evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2022-2-80-85evrazkar-6324Research ArticleОБЗОРREVIEWРезистентная артериальная гипертензия: так ли это на самом деле или мы что-то упустили?Resistant arterial hypertension: is it really so or have we missed something?https://orcid.org/0000-0001-7293-1144ИонинВ. А.IoninV. A.

Ионин Валерий Александрович, к.м.н., доцент кафедры терапии факультетской с курсом эндокринологии, кардиологии с клиникой им. акад. Г.Ф. Ланга, ст.н.с. НИИССЗ НКИЦа. Scopus Author ID: 57147881300

ул. Льва Толстого, д.6/8, г. Санкт-Петербург 197022

Valerij A. Ionin, Cand. of Sci. (Med.), Associate Professor, Department of Faculty Therapy, senior researcher. Scopus Author ID: 57147881300

6/8 st. Leo Tolstoy, St. Petersburg 197022

ionin.v.a@gmail.comФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияPavlov St-Petersburg State Medical UniversityRussian Federation202228052022028085Copyright © Ионин В.А., 20222022Ионин В.А.Ionin V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/6324

В данной публикации обсуждается актуальность проблемы контроля артериального давления у пациентов с резистентностью к медикаментозной терапии в реальной клинической практике. Представлены данные по распространенности истинной резистентной артериальной гипертензии и клинические особенности пациентов. В то же время, с учетом более широкой распространенности пациентов с псевдорезистентной артериальной гипертензией особое внимание в публикации уделено алгоритмам диагностики, подробно разобраны критерии исключения псевдорезистентной артериальной гипертензии. Представленные современные представления о наиболее частых вторичных причинах артериальной гипертензии, таких как синдром обструктивного апноэ сна, возможности коррекции этого состояния и выбора медикаментозной терапии. Для данной публикации использовались современные рекомендации в стратегии выбора оптимальной антигипертензивной терапии с учетом фармакокинетических свойств и возможности персонализированного выбора в различных клинических ситуациях. Проанализированы данные о преимуществах антигипертензивной терапии с использованием фиксированных комбинаций для повышения приверженности терапии с стратегии контроля артериального давления и снижении риска сердечно-сосудистых рисков. Для поиска данных и материала использованы различные поисковые системы: PubMed, Google академия, Elsevier, информационные ресурсы Российского кардиологического общества и Европейского общества кардиологов.

This publication discusses the relevance of the problem of blood pressure control in patients with resistance to drug therapy in real clinical practice. Data on the prevalence of true resistant arterial hypertension and clinical features of patients are presented. At the same time, taking into account the wider prevalence of patients with pseudo resistant arterial hypertension, special attention is paid to diagnostic algorithms in the publication, and the criteria for excluding pseudo resistant arterial hypertension are analyzed in detail. Presented are modern ideas about the most common secondary causes of arterial hypertension, such as obstructive sleep apnea syndrome, the possibility of correcting this condition and the choice of drug therapy. For this publication, modern recommendations were used in the strategy for choosing the optimal antihypertensive therapy, taking into account the pharmacokinetic properties and the possibility of personalized choice in various clinical situations. We analyzed data on the benefits of antihypertensive therapy using fixed combinations to increase adherence to therapy with a blood pressure control strategy and reduce the risk of cardiovascular risks. Various search engines were used to search for data and material: PubMed, Google Academy, Elsevier, information resources of the Russian Society of Cardiology and the European Society of Cardiology.

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