russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2024-5924VPKVJTrussjcardiol-5924Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONАртериальная гипертония и жесткость артериальной стенки в клинической практике: обзор литературыHypertension and arterial wall stiffness in clinical practice: literature reviewhttps://orcid.org/0000-0002-3620-0659ГапонЛ. И.GaponL. I.

д. м. н., профессор, заслуженный деятель науки РФ, научный руководитель отделения артериальной гипертонии и коронарной недостаточности

Tyumen

gapon@infarkta.netТюменский кардиологический научный центр — филиал ФГБНУ Томского национального исследовательского медицинского центра РАНРоссияTyumen Cardiology Research Center — a branch of the Tomsk National Research Medical CenterRussian Federation20242604202429559245924Copyright © Гапон Л.И., 20242024Гапон Л.И.Gapon L.I.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/5924

Артериальная ригидность как маркер субклинического поражения органов-мишеней у больных артериальной гипертонией (АГ) является важным и независимым предиктором смертности и сердечно-сосудистой заболеваемости. В обзоре рассматриваются факторы, способствующие повышению жесткости сосудистой стенки с фокусом на курение, механизмы повышения артериальной ригидности при старении, влияние артериальной жесткости на повышение систолического и пульсового артериального давления (АД). Особое внимание уделяется влиянию пульсового АД на риск сердечно-сосудистых осложнений, прежде всего на частоту инсульта и когнитивных нарушений. Тиазидоподобные диуретики и антагонисты кальция имеют наибольшую доказательную базу в терапии АГ пожилого возраста в связи возможностью снижать систолическое и пульсовое АД, уменьшать артериальную жесткость и положительно влиять на прогноз. Применение комбинированного препарата амлодипин/индапамид ретард способствует более эффективному лечению пациентов АГ пожилого возраста.

Arterial stiffness, as a marker of subclinical target organ damage in patients with hypertension (HTN), is an important and independent predictor of mortality and cardiovascular morbidity. The review examines factors contributing to increased vascular wall stiffness with a focus on smoking, pathogenesis of increased arterial stiffness with aging, and the effect of arterial stiffness on increased systolic and pulse pressure. Particular attention is paid to the effect of pulse pressure on the risk of cardiovascular events, primarily on the incidence of stroke and cognitive impairment. Thiazide-like diuretics and calcium antagonists have the greatest evidence base in HTN treatment in the elderly due to their ability to reduce systolic and pulse pressure, reduce arterial stiffness and have a positive effect on prognosis. The use of amlodipine/indapamide retard combination promotes more effective treatment of elderly patients with HTN.

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