arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2010--2-arthyper-1525Research ArticleОБЗОРREVIEWПовреждение крупных артерий пригипертензииLarge artery damagein hypertensionLaurentS.LaurentS.stephane.laurent@egp.aphp.frBeaussierH.BeaussierH.noemail@neicon.ruCollinC.CollinС.noemail@neicon.ruBoutouyrieP.BoutouyrieP.noemail@neicon.ruUniversité Paris-DescartesRussian Federation201028042010162115125Copyright © Laurent S., Beaussier H., Collin C., Boutouyrie P., 20102010Laurent S., Beaussier H., Collin C., Boutouyrie P.Laurent S., Beaussier H., Collin С., Boutouyrie P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1525

Артериальная жесткость и отражение пульсовой волны, принятые в качестве наиболее важных факторов увеличения систолического и пульсового артериального давления у пожилых людей, отражают повреждение крупных артерий при гипертензии. Эти параметры все чаще используются в клинической практике при оценке состояния пациентов с артериальной гипертензией и различными сердечно-сосудистыми (СС) факторами риска. В обзоре рассматриваются последние достижения в области изучения роли артериальной жесткости и отражения пульсовой волны в патофизиологии и лечении артериальной гипертензии. Также приводятся данные большого числа продольных эпидемиологических исследований, демонстрирующих независимое прогностическое значение артериальной жесткости, каротидного пульсового давления и индекса аугментации в отношении развития сердечно-сосудистых событий, и отмечено, что теперь эти параметры приняты в качестве промежуточных конечных точек СС событий. Мы также обсуждаем влияние фармакологических средств на жесткость аорты и отражение пульсовой волны. Главной проблемой остается вопрос, ассоциировано ли снижение скорости распространения и отражения пульсовой волны с уменьшением числа СС событий у пациентов с артериальной гипертензией и является ли эта связь независимой от нормализации традиционных СС факторов риска.

Arterial stiffness and wave reflections, which are now well accepted as the most important determinants of increasing systolic and pulse pressures in ageing societies, reflect large artery damage in hypertension. These parameters are increasingly used in the clinical assessment of patients with hypertension and various cardiovascular (CV) risk factors. This review addresses recent advances in our understanding of the role played by arterial stiffness and wave reflection in the pathophysiology and treatment of hypertension. We also report a large number of longitudinal epidemiological studies demonstrating the independent predictive value of arterial stiffness, carotid pulse pressure and augmentation index, for cardiovascular events, and show that these parameters are now well accepted as intermediate end-points for CV events. We also discuss the effects of pharmacological agents on aortic stiffness and wave reflections. A remaining major issue is to determine whether a reduction in PWV or wave reflection in hypertensive patients is associated with a concomitant reduction in CV events, independently of the normalization of classical CV risk factors.

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