Резистентная артериальная гипертензия: поиск новых подходов к антигипертензивной медикаментозной терапии

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.

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