russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2021-4221russjcardiol-4221Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWОртостатическая артериальная гипертензия в стратификации сердечно-сосудистого риска у больных гипертонической болезньюOrthostatic hypertension in cardiovascular risk stratification in hypertensive patientshttps://orcid.org/0000-0001-6824-3963ГубареваЕ. Ю.GubarevaE. Yu.

Кандидат медицинских наук, ассистент кафедры факультетской терапии, врач отделения функциональной диагностики.Самара.

Samara.

ekaterina.ju.gubareva@gmail.comhttps://orcid.org/0000-0002-4928-5989ФатенковО. В.FatenkovO. V.

Доктор медицинских наук, главный внештатный специалист министерства здравоохранения Самарской области по терапии и общей врачебной практике, заведующий кафедрой факультетской терапии, доцент.Самара.

Samara.

kdmc@mail.ruhttps://orcid.org/0000-0003-1881-024XГубареваИ. В.GubarevaI. V.

Доктор медицинских наук, заведующая кафедрой внутренних болезней, доцент.Самара.

Samara.

irigub@rambler.ruhttps://orcid.org/0000-0003-1497-6023КлименкоД. A.KlimenkoD. A.

Врач-ординатор кафедры факультетской терапии.Самара.

Samara.

ekaterina.ju.gubareva@gmail.comhttps://orcid.org/0000-0002-9525-987XШванЛ. Ю.ShvanL. Yu.

Старший лаборант кафедры внутренних болезней.Самара.

Samara.

ekaterina.ju.gubareva@gmail.comhttps://orcid.org/0000-0003-4529-5896ЛимареваЛ. В.LimarevaL. V.

Доктор биологических наук, директор НИИ экспериментальной медицины и биотехнологий, доцент.Самара.

Samara.

ekaterina.ju.gubareva@gmail.comСамарский государственный медицинский университет Минздрава РоссииРоссияSamara State Medical UniversityRussian Federation202115032021261SОбразование42214221Copyright © Губарева Е.Ю., Фатенков О.В., Губарева И.В., Клименко Д.A., Шван Л.Ю., Лимарева Л.В., 20212021Губарева Е.Ю., Фатенков О.В., Губарева И.В., Клименко Д.A., Шван Л.Ю., Лимарева Л.В.Gubareva E.Y., Fatenkov O.V., Gubareva I.V., Klimenko D.A., Shvan L.Y., Limareva L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/4221

Артериальная гипертензия (АГ) — важный модифицируемый фактор риска сердечно-сосудистых заболеваний, связанный с неблагоприятными исходами и высокими расходами на здравоохранение. Оценка сердечно-сосудистого риска (ССР), согласно действующим рекомендациям ЕОК/ЕОАГ по лечению больных с АГ, представляет ряд трудностей и инициирует поиск новых диагностических методик, способствующих пониманию фенотипа пациента, персонализации диагностической и лечебной тактики и улучшению исходов пациента с АГ. Регуляторные механизмы, участвующие в формировании ортостатического ответа организма, такие как активация симпатического отдела вегетативной нервной системы, продукция катехоламинов, эндотелиальная функция, вносят существенный вклад в поддержание уровня артериального давления, а их нарушение играет активную роль в формировании АГ, что позволяет рассматривать наличие ортостатической АГ у пациента с АГ в качестве маркера стратификации ССР. В статье обсуждаются диагностические критерии ортостатической АГ, ее патофизиологические механизмы и возможное использование в качестве маркера стратификации ССР.

Hypertension (HTN) is an important modifiable risk factor for cardiovascular disease associated with poor outcomes and high health care costs. The assessment of cardiovascular risk (CVR) according to the current ESC/ESH guidelines for the treatment of hypertensive patients presents a number of difficulties and initiates the search for new diagnostic methods that contribute to understanding the patient's phenotype, personalizing diagnostic and treatment tactics, and improving the outcomes of hypertensive patients. Regulatory mechanisms involved in the body's orthostatic response, such as activation of the sympathetic nervous system, catecholamine production, endothelial function, significantly contributes to maintaining blood pressure levels. Their violation plays an active role in hypertension development, which allows considering orthostatic HTN in a hypertensive patient as a marker of CVR stratification. The article discusses the diagnostic criteria for orthostatic HTN, its pathophysiological mechanisms and possible use as a marker of CVR stratification.

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