arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2025-2516OMVKITarthyper-2516Research ArticleСтатьиArticlesСосудистое старение и изолированная систолическая артериальная гипертензия: научные данные и собственный опыт использования фиксированной комбинации амлодипина и индапамидаVascular aging and isolated systolic hypertension: scientific data and personal experience with the use of a fixed combination of amlodipine and indapamidehttps://orcid.org/0000-0001-6142-0832ГолендяеваП. И.GolendyaevaP. I.

Голендяева Полина Игоревна — врач-кардиолог БУЗОО «ККД».

ул. Лермонтова, д. 41, Омск, 644024

Тел.: +7 (3812) 53–18–90

Polina I. Golendyaeva - MD, Cardiologist, Clinical Cardiology Dispensary.

41 Lermontov str., Omsk, 644024

Phone: +7(3812) 53–18–90

omskcardio@yandex.ruhttps://orcid.org/0000-0001-9339-7024ПриходькоЕ. П.PrihodkoE. P.

Приходько Екатерина Петровна — заведующая отделением медицинской реабилитации БУЗОО «ККД».

644024, Омск, ул. Лермонтова, д. 41

Ekaterina P. Prikhodko - Head, Medical Rehabilitation Department, Clinical Cardiology Dispensary.

Omsk

katy198282@mail.ruhttps://orcid.org/0000-0001-8047-5521КоренноваО. Ю.KorennovaO. Yu.

Кореннова Ольга Юрьевна — доктор медицинских наук, профессор, профессор кафедры факультетской терапии и гастроэнтерологии ФГБОУ ВО «ОмГМУ» Минздрава России.

644024, Омск, ул. Лермонтова, д. 41; 644099, Омск, ул. Ленина, 12

Olga Yu. Korennova - MD, PhD, Professor of the Department of Therapy and Gastroenterology, Omsk State Medical University; Chief Physician, Clinical Cardiology Dispensary.

Omsk

korennova@mail.ruhttps://orcid.org/0000-0003-0149-6119ШкиринецА. В.ShkirinecA. V.

Шкиринец Анастасия Владимировна — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней ФГБОУ ВО «ОмГМУ» Минздрава России; заместитель главного врача по амбулаторно-поликлинической работе БУЗОО «ККД».

644099, Омск, ул. Ленина, д. 12; 644024, Омск, ул. Лермонтова, д. 41

Anastasia V. Shkirinets - MD, PhD, Associate Professor, Department of Internal Medicine Propaedeutics, Omsk State Medical University; Deputy Chief Physician for Outpatient and Out-patient Work, Clinical Cardiology Dispensary.

Omsk

avnelidova@mail.ruhttps://orcid.org/0000-0002-2059-7727ПодольнаяС. П.PodolnayaS. P.

Подольная Светлана Павловна — кандидат медицинских наук, заведующая отделом по клинико-экспертной работе и контролю качества и безопасности медицинской деятельности БУЗОО «ККД».

644024, Омск, ул. Лермонтова, д. 41

Svetlana P. Podolnaya - MD, PhD, Head, Department for Clinical Expertise and Quality Control and Safety of Medical Activities, Clinical Cardiology Dispensary.

Omsk

podolnayasvetlana@mail.ruhttps://orcid.org/0000-0001-7508-6177СтаринскаяС. Н.StarinskayaS. N.

Старинская Снежана Николаевна — заведующая отделением функциональной диагностики БУЗОО «ККД».

644024, Омск, ул. Лермонтова, д. 41

Snezhana N. Starinskaya - MD, PhD, Head, Functional Diagnostics Department, Clinical Cardiology Dispensary.

Omsk

snestar@yandex.ruhttps://orcid.org/0000-0002-1546-0734ШукильЛ. В.ShukilL. V.

Шукиль Людмила Владимировна — кандидат медицинских наук, доцент кафедры фармакологии и клинической фармакологии. ФГБОУ ВО «ОмГМУ» Минздрава России.

644099, Омск, ул. Ленина, д. 12

LyudmilaV. Shukil - MD, PhD, Associate Professor, Department of Pharmacology and Clinical Pharmacology. Omsk State Medical University.

Omsk

guomsk@yandex.ruБУЗОО «Клинический кардиологический диспансер»РоссияClinical Cardiology DispensaryRussian FederationБУЗОО «Клинический кардиологический диспансер»; ФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииРоссияClinical Cardiology Dispensary; Omsk State Medical UniversityRussian FederationФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииРоссияOmsk State Medical UniversityRussian Federation202505082025312164174Copyright © Голендяева П.И., Приходько Е.П., Кореннова О.Ю., Шкиринец А.В., Подольная С.П., Старинская С.Н., Шукиль Л.В., 20252025Голендяева П.И., Приходько Е.П., Кореннова О.Ю., Шкиринец А.В., Подольная С.П., Старинская С.Н., Шукиль Л.В.Golendyaeva P.I., Prihodko E.P., Korennova O.Y., Shkirinec A.V., Podolnaya S.P., Starinskaya S.N., Shukil L.V.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/2516

Артериальная гипертензия (АГ) остается глобальной медико-социальной проблемой, оказывая значительное влияние на сердечно-сосудистую заболеваемость и смертность. Детальное изучение механических и функциональных изменений в стенке артерий, ассоциированных с возрастом, привело к разработке концепций раннего (англ. Early Vascular Aging — EVA-синдром), здорового (англ. Healthy Vascular Aging — HVA) и сверхнормального (англ. SUPERNOrmal Vascular Aging — SUPERNOVA) сосудистого старения. Выявление предикторов и патогенетических механизмов формирования вышеперечисленных фенотипов, а также детерминант прогрессирования артериальной жесткости позволит разработать профилактические и терапевтические стратегии с целью снижения смертности от сердечно-сосудистых заболеваний. При этом не менее значимым является выделение пациентов с уже сформированной артериальной ригидностью и, как следствие, изолированной систолической артериальной гипертензией (ИСАГ) в отдельную группу ввиду необходимости оптимизации лечения данной когорты с целью замедления процессов нарастания жесткости артерий и минимизации нежелательных эффектов гипоперфузии. Таким образом, целью данного литературного обзора стала систематизация накопленных знаний о возможностях замедления процессов сосудистого старения, а также инструментах повышения эффективности и безопасности лечения в группе пациентов с ИСАГ. Представлено клиническое наблюдение за 44 пациентами с ИСАГ, которые проходили лечение на базе бюджетного учреждения здравоохранения Омской области «Клинический кардиологический диспансер» и получали фиксированную комбинацию амлодипин/индапамид. К концу периода наблюдения выявлены высокая приверженность, переносимость и эффективность данной терапии, а также зафиксирована тенденция к снижению артериальной жесткости, оцененной по сердечно-лодыжечному сосудистому индексу (англ. cardio-ankle vascular index — CAVI). Однако определена необходимость в проведении дальнейших исследований для стратификации пациентов с целью выделения когорт, которые потенциально могут получить бóльшую выгоду от использования превентивных вмешательств.

Arterial hypertension (HTN) remains a global medical and social problem, significantly affecting cardiovascular morbidity and mortality. Detailed study of mechanical and functional changes in the arterial wall associated with age has led to the development of the concepts of Early Vascular Aging (EVA syndrome), Healthy Vascular Aging (HVA) and SUPERNOrmal Vascular Aging (SUPERNOVA). Identification of predictors and pathogenetic mechanisms of the phenotypes formation, as well as determinants of arterial stiffness progression, allows developing preventive and therapeutic strategies to reduce mortality from cardiovascular diseases. At the same time, it is no less important to isolate patients with already formed arterial rigidity and, as a consequence, isolated systolic arterial hypertension (ISAH) into a separate group due to the need to optimize the treatment of this cohort in order to slow down the processes of increasing arterial stiffness and minimize the undesirable effects of hypoperfusion. Thus, the purpose of this literature review was to systematize the accumulated knowledge about the possibilities of slowing down the processes of vascular aging, as well as tools to improve the effectiveness and safety of treatment in the group of patients with ISAH. The article presents a clinical observation of 44 patients with ISAH who were treated at the Omsk Region Budgetary Healthcare Institution “Clinical Cardiology Dispensary” and received a fixed combination of amlodipine/indapamide. By the end of the observation period, high adherence, tolerability and effectiveness of this therapy were observed, as well as a trend towards a decrease in arterial stiffness, assessed by the cardio-ankle vascular index (CAVI). However, there is a need for further studies to stratify patients in order to identify cohorts that can potentially benefit more from the use of preventive interventions.

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