Сравнительный анализ блокаторов рецепторов ангиотензина и ингибиторов ангиотензин-превращающего фермента в лечении артериальной гипертензии (обзор литературы)

Abstract

Cardiovascular diseases are still one of the main causes of death and disability among the adult population, the search for optimal pharmacotherapy of arterial hypertension remains an urgent task. The renin-angiotensin-aldosterone system (RAAS) plays a direct role in the pathophysiology of arterial hypertension, being responsible for regulating fluid volume and maintaining water - salt balance. RAAS is also responsible for the processes of tissue growth and differentiation, apoptosis, and affects the synthesis of many neurohumoral factors. By increasing the activity of the RAAS angiotensin II contributes to vasoconstriction, increased secretion of aldosterone and the activity of the sympathetic nervous system, which in turn leads to the development and progression of hypertension. Angiotensin–II receptor blockers (ARBs) block the AT1 subtype receptors of the same name, which is accompanied by vasodilation, a decrease in the secretion of vasopressin and aldosterone. RAAS blockade is an effective modern reliable way to control blood pressure, as well as prevent related complications. angiotensin converting enzyme inhibitors and angiotensin receptor blockers have similar hypotensive effects and a high safety profile. Due to differences in the mechanism of action, when taking angiotensin receptor blockers, the frequency of undesirable side effects is recorded less, and, accordingly, adherence to treatment is greater. One of the modern angiotensin receptor blockers, olmesartan in various studies has demonstrated its superiority over angiotensin-converting enzyme inhibitors (ramipril and perindopril) in the treatment of arterial hypertension. Olmesartan has proven itself both in monotherapy and in combination with a dihydropyridine calcium channel blocker or a thiazide diuretic.