CHANGES IN THE CARDIOVASCULAR SYSTEM THAT OCCUR WITH THE COMBINED USE OF ANTIHYPERTENSION DRUGS

Аннотация

In this article, the analysis of literature data on the clinical efficacy and safety of antihypertensive drugs shows that there is a significant difference between original and generic drugs, both in therapeutic equivalence and in the frequency and severity of adverse reactions caused by them. Key words: arterial hypertension, antihypertensive drugs, original drug, generic, therapeutic equivalence, side effects. Arterial hypertension (AH) is a long-term increase in blood pressure (BP) above 140/90 mm Hg. Art. arterial hypertension (systolic and diastolic blood pressure, respectively) in people who do not receive adequate antihypertensive therapy. Hypertension is one of the leading risk factors for the development of cardiovascular and cerebrovascular diseases, the main cause of high mortality and disability in all countries, and the most common heart disease. The prevalence of hypertension is high throughout the world, 20-30% of the adult population in developed countries suffer from it. [4,5] In Uzbekistan, hypertension occurs in 30-40% of the elderly population, and in people over 60 years old - up to 60-70%. The main types of arterial hypertension are essential hypertension of unknown etiology, which accounts for 90-95% of patients with hypertension, or arterial hypertension, and secondary hypertension - symptomatic, the cause of which may be kidney pathology (kidney damage), renal parenchyma, adrenal glands. glands (pheomocytoma, hyperaldosteronism), large vessels (renal artery stenosis, coarctation of the aorta). Isolated systolic hypertension is also distinguished, in which systolic blood pressure exceeds 160, and diastolic blood pressure is less than 90 mm Hg. Art. This form of hypertension occurs mainly in the elderly and is caused by a decrease in vascular elasticity. Adequate treatment of arterial hypertension should lead to a decrease in pressure to target values (140/90 mm Hg, in diabetes mellitus and kidney pathology - 130/80). The prognosis of hypertension depends not only on blood pressure. Of great importance are: the presence of concomitant risk factors: age, family history of early cardiovascular diseases, smoking, high cholesterol and lipid spectrum disorder in the blood 50 THEORETICAL ASPECTS IN THE FORMATION OF PEDAGOGICAL SCIENCES International scientific-online conference plasma, physical inactivity; weight gain; abdominal obesity, diabetes mellitus (DM), high doses of alcohol; the degree of damage to target organs and the presence of concomitant clinical conditions [7]. The main goal of hypertension treatment is to reduce mortality from cardiovascular diseases. Antihypertensive therapy strategies are developed to prevent damage to target organs and death associated with hypertension. In patients with high blood pressure, the greatest risk of developing myocardial infarction or stroke occurs when antihypertensive therapy is discontinued (even temporarily). According to a meta-analysis of many clinical studies, a decrease in systolic blood pressure by 12–13% leads to a decrease in cardiovascular complications by 21–37%. Adequate, regular antihypertensive therapy reduces mortality in patients: from myocardial infarction - by 15–20%, from stroke - by 40–50%. This explains the need for timely and justified treatment [6,7]. According to leading world experts, treatment of arterial hypertension should be as early and intensive as possible. Therefore, effective treatment often requires a combination of two or more antihypertensive drugs even in the early stages of the disease. Combined low doses of drugs are used in therapy, which reduces the risk of side effects; Acts simultaneously on various mechanisms of arterial hypertension, which increases the effectiveness of treatment; In addition, a fixed combination of two or more drugs allows for combination therapy with one tablet, which is more convenient for the patient [2,6]. The main groups of drugs for the treatment of arterial hypertension: First-line drugs (main): angiotensin-converting enzyme inhibitors; beta-blockers (BB); calcium channel blockers (Ca2+ antagonists); diuretics; angiotensin receptor blockers; Second-line drugs (alternative): alpha-blockers; A2-adrenergic receptor agonists and imidazoline receptors (central neurotropic agents, central sympatholytics), direct renin inhibitors. Features of the main groups of antihypertensive drugs AAF inhibitors: more effective in young people; improve quality of life; organoprotective action (cardio-, nephrovasoprotective); prevention of diabetic nephropathy; slowing down the development of addiction; positive metabolic effects: improved glucose metabolism, increased sensitivity of peripheral tissues to insulin, does not affect lipid metabolism, urea or creatinine levels; no withdrawal syndrome; But! May cause cough in 11.5% of cases - with captopril, in 24.7% of cases - with enalapril, as a result of irritation of the afferent fibers of the vagus nerve of the upper respiratory tract due t