<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2019-5-46-52</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-2917</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ARTERIAL HYPERTENSION</subject></subj-group></article-categories><title-group><article-title>Новые цели и старые средства лечения артериальной гипертонии</article-title><trans-title-group xml:lang="en"><trans-title>New targets and old therapies for arterial hypertension</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гиляревский</surname><given-names>С. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Gilyarevsky</surname><given-names>S. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гиляревский Сергей Руджерович – д.м.н., профессор кафедры клинической фармакологии и терапии.</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Gilyarevsky Sergei Rudzherovich – Dr. of Sci. (Med.), Professor of Chair for Clinical Pharmacology and Therapy.</p><p> 125993, Russia, Moscow, Barrikadnaya St., 2/1, Bldg. 1. </p></bio><email xlink:type="simple">sgilarevsky@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бенделиани</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Bendeliani</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бенделиани Нана Георгиевна – д.м.н., старший научный сотрудник, научно-консультативное отделение. </p><p>119049, Россия, г. Москва, Ленинский пр-т, д. 8, корп. 4.</p></bio><bio xml:lang="en"><p>Bendeliani Nana Georgievna – Dr. of Sci. (Med.), Senior Researcher, Scientific Advisory Department.</p><p>119049 Russia, Moscow, Volokolamskoe Shosse, 8, Bldg. 4.</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Голшмид</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Golshmid</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Голшмид Мария Владимировна – к.м.н., доцент кафедры клинической фармакологии и терапии. </p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Golshmid Maria Vladimirovna – Cand. of Sci. (Med.), Associate Professor of Chair for Clinical Pharmacology and Therapy.</p><p>125993, Russia, Moscow, Barrikadnaya St., 2/1, Bldg. 1. </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>Г. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharova</surname><given-names>G. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захарова Галина Юрьевна – к.м.н., доцент кафедры клинической фармакологии и терапии.</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Zakharova Galina Yurievna – Cand. of Sci. (Med.), Associate Professor of Chair for Clinical Pharmacology and Therapy.</p><p>125993, Russia, Moscow, Barrikadnaya St., 2/1, Bldg. 1. </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кузьмина</surname><given-names>И. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzmina</surname><given-names>I. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кузьмина Ирина Михайловна – к.м.н., ведущий научный сотрудник отделения неотложной кардиологии. </p><p>129090, Россия, г. Москва, Б. Сухаревская пл., д. 3, стр. 21. </p><p> </p></bio><bio xml:lang="en"><p>Kuzmina Irina Mikhailovna – Cand. of Sci. (Med.), Leading Researcher of Emergency Cardiology Department.</p><p> 129090, Moscow, B. Sukharevskaya Pl., 3, Bldg. 21. </p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Синицина</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Sinitsina</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Синицина Ирина Ивановна – д.м.н., профессор кафедры клинической фармакологии и терапии. </p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Sinitsina Irina Ivanovna – Dr. of Sci. (Med.), Professor of Chair for Clinical Pharmacology and Therapy.</p><p>125993, Russia, Moscow, Barrikadnaya St., 2/1, Bldg. 1. </p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации.</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation.</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Институт коронарной и сосудистой хирургии Федерального государственного бюджетного учреждения «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Министерства здравоохранения Российской Федерации.</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Coronary and Vascular Surgery Institute of the Federal State Budgetary Institution «Bakulev National Medical Research Center for Cardiovascular Surgery» of the Ministry of Health of the Russian Federation.</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Государственное бюджетное учреждение здравоохранения города Москвы «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения города Москвы».</institution><country>Россия</country></aff><aff xml:lang="en"><institution>State Budgetary Healthcare Institution of Moscow «Sklifosovsky Research Institute of Emergency Medicine of the Department of Health of Moscow».</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>02</day><month>04</month><year>2019</year></pub-date><volume>0</volume><issue>5</issue><fpage>46</fpage><lpage>52</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Гиляревский С.Р., Бенделиани Н.Г., Голшмид М.В., Захарова Г.Ю., Кузьмина И.М., Синицина И.И., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Гиляревский С.Р., Бенделиани Н.Г., Голшмид М.В., Захарова Г.Ю., Кузьмина И.М., Синицина И.И.</copyright-holder><copyright-holder xml:lang="en">Gilyarevsky S.R., Bendeliani N.G., Golshmid M.V., Zakharova G.Y., Kuzmina I.M., Sinitsina I.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/2917">https://www.med-sovet.pro/jour/article/view/2917</self-uri><abstract><p>В статье обсуждаются подходы к выбору антигипертензивных препаратов, которые могут быть обусловлены принятием и внедрением в практику новых клинических рекомендаций по тактике ведения больных с артериальной гипертонией. Приводятся данные об эффективности и безопасности применения кандесартана, антигипертензивного препарата, преимущества применения которого были выявлены в ходе выполнения большого числа рандомизированных клинических исследований. Обсуждаются недавно опубликованные данные об эффективности применения более интенсивных режимов антигипертензивной терапии для снижения риска развития умеренных когнитивных расстройств у больных с артериальной гипертонией. В связи с этим приводятся результаты ранее выполненных исследований, в которых предпринималась попытка за счет применения кандесартана повлиять на скорость снижения когнитивных функций у больных с артериальной гипертонией пожилого и старческого возраста. Рассматриваются особенности фармакологических характеристик кандесартана, которые могут, хотя бы отчасти, объяснить его клиническую эффективность. Приводятся данные экспериментальных исследований кандесартана на животных, которые дополняют представления о возможных эффектах кандесартана.</p></abstract><trans-abstract xml:lang="en"><p>The article discusses approaches to the choice of antihypertensive drugs, which may be based on the adoption and implementation of new clinical guidelines for the management of patients with arterial hypertension. This paper provides data on the efficacy and safety of candesartan, an antihypertensive drug, which advantages were identified during a large number of randomized clinical trials. It discusses the recently published data on the effectiveness of more intensive regimens of antihypertensive therapy to reduce the risk of moderate cognitive impairment in patients with arterial hypertension. In this regard, the authors provide data of the previously completed studies, which showed the effect of candesartan on the rate of cognitive decline in patients with arterial hypertension in the elderly and senile age. The features of the pharmacological characteristics of candesaratan that can remotely explain its clinical efficacy are considered. The data of experimental studies of candesartan in animals, which contribute to the concept of the possible effects of candesartan, are presented.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>артериальная гипертония</kwd><kwd>клинические рекомендации</kwd><kwd>блокаторы рецепторов ангиотензина II</kwd><kwd>кандесартан</kwd></kwd-group><kwd-group xml:lang="en"><kwd>arterial hypertension</kwd><kwd>clinical guidelines</kwd><kwd>angiotensin II receptor blockers</kwd><kwd>candesartan</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Williams B., Mancia G., Spiering W. et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. doi: 10.1093/eurheartj/ ehy339.</mixed-citation><mixed-citation xml:lang="en">Williams B., Mancia G., Spiering W. et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. doi: 10.1093/eurheartj/ ehy339.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Whelton P.K., Carey R.M., Aronow W.S. et al. 2017. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension. 2018;71:e13-e115. doi: 10.1161/ HYP.0000000000000065. 2017.</mixed-citation><mixed-citation xml:lang="en">Whelton P.K., Carey R.M., Aronow W.S. et al. 2017. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension. 2018;71:e13-e115. doi: 10.1161/ HYP.0000000000000065. 2017.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">SPRINT Research Group. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015;373:2103-2116.</mixed-citation><mixed-citation xml:lang="en">SPRINT Research Group. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015;373:2103-2116.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Phillips R.A., Xu J., Peterson L.E. et al. Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension. J Am Coll Cardiol. 2018;71:1601-1610. doi: 10.1016/j.jacc.2018.01.074.</mixed-citation><mixed-citation xml:lang="en">Phillips R.A., Xu J., Peterson L.E. et al. Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension. J Am Coll Cardiol. 2018;71:1601-1610. doi: 10.1016/j.jacc.2018.01.074.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Julius S., Nesbitt S.D., Egan B.M. et al. Feasibility of treating prehypertension with an angiotensinreceptor blocker. N Engl J Med. 2006;354:1685-1697.</mixed-citation><mixed-citation xml:lang="en">Julius S., Nesbitt S.D., Egan B.M. et al. Feasibility of treating prehypertension with an angiotensinreceptor blocker. N Engl J Med. 2006;354:1685-1697.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Lithell H., Hansson L., Skoog I. et al. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hyperens. 2003;21:875-886.</mixed-citation><mixed-citation xml:lang="en">Lithell H., Hansson L., Skoog I. et al. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hyperens. 2003;21:875-886.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Skoog I., Lithell H., Hansson L. et al. Effect of baseline cognitive function and antihypertensive treatment on cognitive and cardiovascular outcomes: Study on COgnition and Prognosis in the Elderly (SCOPE). Am J Hypertens. 2005;18:1052-1059.</mixed-citation><mixed-citation xml:lang="en">Skoog I., Lithell H., Hansson L. et al. Effect of baseline cognitive function and antihypertensive treatment on cognitive and cardiovascular outcomes: Study on COgnition and Prognosis in the Elderly (SCOPE). Am J Hypertens. 2005;18:1052-1059.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Levi Marpillat N., Macquin-Mavier I., Tropeano A.I. et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens. 2013;31:1073-1082.</mixed-citation><mixed-citation xml:lang="en">Levi Marpillat N., Macquin-Mavier I., Tropeano A.I. et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens. 2013;31:1073-1082.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">The SPRINT MIND Investigators for the SPRINT Research Group. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia. A Randomized Clinical Trial. JAMA. 2019;321(6):553561. doi: 10.1001/jama.2018.21442.</mixed-citation><mixed-citation xml:lang="en">The SPRINT MIND Investigators for the SPRINT Research Group. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia. A Randomized Clinical Trial. JAMA. 2019;321(6):553561. doi: 10.1001/jama.2018.21442.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">McMurray J., Ostergren J., Pfeffer M. et al. Clinical features and contemporary management of patients with low and preserved ejection fraction heart failure: baseline characteristics of patients in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme. Eur J Heart Fail. 2003;5(3):261-270.</mixed-citation><mixed-citation xml:lang="en">McMurray J., Ostergren J., Pfeffer M. et al. Clinical features and contemporary management of patients with low and preserved ejection fraction heart failure: baseline characteristics of patients in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme. Eur J Heart Fail. 2003;5(3):261-270.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Swedberg K., Pfeffer M., Granger C. et al. Candesartan in heart failure – assessment of reduction in mortality and morbidity (CHARM): Rationale and design. J Cardiac Failure. 1999;5:276-282.</mixed-citation><mixed-citation xml:lang="en">Swedberg K., Pfeffer M., Granger C. et al. Candesartan in heart failure – assessment of reduction in mortality and morbidity (CHARM): Rationale and design. J Cardiac Failure. 1999;5:276-282.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Pool-Wilson P. Official critique: CHARM results «Do not disappoint». Available at: www.medscape.com.</mixed-citation><mixed-citation xml:lang="en">Pool-Wilson P. Official critique: CHARM results «Do not disappoint». Available at: www.medscape.com.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Cernes R., Mashavi M., Zimlichman R. Differential clinical profile of candesartan compared to other angiotensin receptor blockers. Vasc Health Risk Manag. 2011;7:749-759. doi: 10.2147/VHRM.S22591.</mixed-citation><mixed-citation xml:lang="en">Cernes R., Mashavi M., Zimlichman R. Differential clinical profile of candesartan compared to other angiotensin receptor blockers. Vasc Health Risk Manag. 2011;7:749-759. doi: 10.2147/VHRM.S22591.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Van Liefde I., Vauquelin G. Sartan-AT1 receptor interactions: in vitro evidence for insurmountable antagonism and inverse agonism. Mol Cell Endocrinol. 2009;302:237-243.</mixed-citation><mixed-citation xml:lang="en">Van Liefde I., Vauquelin G. Sartan-AT1 receptor interactions: in vitro evidence for insurmountable antagonism and inverse agonism. Mol Cell Endocrinol. 2009;302:237-243.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Morsing P., Adler G., Brandt-Eliasson U. et al. Mechanistic differences of various AT1-receptor blockers in isolated vessels of different origin. Hypertension. 1999;33:1406-1413.</mixed-citation><mixed-citation xml:lang="en">Morsing P., Adler G., Brandt-Eliasson U. et al. Mechanistic differences of various AT1-receptor blockers in isolated vessels of different origin. Hypertension. 1999;33:1406-1413.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Nasser M., Chedid P., Salami A. et al. Dataset on significant role of Candesartan on cognitive functions in rats having memory impairment induced by electromagnetic waves. Data Brief. 2018 Nov 26;21:2390-2394. doi: 10.1016/j.dib.2018.11.106. eCollection 2018 Dec.</mixed-citation><mixed-citation xml:lang="en">Nasser M., Chedid P., Salami A. et al. Dataset on significant role of Candesartan on cognitive functions in rats having memory impairment induced by electromagnetic waves. Data Brief. 2018 Nov 26;21:2390-2394. doi: 10.1016/j.dib.2018.11.106. eCollection 2018 Dec.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Trofimiuk E., Wielgat P., Braszko J.J. Candesartan, angiotensin II type 1 receptor blocker is able to relieve age-related cognitive impairment. Pharmacol Rep. 2018;70:87-92. doi: 10.1016/j.pharep.2017.07.016.</mixed-citation><mixed-citation xml:lang="en">Trofimiuk E., Wielgat P., Braszko J.J. Candesartan, angiotensin II type 1 receptor blocker is able to relieve age-related cognitive impairment. Pharmacol Rep. 2018;70:87-92. doi: 10.1016/j.pharep.2017.07.016.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
