arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2024-2393XKFDMCarthyper-2393Research ArticleСтатьиArticlesНовые лекарственные средства для лечения резистентной артериальной гипертензии: нестероидный антагонист минералкортикоидных рецепторов финеренон и ингибитор альдостеронсинтазы баксдростатNew drugs for the treatment of resistant hypertension: nonsteroidal mineralcorticoid receptor antagonist finerenone and aldosterone synthase inhibitor baxdrostathttps://orcid.org/0000-0003-3730-3665КузьминО. Б.KuzminO. B.

Кузьмин Олег Борисович — доктор медицинских наук, профессор кафедры фармакологии ФГБОУ ВО ОрГМУ Минздрава России.

Парковый пр., д. 7, Оренбург, 460000

Oleg B. Kuzmin - MD, PhD, DSc, Professor, Department of Pharmacology, Orenburg State Medical University.

7 Park Avenue, Orenburg, 460000

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

Белянин Виталий Васильевич — кандидат медицинских наук, доцент кафедры фармакологии ФГБОУ ВО ОрГМУ Минздрава России.

Парковый пр., д. 7, Оренбург, 460000

Vitaliy V. Belyanin - MD, PhD, Associate Professor, Department of Pharmacology, Orenburg State Medical University.

7 Park Avenue, Orenburg, 460000

Vitbelya@yandex.ruhttps://orcid.org/0000-0002-4431-9641БучневаН. В.BuchnevaN. V.

Бучнева Наталья Викторовна — кандидат медицинских наук, доцент кафедры фармакологии ФГБОУ ВО ОрГМУ Минздрава России.

Парковый пр., д. 7, Оренбург, 460000

Nataliya N. Buchneva - MD, PhD, Associate Professor, Department of Pharmacology, Orenburg State Medical University.

7 Park Avenue, Orenburg, 460000

buzap01@yandex.ruhttps://orcid.org/0000-0003-1321-2101ЖежаВ. В.ZhezhaV. V.

Жежа Владислав Викторович — кандидат медицинских наук, доцент кафедры фармакологии ФГБОУ ВО ОрГМУ Минздрава России.

Парковый пр., д. 7, Оренбург, 460000

Vladislav V. Zhezha - MD, PhD, Associate Professor, Department of Pharmacology, Orenburg State Medical University.

7 Park Avenue, Orenburg, 460000

zhezha56@mail.ruhttps://orcid.org/0000-0001-5021-5964ЛандарьЛ. Н.LandarL. N.

Ландарь Лариса Николаевна — кандидат медицинских наук, доцент кафедры фармакологии ФГБОУ ВО ОрГМУ Минздрава России.

Парковый пр., д. 7, Оренбург, 460000

Larisa N. Landar - MD, PhD, Associate Professor, Department of Pharmacology, Orenburg State Medical University.

7 Park Avenue, Orenburg, 460000

landar@mail.ruhttps://orcid.org/0000-0002-7536-0209СтолбоваМ. В.StolbovaM. V.

Столбова Марина Владимировна — кандидат медицинских наук, доцент, заведующий кафедрой фармакологии ФГБОУ ВО ОрГМУ Минздрава России.

Парковый пр., д. 7, Оренбург, 460000

Marina B. Stolbova - MD, PhD, Associate Professor, Head, Department of Pharmacology, Orenburg State Medical University.

7 Park Avenue, Orenburg, 460000

stolbovam@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Оренбургский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияOrenburg State Medical UniversityRussian Federation202430042024304364372Copyright © Кузьмин О.Б., Белянин В.В., Бучнева Н.В., Жежа В.В., Ландарь Л.Н., Столбова М.В., 20242024Кузьмин О.Б., Белянин В.В., Бучнева Н.В., Жежа В.В., Ландарь Л.Н., Столбова М.В.Kuzmin O.B., Belyanin V.V., Buchneva N.V., Zhezha V.V., Landar L.N., Stolbova M.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2393

Включение спиронолактона в антигипертензивную терапию не обеспечивает контроль артериального давления (АД) у значительной части пациентов с резистентной артериальной гипертензией (АГ) и сопровождается повышенным риском развития гиперкалиемии и осложнений, связанных с блокадой рецепторов мужских и женских половых гормонов. В связи с этим ведется поиск новых лекарственных средств, которые не только способны эффективно контролировать АД в этой популяции пациентов, но и отличаются от своих предшественников более благоприятным профилем безопасности. Наиболее перспективными из них являются новые лекарственные препараты, избирательно подавляющие активность гормональной системы альдостеронсинтаза-альдостерон-минералкортикоидный рецептор, избыточная активность которой лежит в основе формирования резистентной АГ. В обзоре представлены данные об особенностях фармакокинетики и результаты клинических исследований, полученные у пациентов с резистентной АГ при оценке эффективности и безопасности применения нового нестероидного антагониста минералкортикоидных рецепторов финеренона и селективного ингибитора альдостеронсинтазы баксдростата.

The inclusion of spironolactone in antihypertensive therapy does not provide blood pressure (BP) control in the significant proportion of patients with resistant hypertension (HTN) and is accompanied by an increased risk of developing of hyperkalemia and complications associated with blockade of male and female sex hormone receptors. In this regard, a search is underway for new drugs that are not only capable of effectively controlling BP in this population, but also have a more favorable safety profile than their predecessors. The most promising are new drugs that selectively suppress the activity of aldosterone synthase-aldosterone-mineralcorticoid receptor hormonal system, the excessive activity of which underlies the formation of resistant HTN. The review presents data on the characteristics of pharmacokinetics and the results of the clinical studies obtained in patients with resistant HTN when assessing the effectiveness and safety of the use of the new nonsteroidal mineralcorticoid receptor antagonist finerenone and the selective aldosterone synthase inhibitor baxdrostat.

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