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Артериальная гипертензия

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ОПРЕДЕЛЕНИЕ АКТИВНОСТИ РЕНИНА ПЛАЗМЫ КАК СТРАТЕГИЯ ВЫБОРА И ИЗМЕНЕНИЯ АНТИГИПЕРТЕНЗИВНОЙ ТЕРАПИИ

https://doi.org/10.18705/1607-419X-2013-19-5-380-388

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Аннотация

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.

Об авторах

Ю. В. Котовская
Российский университет дружбы народов, Москва
Россия

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).



О. А. Кравцова
Российский университет дружбы народов, Москва
Россия
Аспирант кафедры пропедевтики внутренних болезней РУДН


Е. А. Павлова
Российский университет дружбы народов, Москва
Россия
Ассистент кафедры пропедевтики внутренних болезней РУДН


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Для цитирования:


Котовская Ю.В., Кравцова О.А., Павлова Е.А. ОПРЕДЕЛЕНИЕ АКТИВНОСТИ РЕНИНА ПЛАЗМЫ КАК СТРАТЕГИЯ ВЫБОРА И ИЗМЕНЕНИЯ АНТИГИПЕРТЕНЗИВНОЙ ТЕРАПИИ. Артериальная гипертензия. 2013;19(5):380-388. https://doi.org/10.18705/1607-419X-2013-19-5-380-388

For citation:


Kotovskaya Y.V., Kravtsova O.A., Pavlova E.A. PLASMA RENIN ASSESSMENT AS THE STRATEGY OF HYPERTENSION MANAGEMENT. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2013;19(5):380-388. (In Russ.) https://doi.org/10.18705/1607-419X-2013-19-5-380-388

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