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Артериальная гипертензия

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Интервенционные подходы к лечению артериальной гипертензии

https://doi.org/10.18705/1607-419X-2015-21-5-450-458

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Аннотация

Несмотря на широкие возможности медикаментозной терапии, необходим поиск новых подходов к лечению артериальной гипертензии (АГ), прежде всего ее резистентных форм. В кратком обзоре представлены последние данные по интервенционным методам лечения АГ. При этом основной акцент сделан не на самом изученном и активно обсуждаемом подходе — радиочастотной аблации симпатических почечных нервов (ренальной денервации), а на методах, находящихся на ранних стадиях разработки: стимуляция каротидных барорецепторов, аблация каротидного тельца, артериовенозная фистула, нейрососудистая декомпрессия, стимуляция спинного и головного мозга. Большинство данных методов влияют на уровень артериального давления опосредованно через модуляцию активности вегетативной нервной системы. Многие из них (например, ренальная денервация и стимуляция каротидных барорецепторов) являются современными модификациями применявшихся еще в прошлом веке методов лечения, в то время как другие (например, стимуляция глубинных структур головного мозга и спинного мозга, артериовенозная фистула) разрабатывались для применения при других заболеваниях. Все эти подходы пока еще очень далеки от широкого применения в клинической практике, требуют дальнейшего изучения эффективности и безопасности в рамках рандомизированных клинических исследований, технической оптимизации и выбора наиболее подходящей популяции или критериев и предикторов эффективности.

Об авторах

Н. Э. Звартау
ФГБУ «СЗФМИЦ им. В.А. Алмазова» Минздрава России
Россия

кандидат медицинских наук, старший научный сотрудник научно-исследовательской лаборатории патогенеза и терапии артериальной гипертензии научно-исследовательского отдела артериальной гипертензии,

ул. Аккуратова, д. 2, Санкт-Петербург, 197341



А. О. Конради
ФГБУ «СЗФМИЦ им. В.А. Алмазова» Минздрава России
Россия

доктор медицинских наук, профессор, заведующая научно-исследовательским отделом артериальной гипертензии, заместитель генерального директора по научной работе,

ул. Аккуратова, д. 2, Санкт-Петербург, 197341



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Для цитирования:


Звартау Н.Э., Конради А.О. Интервенционные подходы к лечению артериальной гипертензии. Артериальная гипертензия. 2015;21(5):450-458. https://doi.org/10.18705/1607-419X-2015-21-5-450-458

For citation:


Zvartau N.E., Konradi A.O. Update on interventional approaches to treatment of hypertension. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2015;21(5):450-458. (In Russ.) https://doi.org/10.18705/1607-419X-2015-21-5-450-458

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