Specific features of impaired tolerance to antihypertensive treatment in patients with primary open-angle glaucoma and a hereditary history of the disease

I. A. Bulakh, A. V. Kuroyedov, A. V. Seleznev, Z. M. Nagornova
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Abstract

This review considers possible reasons for the decrease in the effectiveness of antihypertensive treatment in primary open-angle glaucoma (POAG) patients with a family history of the disease, presents clinical practice examples of the effectiveness and duration of antiglaucoma topical therapy and the mechanisms and manifestations of tachyphylaxis and tolerance disorders in such patients. Clinical features and the nature of POAG progression in patients with a hereditary predisposition may be reflected in the early decrease in the effectiveness of antihypertensive treatment. In some recent publications the authors proved a more aggressive course of POAG in patients with a family history of the disease, but despite that, such works at the moment are very limited in number and unsystematized. This, in turn, prevents drawing unambiguous conclusions regarding the features of the prescribed antihypertensive therapy. The article also discusses modern aspects of pharmacogenetics in patients with POAG, its further development will help minimize unwanted side effects as well as increase the effectiveness of antihypertensive drug treatment. The results of the work presented in this review allow systematization of the available data on impaired tolerance to antihypertensive therapy and maintain the need of further clinical research in this area.
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原发性开角型青光眼患者抗高血压治疗耐受性受损的特殊特征及该病的遗传史
本文综述了有家族病史的原发性开角型青光眼(POAG)患者降压治疗有效性下降的可能原因,介绍了抗青光眼局部治疗的有效性和持续时间的临床实例,以及这类患者快速反应和耐受性障碍的机制和表现。具有遗传易感性的患者的临床特征和POAG进展的性质可能反映在抗高血压治疗有效性的早期下降。在最近的一些出版物中,作者证明了有家族病史的患者的POAG病程更积极,但尽管如此,目前这样的工作在数量上非常有限,而且没有系统化。这反过来又阻碍了对规定的抗高血压治疗的特点得出明确的结论。本文还讨论了POAG患者药物遗传学的现代方面,其进一步发展将有助于减少不良反应,提高抗高血压药物治疗的有效性。本综述中提出的工作结果使抗高血压治疗耐受性受损的现有数据系统化,并维持该领域进一步临床研究的必要性。
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