Tillbaka

enalapril + hydroklortiazid
Enalapril Comp ..., Enalapril/Hydrochlorothiazide ..., Linatil comp, Renitec comp, Synerpril

2017-12-14 Expertråd hjärt-kärlsjukdomar

Beslut

Kvarstår

Indikation

Hypertoni

Förbehåll / Kommentar

Generisk substitution tillämpas vid expedition på recept.

Enalapril och hydroklortiazid är miljöklassificerade.

Motivering

Blodtryckssänkning ger en riskreduktion för insjuknande i hjärtkärlsjukdom. Optimal hypertonibehandling kräver ofta kombinationsbehandling. ACE-hämmare och lågdos tiazid har synergistiska effekter och är därför en logisk kombination.


Utredningsmaterial och referenser

  1. STOP I: Dahlof B, Lindholm LH, Hansson L, Schersten B, Ekbom T, Wester PO. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet 1991;338:1281-5. PubMed
  2. SBU-rapport nr 170, 2004. Måttligt förhöjt blodtryck. SBU
  3. NICE. Management of hypertension guidance. BMJ 2011;343
  4. STOP-2: Hansson L, Lindholm LH, Ekbom T, Dahlof B, Lanke J, Schersten B et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet 1999;354:1751-6. PubMed
  5. ABCD-studien: Estacio RO, Jeffers BW, Hiatt WR, Biggerstaff SL, Gifford N, Schrier RW. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med 1998;338:645-52. PubMed
  6. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA. 2002;288:2981-97. PubMed
  7. Psaty BM, Lumley T, Furberg CD, Schellenbaum G, Pahor M, Alderman MH, Weiss NS. Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA. 2003;289:2534-44. PubMed
  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72. PubMed
  9. Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a quantitative overview updated until 1 March 2003. J Hypertens. 2003 Jun;21(6):1055-76. PubMed
  10. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M et al. 2013 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281-357. PubMed
  11. Kostis JB, Wilson AC, Freudenberger RS, Cosgrove NM, Pressel SL, Davis BR; SHEP Collaborative Research Group. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes. Am J Cardiol. 2005;95:29-35. PubMed
  12. MRC: Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party. BMJ 1992;304:405-12. PubMed
  13. HAPPHY: Wilhelmsen L, Berglund G, Elmfeldt D, Fitzsimons T, Holzgreve H, Hosie J et al. Beta-blockers versus diuretics in hypertensive men: main results from the HAPPHY trial. J Hypertens 1987;5:561-72. PubMed
  14. Att förebygga aterosklerotisk hjärt-kärlsjukdom med läkemedel – behandlingsrekommendation. Information från Läkemedelsverket 2014;25(5):20–33. Läkemedelsverket

Bedömning utförd av

Expertrådet för hjärt-kärlsjukdomar