Many studies have shown that the efficiency of antihypertensive therapy increases by using combinations of different classes of drugs. If the reception of one antihypertensive drug does not achieve the target blood pressure, the question of adding the drug of another class should be resolved. Typical antihypertensive therapy of elderly people with hypertension should include a diuretic, ACE inhibitor or ARB and AK. These drugs have vasodilatation action, increase the elasticity of the arterial walls, reduce the speed of the pulse wave and the return pulse wave amplitude, in addition, diuretics reduce the volume of circulating blood and cardiac output. The combination of these effects contributes to achieving the target blood pressure. Undesirable combinations of drugs for elderly patients are p-blockers and calcium antagonists (increase the risk of bradyarrhythmia), ACE inhibitors and potassium-sparing diuretics (increase the risk of hyperkaliemia and renal failure), a-blocker and AK (increase the risk of orthostatic hypotension). If the target blood pressure is not achieved by three agents, it is necessary to reassess the situation, to carry out further e x amination, as an important factor that must be considered in the treatment of this patient could have been missed in the initial evaluation. About the drug stability, which is often encountered in the NRI, we can talk when the reception of three antihypertensive drugs does not help to normalize the SAD despite the good tolerability. Before stating the drug resistance, it is necessary to clarify whether the e x isting pathology is cured normally and the fact that patient does not take another Вісник проблем біології і медицини 2015 Вип. 2, Том 3 (120) 23 ОГЛЯДИ ЛІТЕРАТУРИ drugs which may influence the effectiveness of the antihypertensive therapy. Such medicine may be non-steroidal anti-inflammatory drugs, steroid hormones, immunosuppressant’s (e. g., cyclosporin). Other factors contributing to the decrease of efficiency of antihypertensive therapy may be smoking, obesity, alcohol abuse, hyperinsulinemia and insulin resistance syndrome, sleep apnea, the presence of diseases associated with long, poorly cropped pain. Thus, at the present time the feasibility of the treatment of hypertension of elderly patients is not in doubt, since only this tactics of patients with hypertension leads to a significant reduction of cardiovascular mortality. Further clinical trials and studies should help, finally, to decide with the tactics of curing elderly patients with hypertension, the right choice in the treatment of resistant hypertension, and will facilitate the introduction of a daily practice of new, effective and safe antihypertensive drugs. When one is getting old amount of problems with health is increasing correspondingly. Arterial hypertension is among those health problems and one of the main factors of risk of development cardiovascular complications and death. Many studies ascertain a higher efficiency of combination therapy, which refers to the simultaneous administration of two or more antihypertensive medications of different types. Combination therapy should be prescribed when a single medication is not adequate to treat the medical condition, i. e. when monotherapy doesn’t ensure achieving the aim of treatment reduce blood pressure to the target inde x.

Перехід людини в категорію осіб похилого віку супроводжується зростанням проблем зі здоров’ям, серед яких не останнє місце займає артеріальна гіпертензія. Багато досліджень свідчать про те, що ефективність антигіпертензивної терапії підвищується при одночасному використанні комбінацій препаратів різних класів. Якщо після прийому одного антигіпертензивного препарату не можливо досягти цільового рівня артеріального тиску, повинно бути вирішено питання про додавання у схему лікування ще одного препарату іншого класу в оптимальній дозі.Переход человека в категорию лиц пожилого возраста сопроврждается повышением проблем со здоровьем, среди которых не последнее место занимает артериальная гипертензия. Много исследований свидетельствует о том, что эффективность антигипертензивной терапии повышается при одновременном использовании комбинации препаратов разных классов. Если после приема одного антигипертензивного препарата невозможно достичь целевого уровня артериального давления, должен быть решен вопрос о дополнении в схему лечения еще одного препарата другого класса в оптимальной дозе.