arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2010--2-arthyper-1526Research ArticleОБЗОРREVIEWАртериальная ригидность и центральное давление: новые патофизиологические и лечебные концепцииArterial rigidity and central pressure: novel aspects of pathophysiology and therapyКобалаваЖ. Д.KobalavaZh. D.

Moscow

noemail@neicon.ruКотовскаяЮ. В.KotovskayaYu. V.

Moscow

kotovskaya@bk.ruАхметовР. Е.AkhmetovR. E.

Moscow

noemail@neicon.ruРоссийский университет дружбы народовРоссияPeople’s Friendship University of RussiaRussian Federation201028042010162126133Copyright © Кобалава Ж.Д., Котовская Ю.В., Ахметов Р.Е., 20102010Кобалава Ж.Д., Котовская Ю.В., Ахметов Р.Е.Kobalava Z.D., Kotovskaya Y.V., Akhmetov R.E.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/1526

Сохранение высоких показателей сердечно-сосудистой заболеваемости и смертности, несмотря на широкое использование лечения, направленного на коррекцию классических факторов риска, постоянно стимулирует поиск новых патофизиологических концепций для улучшения понимания сердечно-сосудистого риска и оптимизации путей его снижения. Поражение органов-мишеней рассматривается как переходная стадия между факторами риска и сердечно-сосудистыми заболеваниями. К вариантам поражения органов-мишеней с доказанной прогностической значимостью как для выделения групп высокого риска, так и в качестве целей терапевтического воздействия, относятся гипертрофия левого желудочка и микроальбуминурия. В последние годы было накоплено большое количество данных, подтверждающих значение артериальной ригидности - скорости распространения пульсовой волны и центрального пульсового давления - как важных независимых предикторов сердечно-сосудистых событий. Эти параметры характеризуют не только поражение органов-мишеней, но и их патогенетические механизмы. Представление об артериальной стенке как о «накопителе» повреждающего воздействия традиционных и других факторов риска легло в основу концепции раннего (преждевременного) старения сосудов и стратегий лечения, направленных на замедление этого процесса.

As cardiovascular morbidity and mortality is still representing a challenge in spite of prevention and all treatment efforts, there is a need for new pathophysiological models for better understanding of cardiovascular risk and its treatment. Target organ damage including left ventricular hypertrophy and microalbuminuria is considered to be a mediating step between risk factors and cardiovascular events. Substantial evidence has been accumulated to show that arterial stiffness and increased pulse wave velocity (PWV), as well as central aortic pulse pressure, are important independent predictors of cardiovascular events, and they reflect not only target organ damage but also the underlying pathological process, because increased PWV might determine the degree of left ventricular mass through increased arterial pulse wave reflection, central pulse pressure, and postload. A concept of early (premature) vascular aging is based on perception of arterial wall as an accumulator of damaging effect of classical and other risk factors. This concept may be potentially useful for potential vascular protective treatment strategies.

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