systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.38109/2075-082X-2022-1-49-54systhiper-7Research ArticleОБЗОРREVIEWСовременные тенденции применения препаратов, блокирующих ренин-ангиотензиновую систему при реноваскулярной артериальной гипертонииCurrent trends in the use of the renin-angiotensin system blocking drugs in renovascular arterial hypertensionhttps://orcid.org/0000-0002-8826-9690ЧихладзеН. М.ChikhladzeN. M.

Чихладзе Новелла Михайловна, д-р мед. наук, ведущий научный сотрудник отдела гипертонии НИИ клинической кардиологии им. А.Л. Мясникова

ул. 3-я Черепковская, д. 15а, г. Москва 121552

Novella M. Chikhladze, Dr. Sci. (Med.), National Medical Research Center of Cardiology

3rd Cherepkovskaya str., 15a, Moscow 121552

novella.cardio@mail.ruФГБУ «Национальный медицинский исследовательский центр кардиологии имени академика Е.И. Чазова» Минздрава РоссииРоссияChazov National Medical Research Center of CardiologyRussian Federation2022161020221914954Copyright © Чихладзе Н.М., 20222022Чихладзе Н.М.Chikhladze N.M.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/7

Реноваскулярная артериальная гипертония (РВАГ) — одна из наиболее распространенных вторичных форм АГ, в большинстве случаев обусловлена атеросклеротическим стенозом почечных артерий (АСПА). Характерно развитие резистентного к антигипертензивной терапии течения АГ с неблагоприятным прогнозом ухудшения функции почек и сердечно-сосудистых осложнений. В обзоре обсуждаются патофизиологические механизмы развития РВАГ при АСПА, обращено внимание на важную роль активации ренин-ангиотензиновой системы (РАС), определяющую характер течения заболевания, высокую частоту поражения органов-мишеней. Рассматриваются современные подходы к медикаментозному лечению этой формы АГ, вопросы обоснованности и преимуществ применения препаратов, блокирующих эффекты РАС, у пациентов с РВАГ атеросклеротического генеза, составляющих категорию высокого риска сердечно-сосудистых осложнений. Обсуждаются вопросы эффективности применения этих препаратов с целью снижения риска сердечно-сосудистых осложнений и улучшения долгосрочного прогноза течения этой формы АГ.

Renovascular hypertension (RH) is one of the most common secondary forms of arterial hypertension, in most cases caused by atherosclerotic renal artery stenosis (ARAS). The development of a course of hypertension resistant to antihypertensive therapy with an unfavorable prognosis of deterioration of kidney function and cardiovascular complications is characteristic. The review discusses the pathophysiological mechanisms of RH development in ARAS, draws attention to the important role of the renin-angiotensin system (RAS) activation, which determines the nature of the course of the disease, the high frequency of target organ damage. Modern approaches to the drug treatment of this form of hypertension, the validity and benefits of the use of drugs that block the effects of RAS in patients with RH of atherosclerotic genesis, constituting a category of high risk of cardiovascular complications, are The issues of the effectiveness of the use of these drugs in order to reduce the risk of cardiovascular complications and improve the long-term prognosis of the course of this form of hypertension are discussed.

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