systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»systhiper-474Research ArticleКАРДИОЛОГИЯCARDIOLOGYРоль бисопролола в ведении пациентов с артериальной гипертензиейThe role of bisoprolol in the management of patients with arterial hypertensionНедогодаС. В.NedogodaS. V.nedogodasv@rambler.ruФГБОУ ВО Волгоградский государственный медицинский университет Минздрава РоссииРоссияVolgograd State Medical University of the Ministry of Health of the Russian FederationRussian Federation2016231220221333234Copyright © Недогода С.В., 20222022Недогода С.В.Nedogoda S.V.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/474

В ряде рекомендаций (NICE, JNC-8, ASH/ISH) по лечению артериальной гипертензии (АГ) β-адреноблокаторы (β-АБ) отнесены на 3-4-е место среди прочих антигипертензивных препаратов (АГП), так как результаты различных метаанализов свидетельствуют об их меньшей антигипертензивной активности в сравнении с другими классами препаратов, худшем влиянии на жесткие конечные точки (особенно у лиц старше 60 лет), повышении риска развития сахарного диабета (прежде всего в комбинации с тиазидными диуретиками), негативном влиянии на эластичность аорты. Однако «новые» β-АБ по ряду ключевых для АГП характеристик (кардиоселективность, амфифильность, длительность действия, метаболическая нейтральность и т.д.) занимают лидирующие позиции. Бисопролол может рассматриваться как препарат выбора у пациентов с АГ в сочетании с ише-мической болезнью сердца (стабильной стенокардией), особенно при тенденции к увеличению частоты сердечных сокращений, у больных с хронической сердечной недостаточностью, причем он эффективен как у пожилых (старше 60 лет), так и у более молодых больных (моложе 60 лет).

According to the different recommendations (NICE, JNC-8, ASH/ISH) concerning the treatment of AH, β-blockers are in 3rd-4th place among the other antihypertensive drugs (AHD), because the results of various meta-analyses show that their antihypertensive activity was less potent in comparison with other classes of drugs, their worst impact on hard endpoints (especially in people over 60). The application of beta-blockers can increase the risk of diabetes mellitus (especially in combination of thiazide-type diuretics) and shows negative effects on aortic elasticity. However, "new" β-blockers occupy leading positions because of number of main AHD characteristics (cardioselectivity, amphiphilicity, duration of action, metabolic neutrality, etc.). Bisoprolol can be regarded as the drug of choice in patients with AH associated with ischemic heart disease (stable angina), especially with the trend towards high heart rate, and in patients with chronic heart failure. Bisoprolol is effective both in elderly patients (people over 60) and in younger one (younger than 60).

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