systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.38109/2075-082X-2023-1-5-19systhiper-774Research ArticleКОНСЕНСУСCONSENSUSАртериальная гипертензия и хроническая болезнь почек: консенсус по ведению пациентовArterial hypertension and chronic kidney disease: consensus statement on patient managementhttps://orcid.org/0000-0002-9822-4357ЧазоваИ. Е.ChazovaI. E.

Чазова Ирина Евгеньевна, д.м.н., проф., акад. РАН, зам. ген. директора по научно-экспертной работе, руководитель отдела гипертонии, НИИ клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, д. 15а, г. Москва 121552, Российская Федерация

тел.: +7(495) 415-52-05

Irina E. Chazova, Dr. Sci. (Med.), Prof., Acad. of RAS, Deputy General Director for Scientific and Expert Work, Head of Hypertension Department, A.L. Myasnikov Research Institute of Cardiology

Academician Chazova str. 15a, Moscow 121552, Russian Federation

c34h@yandex.ruhttps://orcid.org/0000-0002-2028-8748КислякО. А.KislyakO. A.

Кисляк Оксана Андреевна, д.м.н., проф., зав. каф. факультетской терапии лечебного факультета

ул. Островитянова, д. 1, г. Москва 117997, Российская Федерация

Oksana A. Kislyak, Dr. Sci. (Med.), Prof., Head of the Department of Faculty Therapy

Ostrovitianov str. 1, Moscow, 117997, Russian Federation

kisliakoa@mail.ruhttps://orcid.org/0000-0002-0758-5609ПодзолковВ. И.PodzolkovV. I.

Подзолков Валерий Иванович, д.м.н., проф., заведующий кафедрой факультетской терапии №2

ул. Трубецкая, д. 8, стр. 2, г. Москва 119991, Российская Федерация

Valeriy I. Podzolkov, Dr. Sci. (Med.), Prof., head of the Department of Faculty Therapy No. 2

Trubetskaya str. 8, building 2, Moscow 119991, Russian Federation

https://orcid.org/0000-0002-2699-1610БрагинаА. Е.BraginaA. E.

Брагина Анна Евгеньевна, д.м.н., проф. каф. факультетской терапии №2

ул. Трубецкая, д. 8, стр. 2, г. Москва 119991, Российская Федерация

тел.: +7(903)628-94-67

Anna E. Bragina, Dr. Sci. (Med.), Prof. of the Department of Faculty Therapy No. 2

Trubetskaya str. 8, building 2, Moscow 119991, Russian Federation

anna.bragina@mail.ruhttps://orcid.org/0000-0002-0060-095XСиваковаО. А.SivakovaO. A.

Сивакова Ольга Анатольевна, к.м.н., заведующая отделением артериальной гипертонии

ул. Академика Чазова, д. 15а, г. Москва 121552, Российская Федерация

тел.: +7(495) 415-66-09

Olga A. Sivakova, Cand. Sci. (Med.), head of the department of arterial hypertension, A.L. Myasnikov Research Institute of Cardiology

Ostrovitianov str. 1, Moscow, 117997, Russian Federation

+7(495) 415-66-09

https://orcid.org/0000-0002-7381-7818СолнцеваТ. Д.SolntsevaT. D.

Солнцева Татьяна Дмитриевна, аспирант отдела гипертонии НИИ кардиологии им. А.Л. Мясникова

ул. Академика Чазова, д. 15а, г. Москва 121552, Российская Федерация

Tatiana D. Solntseva, postgraduate Of Hypertension Department, A.L. Myasnikov Research Institute of Cardiology

Ostrovitianov str. 1, Moscow, 117997, Russian Federation

tatanasolnceva372@gmail.comhttps://orcid.org/0000-0002-3140-5030ЕлфимоваЕ. М.ElfimovaE. M.

Елфимова Евгения Михайловна, к.м.н., науч. сотр. лаб. апноэ сна отд. гипертонии Института клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, д. 15а, г. Москва 121552, Российская Федерация

Evgenia M. Elfimova, Cand. Sci. (Med.), Researcher, Sleep Apnea Laboratory, Hypertension Department, A.L. Myasnikov Research Institute of Cardiology

Ostrovitianov str. 1, Moscow, 117997, Russian Federation

https://orcid.org/0000-0002-9041-3604ВалиеваЗ. С.ValievaZ. S.

Валиева Зарина Солтановна, к.м.н., старший научный сотрудник отдела легочной гипертензии и заболеваний сердца НИИ клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, д. 15а, г. Москва 121552, Российская Федерация

Zarina S. Valieva, Cand. Sci. (Med.), Senior Researcher, Department of Pulmonary Hypertension and Heart Disease, A.L. Myasnikov Research Institute ofCardiology

Ostrovitianov str. 1, Moscow, 117997, Russian Federation

https://orcid.org/0000-0002-2682-4417ФоминВ. В.FominV. V.

Фомин Виктор Викторович, член-корр. РАН, проф., д.м.н., проректор по инновационной и клинической деятельности, заведующий кафедрой факультетской терапии №1 Института клинической медицины им. Н.В. Склифосовского

ул. Трубецкая, д. 8, стр. 2, г. Москва 119991, Российская Федерация

Viktor V. Fomin, corresponding member of RAS, Prof., Dr. Sci. (Med.), Vice-Rector for Innovation and Clinical Activities, Head of the Department of Faculty Therapy No. 1

Trubetskaya str. 8, building 2, Moscow 119991, Russian Federation

https://orcid.org/0000-0002-5820-1759МироноваО. Ю.MironovaO. Iu.

Миронова Ольга Юрьевна, д.м.н., профессор кафедры факультетской терапии №1 Института клиническоймедицины им. Н.В. Склифосовского

ул. Трубецкая, д. 8, стр. 2, г. Москва 119991, Российская Федерация

Olga Iu. Mironova, Dr. Sci. (Med.), Prof. of the Department of Faculty Therapy No. 1, N.V. Sklifosovsky Institute

Trubetskaya str. 8, building 2, Moscow 119991, Russian Federation

mironova_o_yu@staff.sechenov.ruФГБУ «Национальный медицинский исследовательский центр кардиологии имени академика Е.И. Чазова» Минздрава РоссииРоссияE.I. Chazov National Medical Research Center of CardiologyRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian FederationФГАОУ Первый МГМУ им. И.М. Сеченова (Сеченовский Университет) МЗ РФРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202328032023201519Copyright © Чазова И.Е., Кисляк О.А., Подзолков В.И., Брагина А.Е., Сивакова О.А., Солнцева Т.Д., Елфимова Е.М., Валиева З.С., Фомин В.В., Миронова О.Ю., 20232023Чазова И.Е., Кисляк О.А., Подзолков В.И., Брагина А.Е., Сивакова О.А., Солнцева Т.Д., Елфимова Е.М., Валиева З.С., Фомин В.В., Миронова О.Ю.Chazova I.E., Kislyak O.A., Podzolkov V.I., Bragina A.E., Sivakova O.A., Solntseva T.D., Elfimova E.M., Valieva Z.S., Fomin V.V., Mironova O.I.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/774

Артериальная гипертензия является как причиной, так и результатом прогрессирования хронической болезни почек, которая поражает порядка 10-15% популяции во все мире и распространенность которой неуклонно растет. По мере снижения скорости клубочковой фильтрации, уровень артериального давления закономерно растет. Артериальная гипертензия (АГ) и хроническая болезнь почек (ХБП) являются независимыми и широко известными факторами риска развития сердечно-сосудистых заболеваний, а их сочетание значительно увеличивает заболеваемость и смертность от сердечно-сосудистой патологии. Контроль артериального давления является важнейшим фактором, позволяющим замедлить прогрессирование ХБП

и снизить сердечно-сосудистый риск. В настоящее время в научной среде существует ряд разногласий в отношении целевых уровней артериального давления у пациентов, страдающих ХБП. Немедикаментозные методы лечения позволяют снизить уровень артериального давления в ряде случаев, но не добиться достижения целевых значений. Пациенты с АГ и ХБП нуждаются в проведении комбинированной медикаментозной терапии. Ряд современных препаратов обладают дополнительными кардио- и нефропротективными свойствами и должны рассматриваться как первая линия терапии. Персонализированный подход, основанный на принципах доказательности, позволяет добиться контроля артериального давления, снижая сердечно-сосудистый риск и замедляя прогрессирование ХБП. Данный консенсус обобщает современные данные литературы, а также освещает основные подходы к ведению пациентов с АГ и ХБП.

Arterial hypertension is both the cause and the result of the progression of chronic kidney disease, which affects about 10-15% of the population worldwide and the prevalence of which is steadily increasing. As the glomerular filtration rate decreases, the blood pressure level rises respectively. Arterial hypertension (AH) and chronic kidney disease (CKD) are independent and well-known risk factors for the development of cardiovascular diseases, and their combination significantly increases the incidence and mortality from cardiovascular disease. Blood pressure control is the most important factor in slowing the progression of CKD and reducing cardiovascular risk. Currently, there is a place for discussions in the scientific community regarding the target blood pressure levels in patients suffering from CKD. Non-pharmacological methods of treatment can reduce the level of blood pressure in some cases, but do not help to achieve the target values in most of the cases. Patients with hypertension and CKD need combined drug therapy. Certain modern drugs have additional cardio- and nephroprotective properties and should be considered as the first line of therapy. A personalized approach based on evidence-based principles makes it possible to achieve blood pressure control, reducing cardiovascular risk and slowing the progression of CKD. This consensus summarizes the current literature data, as well as highlights the main approaches to the management of patients with hypertension and CKD.

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