arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2021-27-3-309-317arthyper-2060Research ArticleОБЗОРREVIEWРезистентная артериальная гипертензия: поиск новых подходов к антигипертензивной медикаментозной терапииResistant arterial hypertension: the search of new approaches to antihypertensive drug therapyhttps://orcid.org/0000-0003-3730-3665КузьминО. Б.KuzminO. B.

Кузьмин Олег Борисович — доктор медицинских наук, профессор, заведующий кафедрой фармакологии

Парковый пр., д. 7, Оренбург, 460000

Oleg B. Kuzmin, MD, PhD, DSc, Professor, Head, Department of Pharmacology

7 Park Avenue, Orenburg, 460000

kuzmin.orgma@mail.ruhttps://orcid.org/0000-0001-5021-5964ЛандарьЛ. Н.LandarL. N.

Ландарь Лариса Николаевна — кандидат медицинских наук, доцент кафедры фармакологии

Парковый пр., д. 7, Оренбург, 460000

Larisa N. Landar, MD, PhD, Associate Professor, Department of Pharmacology

7 Park Avenue, Orenburg, 460000

landar@mail.ruhttps://orcid.org/0000-0003-4864-5513СердюкС. В.SerdyukS. V.

Сердюк Светлана Владимировна — кандидат медицинских наук, доцент кафедры фармакологии

Парковый пр., д. 7, Оренбург, 460000

Svetlana V. Serdyuk,  MD,  PhD, Associate  Professor, Department of Pharmacology

7 Park Avenue, Orenburg, 460000

chubsvet@mail.ruhttps://orcid.org/0000-0002-1981-179XБелянинВ. В.BelyaninV. V.

Белянин Виталий Васильевич — кандидат медицинских наук, доцент кафедры фармакологии

Парковый пр., д. 7, Оренбург, 460000

Vitaly V. Belyanin, MD, PhD, Associate Professor, Department of Pharmacology

7 Park Avenue, Orenburg, 460000

vitbelya@yandex.ruhttps://orcid.org/0000-0002-9148-2046ТулинаЛ. М.TulinaL. M.

Тулина Лариса Михайловна — кандидат медицинских наук, доцент кафедры фармакологии

Парковый пр., д. 7, Оренбург, 460000

Larisa M. Tulina, MD, PhD, Associate Professor, Department of Pharmacology

7 Park Avenue, Orenburg, 460000

Tulinalm@mail.ruГосударственное бюджетное образовательное учреждение высшего образования «Оренбургский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияOrenburg State Medical UniversityRussian Federation202122072021273309317Copyright © Кузьмин О.Б., Ландарь Л.Н., Сердюк С.В., Белянин В.В., Тулина Л.М., 20212021Кузьмин О.Б., Ландарь Л.Н., Сердюк С.В., Белянин В.В., Тулина Л.М.Kuzmin O.B., Landar L.N., Serdyuk S.V., Belyanin V.V., Tulina L.M.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/2060

Повышение эффективности лекарственной терапии и снижение риска развития неблагоприятных сердечно-сосудистых и почечных исходов у пациентов с резистентной артериальной гипертензией (АГ) остается нерешенной проблемой кардиологии. Результаты исследований PATHWAY-2, PATHWAY-3 и ReHOT показали клиническую эффективность спиронолактона, амилорида и, в меньшей степени, антиадренергических препаратов клонидина, бисопролола и доксазозина в улучшении контроля артериального давления (АД) в этой популяции больных. Однако включение в антигипертензивную терапию спиронолактона и других исследованных лекарственных средств не обеспечивает достижения целевого уровня АД у значительной части таких пациентов. В обзоре представлены результаты клинических исследований, посвященных поиску новых подходов к повышению эффективности медикаментозной терапии больных с резистентной АГ с использованием ингибиторов натрий-глюкозного котранспортера 2-го типа, ингибиторов аминопептидазы А головного мозга и новых антагонистов рецепторов эндотелина.

Improving the effectiveness of drug therapy and reducing the risk of adverse cardiovascular and renal outcomes in patients with resistant hypertension (HTN) remains an unsolved problem of cardiology. The results of the PATHWAY-2, PATHWAY-3 and ReHOT studies have shown the clinical efficacy of spironolactone, amiloride and, to a lesser extent, the antiadrenergic drugs clonidine, bisoprolol and doxazosin in improving blood pressure (BP) control in this patient population. However, the inclusion of spironolactone and other known drugs in antihypertensive therapy does not ensure the achievement of target BP level in a significant proportion of these patients. The review presents the results of clinical studies of new approaches aimed at increasing the effectiveness of drug therapy in resistant HTN including sodium-glucose cotransporter type 2 inhibitors, brain aminopeptidase A inhibitors, and new antagonists of endothelin receptors.

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Hypertension. 2020;75(4):956–965. doi:10.1161/HYPERTENSIONAHA.119.14504A research study to show the effect of aprocitentan in the treatment of difficult to control (resistant) high blood pressure (hypertension) and find out more about its safety. ClinicalTrials. gov. NCT03541174A research study to show the effect of aprocitentan in the treatment of difficult to control (resistant) high blood pressure (hypertension) and find out more about its safety. ClinicalTrials. gov. NCT03541174

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