systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»systhiper-318Research ArticleСТАТЬИARTICLESРациональная фармакотерапия артериальной гипертензии: возможности урапидилаRational pharmacotherapy of hypertension. Urapidil potentialМорозоваТ. Е.MorozovaT. E.temorozova@gmail.comАндрущишинаТ. Б.AndruschishinaT. B.tbraeva@gmail.comШмароваД. Г.ShmarovaD. G.shmarova_dg@mail.ruГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава РоссииRussian Federation2013231220221043843Copyright © Морозова Т.Е., Андрущишина Т.Б., Шмарова Д.Г., 20222022Морозова Т.Е., Андрущишина Т.Б., Шмарова Д.Г.Morozova T.E., Andruschishina T.B., Shmarova D.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/318

Оптимизация фармакотерапии артериальной гипертензии и дифференцированный выбор лекарственных средств остаются актуальной проблемой для практикующего врача. Однако, несмотря на большой выбор эффективных антигипертензивных лекарственных средств, контроль над уровнем артериального давления остается неадекватным. Большинству пациентов необходима комбинированная терапия с использованием двух и более средств для достижения целевых уровней артериального давления, поэтому выбор препаратов 2-й линии терапии имеет особое значение. В качестве дополнительной терапии у пациентов с неконтролируемой артериальной гипертензией могут использоваться a-адреноблокаторы, которые помимо антигипертензивного эффекта обладают рядом других преимуществ, включая улучшение липидного профиля и метаболизма глюкозы, а также уменьшение симптомов доброкачественной гиперплазии простаты. Урапидил оказывает a-блокирующее действие, а также дополнительно проявляет центральный симпатолитический эффект, опосредованный стимуляцией серотониновых 5-HT1A-рецепторов в центральной нервной системе. Доказательная база свидетельствует о том, что препарат обладает выраженным антигипертензивным эффектом в сочетании с благоприятным метаболическим профилем, имеет хороший профиль безопасности и лишен недостатков, свойственных a-адреноблокаторам, в частности развития рефлекторной тахикардии.

Optimizing pharmacotherapy of arterial hypertension (AH) and varied selection of medicines remains an urgent problem for practitioners. However, despite the large variety of effective antihypertensive drugs, the control of blood pressure levels remains inadequate. Most patients require combined therapy with two or more agents to achieve target blood pressure levels, so the choice of second-line therapy is of particular importance. As adjunctive therapy in patients with uncontrolled hypertension a-blockerscan be used, which, in addition to the antihypertensive effect, have a number of other benefits including improved lipid profile and glucose metabolism, as well as reducing the symptoms of benign prostatic hyperplasia. Urapidil provides a-blocking effect and additionally exhibits the central sympatholytic effect which is mediated by stimulation of serotonin 5HT1A-receptor in the central nervous system. The evidence base suggests that the drug has antihypertensive effect in combination with a favorable metabolic profile, and has a good safety profile as well, and has no disadvantages inherent to a-blockers, in particular, the development of reflex tachycardia.

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The authors declare that there are no conflicts of interest present.