arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2026-2618BYQTHLarthyper-2618Research ArticleСтатьиArticlesАртериальная жесткость как мишень для терапии: от патофизиологических механизмов к выбору антигипертензивного препаратаArterial stiffness as a therapeutic target: from pathophysiological mechanisms to the selection of antihypertensive agentshttps://orcid.org/0000-0002-3786-9995СеменкинА. А.SemenkinA. A.

Семенкин Александр Анатольевич — доктор медицинских наук, профессор кафедры внутренних болезней и семейной медицины ДПО

ул. Ленина, д. 12, Омск, 644099

Тел.: +7 (3812) 49-20-85

Alexander A. Semenkin, MD, PhD, DSc, Professor, Professor at the Internal Diseases and Family Medicine Department of Postgraduate education,

12 Lenina str., Omsk, 644099

Phone: +7 (3812) 49-20-85

asemyonkin@mail.ruhttps://orcid.org/0009-0003-3721-4379КанунниковаО. И.KanunnikovaO. I.

Канунникова Олеся Игорьевна — кандидат медицинских наук, доцент кафедры внутренних болезней и семейной медицины ДПО

Омск

Olesya I. Kanunnikova, MD, PhD, Internal Diseases and Family Medicine Department of Postgraduate Education

Omsk

lesia.tch@yandex.ruhttps://orcid.org/0009-0005-7149-249XЖивиловаЛ. А.ZhivilovaL. A.

Живилова Лилия Анатольевна — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней

Омск

Liliya A. Zhivilova, MD, PhD, Associate Professor, Department of Diagnostics of Internal Diseases

Omsk

liliya.zhivilova@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Омский государственный медицинский университет»РоссияOmsk State Medical UniversityRussian Federation202625092026323263277Copyright © Семенкин А.А., Канунникова О.И., Живилова Л.А., 20262026Семенкин А.А., Канунникова О.И., Живилова Л.А.Semenkin A.A., Kanunnikova O.I., Zhivilova L.A.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/2618

Настоящий обзор посвящен современным представлениям о роли артериальной жесткости в развитии сердечно-сосудистых заболеваний и ее значении для клинической практики. В статье подробно проанализированы основные патофизиологические механизмы сосудистого ремоделирования, лежащие в основе повышения ригидности сосудистой стенки. Показан вклад ключевых факторов риска в увеличение сосудистой жесткости, обсуждается прогностическая значимость этого показателя. Особое внимание уделено взаимосвязи между жесткостью артерий и параметрами артериального давления (АД), включая его вариабельность. Рассмотрена проблема коморбидности у пациентов с артериальной гипертензией (АГ), в том числе влияние хронического болевого синдрома и приема нестероидных противовоспалительных препаратов на состояние сосудистой стенки и эффективность антигипертензивной терапии. Проанализированы возможности различных классов антигипертензивных препаратов с точки зрения их способности не только контролировать уровень АД, но и влиять на эластические свойства артерий. Рассмотрены подходы к выбору терапевтических стратегий, направленных на коррекцию сосудистой жесткости для улучшения долгосрочного прогноза у пациентов с высоким сердечно-сосудистым риском.

This review summarizes current understanding of the role of arterial stiffness in the development of cardiovascular diseases and its clinical implications. The article provides a detailed analysis of the main pathophysiological mechanisms of vascular remodeling underlying the increase in arterial wall rigidity. The contribution of key risk factors to the increase in arterial stiffness is demonstrated, and the prognostic significance of this parameter is discussed. Special attention is paid to the relationship between arterial stiffness and blood pressure parameters, including blood pressure variability. The problem of comorbidity in patients with hypertension is addressed, including the impact of chronic pain syndrome and nonsteroidal anti-inflammatory drugs on the vascular wall and the effectiveness of antihypertensive therapy. The potential of different classes of antihypertensive agents is analyzed in terms of their ability not only to control blood pressure levels but also to influence the elastic properties of arteries. Approaches to the selection of therapeutic strategies aimed at reducing vascular stiffness are considered, with the goal of improving long-term prognosis in patients with high cardiovascular risk.

жесткость артерийсосудистое ремоделированиевариабельность артериального давленияантигипертензивная терапиясердечно-сосудистый рискarterial stiffnessvascular remodelingblood pressure variabilityantihypertensive therapycardiovascular riskСтатья опубликована при поддержке АО «Сервье».The article was prepared with the support of JSC Servier.ReferencesWorld Health Organization. Cardiovascular diseases (CVDs) [Internet]. WHO; 2021 [обновлено 11 июня 2021; цитировано 30 марта 2026]. Доступно по: https://www.who.int/ru/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)World Health Organization. Cardiovascular diseases (CVDs) [Internet]. WHO; 2021 [обновлено 11 июня 2021; цитировано 30 марта 2026]. Доступно по: https://www.who.int/ru/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)Lacolley P, Regnault V, Laurent S. Mechanisms of arterial stiffening: from mechanotransduction to epigenetics. 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The authors declare that there are no conflicts of interest present.