Статья
Выбор блокатора ангиотензиновых рецепторов на разных этапах сердечнососудистого континуума
В статье представлены современные представления о компонентах, физиологических и патофизиологических эффектах ренин-ангиотензин-альдостероновой системы, путях ее гиперактивации на различных этапах сердечно-сосудистого и почечного континуума. Особое внимание уделено блокаторам рецепторов ангиотензина (сартанам). Приведены результаты многоцентровых рандомизированных клинических исследований, проведенных с препаратами данной группы. На основе их анализа определены клинические ситуации, позволяющие врачу сделать выбор в пользу того или иного препарата. Так, предпочтительным для пациентов с множественными факторами риска развития сердечно-сосудистых осложнений является назначение телмисартана, при нефропатии - ирбесартана, перенесшим острый инфаркт миокарда - валсартана, а при клинических признаках хронической сердечной недостаточности с низкой фракцией выброса - лозартана, валсартана и кандесартана.
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