hypertension. The issue of drug interactions and comorbidity is considered, the emphasis is placed on ways to overcome polypharmacy. On the example of a clinical case, a rational algorithm for managing a patient with high cardiovascular risk, with multiple comorbid pathologies, in whom previous antihypertensive treatment was ineffective, is presented. The importance of a personalized approach to treatment is emphasized.

References

  • 1. ghdx.healthdata.org/record/paho-epidemiological-update-measles-27-may-2020.
  • 2. Целуйко В.I. (2016) Систолiчна артеріальна гіпертензія в україні: реалії клінічної практики за даними дослідження СИСТЕМА. Артеріальна гіпертензія, 2(46): http://www.mif-ua.com/archive/article/42676.
  • 3. Fortin M., Bravo G., Hudon C. et al. (2005) Prevalence of multimorbidity among adults seen in family practice. Ann. Fam. Med., 3(3): 223–228. doi: 10.1370/afm.272.
  • 4. Fleming G.A. (2000) The FDA, regulation, and the risk of stroke. N. Engl. J. Med., 343(25): 1886–1887.
  • 5. MacIntyre I.M., Turtle E.J., Farrah T.E. et al.; PATH-BP (Paracetamol in Hypertension — Blood Pressure) Investigators (2022) Regular Acetaminophen Use and Blood Pressure in People With Hypertension: The PATH-BP Trial. Circulation, 145(6): 416–423. doi: 10.1161/CIRCULATIONAHA.121.056015.
  • 6. El-Toukhy T., Campo R., Khalaf Y. et al. (2016) Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet, 387(10038): 2614–2621. doi: 10.1016/S0140-6736(16)00258-0.
  • 7. Ahn J.-M., Kang D.-Y., Lee P.H. et al.; PREVENT Investigators (2023) Preventive PCI or medical therapy alone for vulnerable atheroscle-rotic coronary plaque: Rationale and design of the randomized, controlled PREVENT trial. Am. Heart J., 264: 83–96. doi: 10.1016/j.ahj.2023.05.017.
  • 8. Nissen S.E., Tuzcu E.M., Libby P. et al.; CAMELOT Investigators (2004) Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA, 292(18): 2217–2225. doi: 10.1001/jama.292.18.2217.
  • 9. Dahlöf B., Sever P.S., Poulter N.R. et al.; ASCOT Investigators (2005) Prevention of cardiovascular events with an antihypertensive regi-men of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet, 366(9489): 895–906. doi: 10.1016/S0140-6736(05)67185-1.
  • 10. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group (2002) Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA, 288(23): 2981–2997. doi: 10.1001/jama.288.23.2981.