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In spite of optimization and simplification of arterial hypertension (AH) treatment, achieving blood pressure (BP) control is still challenging, with most patients requiring combination treatment to achieve target BP. Due to the multifactorial effect of AH, additional prevention of hypertension-mediated end-organ damage and the maintenance of vascular integrity achieved by antihypertensive medications in addition to the BP-lowering effect are beneficial for the optimal reduction of cardiovascular (CV) risk. The aim of VICTORY II, a multicenter, open, prospective clinical study with 100 patients included in the active phase was to assess the safety and the efficacy of single-pill combinations (SPC) of amlodipine/valsartan (Wamlox®) and amlodipine/valsartan/hydrochlorothiazide (Valtricom®) in naïve or previously treated but uncontrolled patients with grade 2 or 3 AH. All patients with grade 2 AH started the treatment with the SPC of amlodipine/valsartan 5 mg/80 mg, which if necessary could be up-titrated step by step to the final option – the SPC of amlodipine/valsartan/hydrochlorothiazide 10/160/12.5 mg to achieve the target levels of BP. Patients with grade 3 AH started the treatment with the SPC of amlodipine/valsartan 5 mg/160 mg, which could be up-titrated step-by-step to the SPC of amlodipine/valsartan/hydrochlorothiazide 10/160/25 mg if necessary to achieve the target levels of BP. In addition to achieving the target office BP in 90% of the patients after 16 weeks of therapy, the amlodipine/valsartan-based treatments also decreased the prevalence of albuminuria and the central aortic pressure, improved vessel elasticity, and exerted a positive effect on the vascular endothelial function through its effect on the markers involved in the endothelial function., Unatoč optimizaciji i pojednostavnjenju liječenja arterijske hipertenzije (AH), postizanje kontrole arterijskoga tlaka (AT) i dalje je izazov, a većini je bolesnika potrebno kombinirano liječenje da bi postigli ciljnu kontrolu AT-a. Zbog višefaktorskog učinka AH-a, uz smanjenje vrijednosti AT-a, dodatna prevencija oštećenja ciljnih organa te održavanje vaskularnog integriteta postignuta antihipertenzivima korisni su za optimalno smanjenje kardiovaskularnog (KV) rizika. Cilj multicentričnog, otvorenog, prospektivnog kliničkog ispitivanja VICTORY II u 100 bolesnika uključenih u aktivnu fazu bio je procijeniti sigurnost i djelotvornost fiksnih kombinacija amlodipina/valsartana (Wamlox®) i amlodipina/valsartana/ hidroklorotiazida (Valtricom®) u prethodno neliječenih ili prethodno liječenih bolesnika s AH-om 2. ili 3. stupnja u kojih nije postignuta kontrola vrijednosti AT-a. Svi bolesnici s AH-om 2. stupnja započeli su liječenje fiksnom kombinacijom amlodipina/ valsartana 5 mg / 80 mg, koja se po potrebi mogla titrirati naviše korak po korak do konačne opcije – fiksne kombinacije amlodipina/valsartana/hidroklorotiazida 10/160/12,5 mg kako bi se postigle ciljne vrijednosti AT-a. Bolesnici s AH-om 3. stupnja započeli su liječenje fiksnom kombinacijom amlodipina/valsartana 5 mg / 160 mg, koja se po potrebi mogla titrirati naviše korak po korak do fiksne kombinacije amlodipina/valsartana/hidroklorotiazida 10/160/25 mg kako bi se postigle ciljne vrijednosti. Uz postizanje ciljne vrijednosti AT-a mjerena u ordinaciji, u 90 % bolesnika nakon 16 tjedana liječenja, terapije na bazi kombinacije amlodipina/valsartana također su smanjile prevalenciju albuminurije i centralnoga aortalnog tlaka, poboljšale elastičnost krvnih žila i pokazale pozitivan učinak na funkciju vaskularnog endotela putem svojeg djelovanja na markere uključene u funkciju endotela.

Arterijska hipertenzija (AH) vodeći je uzrok kardiovaskularnog (KV) morbiditeta i mortaliteta diljem svijeta. Unatoč brojnim različitim preporukama i mjerama za probir i liječenje AH-a, postizanje ciljnih vrijednosti arterijskoga tlaka (AT) i dalje je izazov u kliničkoj praksi. Glavni cilj pri liječenju bolesnika s AH-om i dalje je maksimalno smanjenje rizika od fatalnih i nefatalnih KV komplikacija, cerebrovaskularnih komplikacija i kronične bolesti bubrega. Da bi se taj cilj postigao, potrebno je sniziti AT na ciljne razine. Osim promjena životnoga stila, potrebni su i učinkoviti antihipertenzivni lijekovi. Ispitivanje VICTORY II provedeno je u svrhu procjene djelotvornosti i sigurnosti primjene fiksnih kombinacija amlodipina/valsartana i amlodipina/valsartana/hidroklorotiazida u jednoj tableti za postizanje ciljnih vrijednosti AT-a u bolesnika s novodijagnosticiranim i nekontroliranim AH-om 2. ili 3. stupnja. U ovo multicentrično, otvoreno, prospektivno kliničko ispitivanje bilo je uključeno ukupno 100 bolesnika. Svi bolesnici s AH-om 2. stupnja započeli su liječenje fiksnom kombinacijom amlodipina/valsartana u jednoj tableti od 5 mg/80 mg, koja se po potrebi mogla titrirati naviše, korak po korak do završne opcije, tj. do fiksne kombinacije amlodipina/valsartana/hidroklorotiazida 10/160/12,5 mg u jednoj tableti kako bi se postigle ciljne vrijednosti AT a. Bolesnici s AH-om 3. stupnja započeli su liječenje fiksnom kombinacijom amlodipina/valsartana 5/160 mg u jednoj tableti, koja se po potrebi mogla titrirati naviše, korak po korak, do fiksne kombinacije amlodipina/valsartana/hidroklorotiazida 10/160/25 mg u jednoj tableti kako bi se postigle ciljne razine AT-a. Rezultati ispitivanja VICTORY II pokazali su da fiksne kombinacije amlodipina/valsartana i amlodipina/valsartana/hidroklorotiazida u jednoj tableti učinkovito smanjuju AT u bolesnika s AH-om 2. ili 3. stupnja te da imaju dobar profil podnošljivosti., Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality worldwide. In spite of many different recommendations and actions related to screening and management of hypertension, reaching target levels of blood pressure (BP) is still a challenge in clinical practice. The main goal of treating patients with hypertension remains the maximum reduction in the risk of fatal and non-fatal CV complications, cerebrovascular complications, and chronic kidney disease. To achieve this goal, it is necessary to lower BP to target levels. In addition to lifestyle changes, effective antihypertensive medication is needed. The VICTORY II study was performed to assess the efficacy and safety of the use of single-pill combinations (SPCs) of amlodipine/valsartan and amlodipine/valsartan/hydrochlorothiazide in achieving the target level of BP in newly diagnosed or uncontrolled patients with grade 2 or 3 arterial hypertension. A total of 100 patients were enrolled in this multicenter, open, prospective clinical study. All patients with grade 2 hypertension started the treatment with SPC of amlodipine/valsartan, 5 mg/80 mg, which if necessary could be up titrated step-by-step to the final option, i.e. SPC of amlodipine/valsartan/ hydrochlorothiazide 10/160/12.5 mg, to achieve target levels of BP. Patients with grade 3 hypertension started the treatment with SPC of amlodipine/valsartan 5 mg/160 mg, which could be up-titrated step-by-step to SPC of amlodipine/valsartan/hydrochlorothiazide 10/160/25 mg if necessary to achieve target levels of BP. The results of the VICTORY II study showed that SPCs of amlodipine/valsartan and amlodipine/valsartan/hydrochlorothiazide effectively reduce BP in patients with grade 2 or 3 hypertension and have a good tolerability profile.

Kardiovaskularne (KV) bolesti i dalje su vodeći uzrok morbiditeta i mortaliteta u svijetu i u Sloveniji. Prema preporukama Europskih smjernica za prevenciju kardiovaskularnih bolesti u kliničkoj praksi, smanjenje razine LDL kolesterola primjenom statina ključno je za prevenciju KV događaja. Brojna klinička ispitivanja i godine iskustva dokazuju djelotvornost terapije statinima. Unatoč tomu, oni se još uvijek premalo uporabljuju u kliničkoj praksi ili se primjenjuju u neadekvatnim dozama. U tromjesečnome neintervencijskom ispitivanju FROZEN praćena je klinička djelotvornost svih doza Krkina rosuvastatina (Roswera®). Rezultati su pokazali da su bolesnici s visokim ili vrlo visokim rizikom od KV događaja nedovoljno liječeni te su imali manje izglede za postizanje ciljnih razina LDL kolesterola nego oni s umjerenim rizikom. Liječenje je ocijenjeno sigurnim i učinkovitim tijekom razdoblja praćenja u bolesnika s umjerenim, visokim i vrlo visokim rizikom od KV a., Cardiovascular (CV) diseases remain the leading cause of morbidity and mortality in the world and in Slovenia. According to the recommendations of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice, reducing LDL-cholesterol levels, especially with statins, is essential for prevention of CV events. A number of clinical studies and years of experience demonstrate the efficacy of statin therapy. Nevertheless, they are still rarely used in clinical practice or are used at insufficient doses. The clinical efficacy of all doses of Krka’s rosuvastatin (Roswera®) was monitored in FROZEN, a three-month non-interventional study. The results showed that patients at high or very high risk of a cardiovascular event were undertreated and were less likely to reach target LDL-C levels than moderate-risk patients. Treatment was evaluated as safe and effective during the follow-up period in patients at a moderate, high, and very high CV risk.

Endotelna disfunkcija najranija je vaskularna abnormalnost, a uključena je u sve faze kardiovaskularnog kontinuuma. Osim sposobnosti snizivanja arterijskoga tlaka, antihipertenzivni lijekovi u idealnom slučaju trebaju imati dodatna svojstva zaštite endotela. Čini se da među inhibitorima angiotenzin-konvertaze perindopril ima najsnažnije protektivne učinke na endotel. Amlodipin je dobro poznat po svojemu ateroprotektivnom učinku. Klinički dokazi pokazuju da perindopril i amlodipin pojedinačno mogu usporiti progresiju kardiovaskularne bolesti, uz dugoročne blagotvorne učinke liječenja na mortalitet. Taj je učinak jači i širi ako se oba lijeka primjenjuju zajedno. Važnim se doima rano propisivanje perindoprila i amlodipina jer se većina koristi od liječenja obama lijekovima događa u ranim ili srednjim fazama kardiovaskularnog kontinuuma. Klinički dokazi također podupiru blagotvorni učinak na vaskularni endotel kakav pruža trojna kombinacija perindoprila i amlodipina s indapamidom., Endothelial dysfunction is the earliest vascular abnormality and it is involved in all stage of the cardiovascular continuum. Antihypertensive compounds should ideally have additional endothelial protective properties beyond their ability to reduce blood pressure. Among angiotensinconverting enzyme inhibitors, perindopril appears to have the greatest endothelial protective effects. Amlodipine is well known for its atheroprotective effect. Clinical evidence has shown that perindopril and amlodipine could individually interrupt and slow the progression of cardiovascular disease with long-term beneficial effects of treatment on mortality. The effect is enhanced and broadened if both agents are used together. Early prescription of perindopril and amlodipine appears to be important, as most of the treatment benefits of both agents occur in the early or middle stages of the cardiovascular continuum. Clinical evidence also supports the beneficial effect on the vascular endothelium offered by the triple combination of perindopril and amlodipine with indapamide.

Tijekom 65 godina svojega postojanja Krka je iz maloga farmaceutskog laboratorija prerasla u jednu od vodećih generičkih farmaceutskih tvrtki u svijetu. Krkini se inovativni generički lijekovi s dodanom vrijednosti razvijaju primjenom našega vlastitog znanja i umijeća. Time se osiguravaju ključne prednosti u odnosu prema konkurentskim proizvodima, koje su rezultat razvoja novih tehnologija primijenjenih u proizvodnji djelatnih tvari i farmaceutskih oblika. Pri planiranju naše ponude lijekova uvijek pažljivo pratimo najčešće bolesti u modernome svijetu. Omogućujemo liječnicima i bolesnicima odabir širokog raspona pakiranja, jačina i kombinacija u jednoj tableti. Terapijska se ekvivalentnost Krkinih proizvoda s originalnim lijekovima dokazuje u in vivo istraživanjima bioekvivalencije. Rezultati mnogobrojnih kliničkih istraživanja pokazuju da su naši lijekovi učinkoviti i dobro podnošljivi u svakodnevnoj kliničkoj praksi., In its 65-year history, Krka has grown from a small pharmaceutical laboratory to become one of the leading generic pharmaceutical companies in the world. Krka’s innovative, added-value generic medications are developed using the company’s own know-how. This ensures that they hold certain key advantages over competitor products, resulting from the development of new technologies used in the production of active ingredients and dosage forms. When planning our product portfolio, we closely monitor the most common diseases in the modern world. We allow doctors and patients to choose from a wide variety of packaging, strengths, and single-pill combinations. The therapeutic equivalence of our medications with the originator’s medications is demonstrated by in vivo bioequivalence studies. The results of numerous clinical studies show that our medications are effective and well-tolerated by patients in clinical practice.

Dokazano je da statini smanjuju kardiovaskularni pobol i smrtnost u primarnoj i sekundarnoj prevenciji kardiovaskularnih bolesti. No liječenje statinima još uvijek nije optimalno jer većina pacijenata ne postiže najveće moguće pozitivne učinke ovakve preventivne strategije. Krka ima širok raspon statina koji su iscrpno testirani. Studije donose jasne i opsežne dokaze o dobrobiti primjene atorvastatina (Atoris®) irosuvastatina (Roswera®) u primarnoj i sekundarnoj prevenciji, uključujući uspješno liječenje ukupnoga lipidnog profila, postizanje ciljne razine lipida, prevencije ozbiljnih ishemijskih ishoda u pacijenata s akutnim koronarnim sindromom, preventivne pleiotropne učinke i dobar sigurnosni profil. Kliničke studije na Krkinim statinima važan su doprinos boljem liječenju hiperlipidemije u različinim skupinama pacijenata., Statins have been proven to reduce cardiovascular morbidity and mortality in primary and secondary prevention of cardiovascular disease. However, statin treatment is still not optimal, with the majority of patients not achieving the maximum benefits of this preventive strategy. Krka offers a wide range of statins that have been extensively studied. The studies have provided clear and conclusive evidence about the benefits of atorvastatin (Atoris®) and rosuvastatin (Roswera®) in primary and secondary prevention patients, including effective management of the total lipid profile, achievement of target lipid levels, prevention of severe ischemic outcomes in patients with acute coronary syndrome, protective pleiotropic effects and a good safety profile. Clinical studies with Krka’s statins represent an important contribution to a better management of hyperlipidemia in different groups of patients

Krka ima više od 25 godina iskustva u proizvodnji visokokvalitetnih lijekova koji djeluju na renin-angiotenzin-aldosteronski sustav (RAAS) te je postala jedan od vodećih proizvođača takvih lijekova u Europi. Otkad je prvi put uvela lijek koji djeluje na RAAS, Krka provodi međunarodna klinička istraživanja kako bi pratila učinkovitost i sigurnost svojih proizvoda unutar opsega primjene, omogućila liječnicima da steknu vlastito iskustvo o njihovom korištenju te dokazala njihovu učinkovitost i sigurnost u kliničkoj praksi. Uz podatke iz istraživanja opisanih u ovom članku, izložit ćemo i dvadesetpetogodišnji doprinos Krkinih lijekova koji utječu na RAAS u liječenju arterijske hipertenzije., Krka has over 25 years of experience in the production of high-quality medicines acting on the renin-anigotensin-aldosterone system (RAAS) and has become one of the leading producers of them in Europe. Since its first introduction of a medicine acting on RAAS it has been performing international clinical studies in order to monitor the efficacy and safety of its products within the scope of the doctrine, enable doctors to gain their own experience with them, and prove their efficacy and safety in clinical practice. With the findings of the studies described in this article, we would like to present the contribution of Krka’s RAAS-acting medicines in the treatment of hypertension in over 25 years.

Tijekom prošlih šest desetljeća Krka je postala jedna od vodećih generičkih farmaceutskih tvrtki u svijetu. Naše inovativne generičke lijekove, tj. generičke lijekove s dodanom vrijednosti, razvijamo sami koristeći se vlastitim znanjem i umijećem. Time se osiguravaju ključne prednosti pred konkurentnim lijekovima zahvaljujući razvoju novih tehnologija primjenjivanih u proizvodnji aktivnih supstancija i farmaceutskih oblika. Lijekovi za liječenje kardiovaskularnih bolesti čine ključni dio među Krkinim lijekovima koji se propisuju na recept. Nudimo širok raspon kardiovaskularnih lijekova dostupnih u različitim oblicima, kombinacijama fiksnih doza i inovativnih jačina, što liječnicima omogućuje optimalno liječenje bolesnika. Terapijska ekvivalentnost Krkinih proizvoda s originalnim lijekovima dokazuje se u in vivo studijama bioekvivalencije. Rezultati mnogobrojnih kliničkih studija dokazali su da su naši lijekovi klinički dokazani, učinkoviti i dobro podnošljivi u svakodnevnoj kliničkoj praksi., In the past six decades, Krka has emerged as one of the leading generic pharmaceutical companies in the world. Our innovative generics, i.e. value-added generic medicines, are developed using the company’s own know-how. This ensures that our products hold certain key advantages over competitor products, resulting from the development of new technologies used in the production of active ingredients and dosage forms. Our key therapeutic area in prescription pharmaceuticals is cardiovascular medicines. We offer a wide range of cardiovascular medicines, available in a variety of different dosage forms, fixed-dose combinations and innovative strengths, which enable doctors to optimize the treatment of their patients. The therapeutic equivalence of Krka’s product with the originator’s product is demonstrated by in vivo bioequivalence studies. The results of numerous clinical studies have shown that our medicines are clinically proven, effective, and well tolerated by patients in real clinical practice.

Koronarna bolest srca (KBS) predstavlja vodeći uzrok smrti diljem svijeta. Nažalost, iznenadna srčana smrt je za mnoge pojedince prvi manifestacija KBS. Prevencija idealno počinje primarnom intervencijom u osoba s povećanim rizikom od kardiovaskularnih bolesti (KVB), ali bez klinički manifestne bolesti. Usmjerena je na zbrinjavanje čimbenika rizika, koji uključuju dislipidemiju i artrijsku hipertenziju, koji su odavno utvrđeni kao važni promjenjivi kardiovaskularni (KV) čimbenici rizika. Međutim, postupci primarne prevencije su još uvijek nedovoljni i ne mogu pružiti optimalnu zaštitu od razvoja KVB. Napori u sekundarnoj prevenciji, gdje zbrinjavanje KV čimbenika rizika postaje još važnije, usmjereni su na prevenciju daljnje progresije bolesti koja može dovesti do ponovne pojave KV događaja, pa čak i smrti. Tijekom proteklog desetljeća, klinička dobrobit hipolipemika i antihipertenzivnih lijekova u smislu smanjenja KV rizika je utvrđena u brojnim randomiziranim kontroliranim istraživanjima. Statini su jedina skupina hipolipemika koji poboljšavaju kliničke ishode u bolesnika sa i bez KVB. Oni dokazano smanjuju KV pobol i smrtnost, kao i potrebu za intervencijama na koronarnim arterijama. Dokazi o djelotvornosti perindoprila u smanjenju pojavnosti KV slučaja su dobro utemeljeni. Rezultati studije EUROPA u bolesnika sa stabilnom KBS pružaju jasne dokaze o djelotvornosti perindoprila u sekundarnoj prevenciji. Mogućnosti liječenja zasnovane na dokazima, poput statina i inhibitora angiotenzin konvertirajućeg enzima bi mogle pomoći u smanjenju faktora rizika kod bolesnika sa KVB, a time i osigurati odgovarajuću zaštitu od daljnje progresije ove bolesti., Coronary heart disease (CHD) is the leading cause of death worldwide. Unfortunately, sudden cardiac death is for many individuals the first manifestation of CHD. Prevention ideally begins with primary interventions in persons at increased risk for cardiovascular disease (CVD) but without clinically manifested disease. It is aimed at managing risk factors, including dyslipidemia and hypertension, which have long been established as important modifiable cardiovascular (CV) risk factors. However, primary prevention practices are still inadequate and may provide suboptimal protection against the development of CHD. Efforts in secondary prevention, where the management of CV risk factors becomes even more crucial, are focused on the prevention of further progression of the disease which can result in recurrence of the CV event or even death. Over the past decade, the clinical benefit of lipid-lowering and antihypertensive medicines in terms of CV risk reduction has been established in numerous randomised controlled trials. Statins are the only lipid-lowering medicines which improve clinical outcomes in patients with and without CVD. They have been shown to reduce CV morbidity and mortality as well as the need for coronary artery interventions. Evidence of the efficacy of perindopril in reducing the incidence of CV events is well established. The findings of the EUROPA study in patients with stable CHD provided clear evidence of the efficacy of perindopril in secondary prevention in patients with stable CHD. Evidence-based treatment options, such as statins and angiotensin-converting enzyme inhibitors, could help reduce risk factors in CHD patients and, consequently, provide adequate protection against further progression of the disease.

Dislipidemija je jedan od najvažnijih i najčešćih promjenjivih čimbenika rizika za kardiovaskularne bolesti (KVB). Postoji mnogo različitih hipolipemika, ali do današnjeg dana statini su i dalje ostali jedini lijekovi koji dokazano smanjuju kardiovaskularnu smrtnost i morbiditet u bolesnika sa i bez utvrđene KVB. To je razlog zašto oni su postali temeljna teraoija u smjernicama. U posljednjih nekoliko godina, smjernice za zbrinjavanje dislipidemije i prevenciju KVB predlažu još više smanjenje ciljnih vrijednosti razine lipida. Bile su prihvaćene na temelju rezultata iz kliničkih studija, uključujući i rezultate iz meta-analiza, što pokazuje da je daljnje sniženje LDL kolesterola rezultiralo dobrobitima, bez novih ili neočekivanih neželjenih nuspojava. Nadalje, kliničke studije su pokazale da čak i malo smanjenje LDL kolesterola ima značajan klinički učinak i da svakim 1% smanjenjem razine LDL kolesterola smanjuje i relativan rizik od velikih manifestacija koronarne bolesti srca za oko 1%. Unatoč poznatim prednostima postizanja ciljnih razina lipida, većina bolesnika, posebice u sekundarnoj prevenciji, ih ne postiže. Statini se obično propisuju u manjim dozama, a često se ne titriraju porastom doze do postizanja terapijskih ciljeva. Posjedovanje cjelovitog asortimana doza može biti jedan od pristupa za poboljšanje uspješnosti u postizanju ciljnih razina lipida u zbrinjavanju hiperlipidemije. To bi moglo pomoći u poboljšanju kliničkih ishoda i pružanju maksimalnih koristi za bolesnike od liječenja statinima za bolesnike., Dyslipidemia is one of the most important and common modifiable risk factors for cardiovascular disease (CVD). There are many different types of lipid lowering medicines, but till this date statins have remained the only medicines proven to reduce cardiovascular mortality and morbidity in patients with and without established CVD. This is why they have become the mainstay of therapeutic guidelines. In recent years, guidelines for the management of dyslipidemia and on CVD prevention have mandated even lower target lipid levels. These were accepted based on the results from clinical studies, including the results of meta-analyses, which demonstrated that further lowering of LDL cholesterol produced additional benefits, without new or unexpected safety issues. Moreover, clinical studies have shown that even a small reduction of LDL cholesterol has a significant clinical effect and that every 1% reduction in the LDL cholesterol level reduces the relative risk for major coronary heart disease events by approximately 1%. Despite the known benefits of reaching target lipid levels, the majority of patients, especially in secondary prevention, are not reaching them. Statins are usually prescribed at lower doses and often not up-titrated to achieve the therapeutic goals. Having a complete range of doses can be one of the approaches to improve the success rate in reaching target lipid levels in the management of hyperlipidemia. It could help improve clinical outcomes and provide maximum benefits of statin treatment for the patients.

Čimbenike rizika čine stanja ili navike koje povećavaju rizik nastanka bolesti. Čimbenici rizika, poput arterijske hipertenzije, pušenja, povišene vrijednosti kolesterola i dijabetesa, značajno doprinose razvoju kardiovaskularnih bolesti koje su vodeći uzrok smrtnosti i pobola u industrijaliziranim zemljama. Inhibitori angiotenzin konvertirajućeg enzima smanjuju rizik od kardiovaskularnih događaja kod pacijenata sa svim razinama rizika. Brojne kliničke studije su već dokazale učinkovitost i sigurnost ramiprila u liječenju hipertenzije. Rezultati studije HOPE su već ukazali na jasne vaskularne i metaboličke prednosti terapije ramiprila. Ove prednosti su dosljedne bez obzira na prisutne čimbenike rizika bolesnika ili primjenu dodatnih liječenja. Kliničke studije Krkinog ramiprila su potvrdile njegovu učinkovitost u postizanju ciljnih razina arterijskog tlaka i ukazale na dodatne koristi kod visokorizičnih bolesnika., Risk factors are conditions or habits that increase the risk of developing a disease. Risk factors such as hypertension, smoking, high cholesterol and diabetes contribute significantly to the development of cardiovascular diseases. Cardiovascular diseases are the major cause of mortality and morbidity in industrialised countries. Angiotensin-converting enzyme inhibitors reduce the risk of cardiovascular events in patients at all levels of risk. Numerous clinical studies have already proved the efficacy and safety of ramipril in hypertension treatment. The results of the HOPE study also demonstrated clear vascular and metabolic benefits of ramipril therapy. These benefits were consistent regardless of the patients’ risk factors or additional treatments. Clinical studies with Krka’s ramipril confirmed its efficacy in achieving target blood pressure levels and demonstrated its various additional benefits in high-risk patients.

Kardiovaskularne bolesti (KVB) su i dalje vodeći uzrok globalnog mortaliteta te uzrokuju gotovo polovicu smrti u Europi. Istraživanja pokazuju da dislipidemija predstavlja jedan od najznačajnijih čimbenika rizika koji doprinose razvoju KVB. U kolovozu 2011. god. Europsko kardiološko društvo i Europsko društvo za aterosklerozu objavili su nove smjernice za liječenje pacijenata s dislipidemijama, koje snižene razine LDL kolesterola i dalje smatraju primarnim ciljem liječenja. Smjernice preporučaju propisivanje terapije statinima do najviše moguće doze ili najviše podnošljive doze kako bi se dosegla ciljna razina LDL kolesterola. Nekoliko kliničkih studija potvrdilo je učinkovitost i sigurnost atorvastatina u kliničkoj praksi kod širokog spektra bolesnika. Studija Anglo Scandinavian Cardiac Outcomes Trial – Lipid-Lowering Arm (ASCOT-LLA) je ukazala da smanjenje velikih kardiovaskularnih događaja primjenom atorvastatina može omogućiti dugoročnu dobrobit na ukupnu smrtnost. Krka je posvećena kontinuiranoj procjeni učinkovitosti i sigurnosti svojih proizvoda., Cardiovascular disease (CVD) still remains the leading cause of global mortality and causes nearly half of all deaths in Europe. Research shows that among many risk factors contributing to the development of CVD, dyslipidemia is one of the most significant. In August 2011, the European Society of Cardiology and the European Atherosclerosis Society released new guidelines for the management of patients with dyslipidemias, which consider low LDL cholesterol levels still as the primary treatment target. The guidelines recommend physicians prescribe statin therapy up to the highest dose possible or the highest tolerable dose to reach the target LDL cholesterol level. Several clinical studies confirmed the efficacy and safety of atorvastatin in clinical practice in a wide range of patients. The Anglo Scandinavian Cardiac Outcomes Trial – Lipid-Lowering Arm (ASCOT-LLA) has demonstrated that reductions in major cardiovascular events with atorvastatin may contribute to long-term benefits on all-cause mortality. Krka is dedicated to continuously evaluate the efficacy and safety of its products.

Hypertension is a major cardiovascular and cerebrovascular risk factor and is highly prevalent throughout the world, affecting 50% of people over 60 years of age. Angiotensin-converting enzyme (ACE) inhibitors are the gold standard in the treatment of hypertension. However, there exist important differences among the available ACE inhibitors. Perindopril is distinguished based on specific characteristics, such as long duration of action, 24-hour blood pressure control, high lipophilicity, and high tissue ACE affinity. Moreover, clinical studies investigating the effects of perindopril on morbidity and mortality have provided evidence of its benefits along cardiovascular disease continuum. Since inappropriate treatment was one of the most important reasons for the inadequate blood pressure control, the high efficacy and safety of Perineva® (Krka’s perindopril) and its availability in a variety of dosage forms, strengths and fixed-dose combinations might facilitate the management of hypertension and improve compliance among the Croatian patients

The risk factors for cardiovascular diseases (CVD) include hypertension, diabetes and dyslipidemia. Therefore, the modern guidelines for CVD prevention suggest several steps to reduce these risk factors, including pharmacological treatment. Numerous clinical studies demonstrated benefits of cholesterol level reduction in hypertensive patients. It was shown that concomitant treatment of hypertension and dyslipidemia significantly reduced CVD risk in comparison with blood pressure or blood cholesterol reduction alone. Clinical studies with Krka’s atorvastatin also demonstrated the efficacy and safety of lipid-lowering therapy in hypertensive patients with dyslipidemia. It is well known that the risk for atherosclerotic cardiovascular disease in diabetic patients is increased two to fourfold. Clinical studies demonstrated that statin treatment was also beneficial in diabetic patients. Similarly, sub-analyses of studies in diabetic patients treated with Krka’s atorvastatin proved the advantages of such treatment, as well as its safety. Thus, reducing high blood cholesterol levels in hypertensive and diabetic patients clearly brings additional benefits for the patients.

Hypertension is a major health problem in the world. One in every three adults has high blood pressure (BP). The excessive pressure on the artery walls caused by high BP can damage blood vessels, as well as organs in the body. Uncontrolled high BP can lead to different complications. Hypertension is accompanied by cardiovascular risk factors, such as diabetes, previous myocardial infarction or stroke, dyslipidemia, obesity or proven vascular disease, in at least twothirds of all cases. Today’s treatment of hypertension is very challenging, especially in patients with enhanced cardiovascular risk, where a multiple pharmacological approach is often required to achieve an acceptable BP goal. Ramipril is a lipophilic ACE inhibitor suitable for once-daily administration. It effectively reduces peripheral vascular resistance, thus regulating high BP. In combination with hydrochlorothiazide, it produces a synergetic effect, which increases the efficacy and safety of both drugs. Ramipril has been studied in numerous clinical studies. Also the efficacy and safety of Krka’s ramipril (Ampril®) have been studied in several clinical and post-authorisation safety and efficacy studies. Krka’s ramipril is offered in a variety of dosage forms, strengths and fixed-dose combinations

Akutni koronarni sindrom (AKS) predstavlja veliki problem sustava zdravstvene skrbi obzirom da je godinama uzrok velikog broja hospitalizacija. Kako AKS može biti s po život opasno tanje, potrebna je pravodobna odluka o farmakološkom liječenju, kao i strategijama revaskularizacije. Postoje čvrsti dokazi o učinkovitosti i dobroj podnošljivosti klopidogrela, antitrombocitnog lijeka za sekundarnu prevenciju ishemijskih događaja kod pacijenata s različitim kardiovaskularnim bolestima, uključujući i one s AKS. Dokazi o učinkovitosti i sigurnosti postoje i za antitrombocitni lijek Zyllt® (Krkin klopidogrel), a temelje se na rezultatima mnogih studija sigurnosti i učinkovitosti koje su provedene nakon odobrenja lijeka. Ove studije donijele su važne rezultate i opsežnu bazu podataka koja nije dostupna niti za jedan drugi generički klopidogrel. Visoka učinkovitost i dobra sigurnost, kao i prihvatljiva cijena, Krkinog klopdogrela mogli bi bez sumnje doprinijeti boljem pridržavanju terapije kod više pacijenata s AKS., Acute coronary syndrome (ACS) is a major problem for healthcare systems, as it is the cause of a large number of hospitalisations every year. Moreover, as ACS may be a life-threatening condition, timely decisions on pharmacological management as well as coronary revascularisation strategies are needed. Clopidogrel has a strong evidence base supporting its use as an effective and well tolerated antiplatelet agent for the secondary prevention of ischemic events in patients with various cardiovascular conditions, including those with ACS. An evidence base demonstrating the efficacy and safety of antiplatelet therapy has also been established for Zyllt® (Krka's clopidogrel) in many post-authorisation safety and efficacy studies. The studies yielded important results and an extensive data base, which is not available for any other generic clopidogrel. The high efficacy and good safety as well as the reasonable price of Krka’s clopidogrel could undoubtedly contribute to a better compliance with the treatment in more patients with ACS.