arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2013-19-5-380-388arthyper-83Research ArticleЛЕКЦИЯLECTUREОПРЕДЕЛЕНИЕ АКТИВНОСТИ РЕНИНА ПЛАЗМЫ КАК СТРАТЕГИЯ ВЫБОРА И ИЗМЕНЕНИЯ АНТИГИПЕРТЕНЗИВНОЙ ТЕРАПИИPLASMA RENIN ASSESSMENT AS THE STRATEGY OF HYPERTENSION MANAGEMENTКотовскаяЮ. В.KotovskayaYu. V.

Доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней РУДН.

Контактная информация: Городская клиническая больница № 64, кафедра пропедевтики внутренних болезней Российского университета дружбы народов, ул. Вавилова, д. 61, Москва, Россия, 117292. E-mail: kotovskaya@bk.ru (Котовская Юлия Викторовна).

Corresponding author: Clinical Hospital № 64, the Department of Internal Diseases Propaedeutics at Russian People’s Friendship University, 61 Vavilov st., Moscow, Russia, 117292. E-mail: kotovskaya@bk.ru (Yulia V. Kotovskaya, MD, PhD, Professor at the Department of Internal Diseases Propaedeutics at Russian People’s Friendship University

kotovskaya@bk.ruКравцоваО. А.KravtsovaO. A.

Аспирант кафедры пропедевтики внутренних болезней РУДН

kotovskaya@bk.ruПавловаЕ. А.PavlovaE. A.

Ассистент кафедры пропедевтики внутренних болезней РУДН

kotovskaya@bk.ruРоссийский университет дружбы народов, МоскваРоссияRussian People’s Friendship University, MoscowRussian Federation201328102013195380388Copyright © Котовская Ю.В., Кравцова О.А., Павлова Е.А., 20132013Котовская Ю.В., Кравцова О.А., Павлова Е.А.Kotovskaya Y.V., Kravtsova O.A., Pavlova E.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/83

В последние годы вновь возник интерес к определению активности ренина плазмы (АРП) как к возможности влияния на тактику выбора и изменения антигипертензивной терапии. Исследование АРП для определения тактики лечения основывается на понимании взаимодействия между ренин-ангиотензин-альдостероновой системой (РААС) и механизмом поддержания водного баланса в организме посредством всасывания натрия почками и задержки жидкости.Определение АРП может ответить на вопрос, какая из систем — первичный участник в повышении артериального давления (АД). Если артериальная гипертензия (АГ) связана с задержкой натрия в организме, то уровень АРП составляет < 0,65 нг/мл/ч. Эти пациенты относятся к низкорениновой объем-зависимой АГ. Если АРП составляет 0,65 нг/мл/ч и более, то развитие АГ связано с чрезмерным высвобождением ренина и активацией РААС. Двойной механизм регуляции АД лежит в основе действия антигипертензивных препаратов, основанного на натрийуретическом эффекте (анти-«объем» препараты) и на противорениновом действии (анти-«ренин» препараты). Определение АРП у пациентов с АГ может помочь как в выборе, так и в добавлении или прекращении приема гипотензивных препаратов с целью улучшения контроля АД при одновременном уменьшении количества применяемых препаратов и их стоимости.

The recent interest to plasma renin activity (PRA) is due to the opportunity of antihypertensive therapy choice that is based on the understanding of the interrelation between renin-angiotensin-aldosterone system (RAAS) and mechanisms of water balance mediated by the renal sodium absorption and water retention. PRA is the way to understand the primary mechanism of blood pressure elevation. PRA < 0,65 ng/ml/h indicates the water retention, and hypertension is considered low-renin and «volume-dependent». If PRA is more than 0,65 ng/ml/h hypertension results from excessive renin secretion and RAAS activation.

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