Статья
Антагонисты АТ<sup>1</sup>-рецепторов ангиотензина II, ингибиторы ангиотензин-превращающего фермента в регуляции гемодинамики и активности ренинангиотензин-альдостероновой системы. Фокус на органопротективные эффекты
При длительной активации ренин-ангиотензин-альдостероновой системы (РААС) отмечается вазоконстрикция, повышение общего периферического сопротивления сосудов, гипоперфузия органов и тканей, задержка жидкости, увеличение объема циркулирующей крови, повышение чувствительности миокарда к токсическому влиянию катехоламинов, ремоделирование миокарда и сосудов, развитие миокардиального и периваскулярного фиброза. Снижение активности РААС может быть обеспечено либо подавлением синтеза ангиотензина II, либо блокадой АТ1-рецепторов. Ингибиторы ангиотензин-превращающего фермента (ИАПФ) представляют собой высокоэффективные препараты, широко используемые в лечении сердечно-сосудистых заболеваний: артериальной гипертонии, хронической сердечной недостаточности, ишемической болезни сердца. Основными фармакологическими эффектами ИАПФ являются гемодинамические, нейрогуморальные, антипролиферативные, кардио- и нефропротективный, а также улучшение эндотелиальной функции. Для антагонистов АТ1-рецепторов характерны высокая антигипертензивная эффективность, великолепная переносимость, органопротективные свойства, простота использования и отсутствие значимых взаимодействий с другими лекарствами, что незаменимо в повседневной практике клинициста.
1. Naylin Bissessor and Harvey White. Valsartan in the treatment of heart failure or left ventricular dysfunction after myocardial infarction. Vasc Health Risk Manag 2007; 3(4): 425-30.
2. Ortlepp J.R., Vosberg H.P., Reith S. et al. Genetic polymorphisms in the renin-angiotensin-aldosterone system associated with expression of left ventricular hypertrophy in hypertrophic cardiomyopathy: a study of five polymorphic genes in a family with a disease causing mutation in the myosin binding protein C gene. Heart 2002; 87(3): 270-5.
3. Funatsu H., Yamashita H., Nakanishi Y., Hori S. Angiotensin II and vascular endothelial growth factor in the vitreous fluid of patients with proliferative diabetic retinopathy. Br J Ophthalmol 2002; 86(3): 311-5.
4. Feman S.S., Mericle R.A., Reed G.W. et al. Serum angiotensin converting enzyme in diabetic patients. Am J Med Sci 1993; 305: 280-4.
5. Wagner J., Danser A.H.J., Derkx F.H.M. et al. Demonstration of renin mRNA, angiotensinogen mRNA, and angiotensin converting enzyme mRNA expression in the human eye: evidence for an intraocular renin-angiotensin system. Br J Ophthalmol 1996; 80: 159-63.
6. Мареев В.Ю. Новые достижения в оптимизации лечения хронической сердечной недостаточности. Кардиология 1997; 12: 4-9.
7. Barajas L. Anatomy of the juxtaglomerular apparatus. Am J Physiol 1979; 236 (Renal Fluid Electrolyte Physiol. 5): F240-6.
8. Taugner R., Bührle C.P., Hackenthal E. et al. Morphology of the juxtaglomerular apparatus. Contrib Nephrol 1984; 43: 76-101.
9. Kurtz A., Wagner Ch. Role of nitric oxide in the control of renin secretion. Am J Physiol Renal Physiol 1998; 275: F849-62.
10. Barajas L. Cell-specific protein and gene expression in the juxtaglomerular apparatus. Clin Exp Pharmacol Physiol 1997; 24: 520-6.
11. Hall J.E. Historical perspective of the renin-angiotensin system. Mol Biotechnol 2003; 24: 27-39.
12. Leyssac P.P., Holstein-Rathlou N.H., Skott O. Renal blood flow, early distal sodium, and plasma renin concentrations during osmotic diuresis. Am J Physiol Regulatory Integrative Comp Physiol 2000; 279: R1268-76.
13. Padmanabhan N., Padmanabhan S., Connell J.M. Genetic basis of cardiovascular disease-the renin-angiotensin-aldosterone system as a paradigm. J Renin Angiotensin Aldosterone Syst 2000; 1: 316-24.
14. Hall J.E., Brands M.W., Shek E.W. Central role of the kidney and abnormal fluid volume control in hypertension. J Hum Hypertens 1996; 10: 633-9.
15. Haber E. The role of renin in normal and pathological cardiovascular homeostasis. Brenner & Rector's The Kidney, 7th ed., Saunders, 2004. pp.2118-9.
16. Kobori Н., Nangaku М., Navar G. et al. The Intrarenal Renin-Angiotensin System: From Physiology to the Pathobiology of Hypertension and Kidney Disease. Pharmacol Rev 2007; 59(3): 251-87.
17. Wai Han Yiu, Chi-Jiunn Pan, Robert A Ruef. The angiotensin system mediates renal fibrosis in glycogen storage disease type Ia nephropathy. Kidney Int 2008; 73(6): 716-23.
18. Hollenberg N., Fisher N., Price D. Pathways for angiotensin II generation in intact human tissue: evidence from comparative pharmacological interruption of the renin system. Hypertension 1998; 32: 387-92.
19. Елисеева Ю.Е. Ангиотензин-превращающий фермент, его физиологическая роль Вопр. мед. хим. 2001; 47(1) http://medi. ru/pbmc/8810103.htm УДК 577.152.34
20. Li Q., Zhang J., Pfaffendorf M., van Zwieten P.A. Comparative effects of angiotensin II and its degradation products angiotensin III and angiotensin IV in rat aorta. Br J Pharmacol 1995; 116: 2963-70.
21. Paul M., Mehr A.P., Kreutz R. Physiology of local renin-angiotensin systems. Physiol Rev 2006; 86: 747-803.
22. Navar L.G., Harrison-Bernard L.M., Imig J.D. et al. Renal responses to AT1 receptor blockade. Am J Hypertens 2000; 13: 45S-54.
23. Zhuo J., Moeller I., Jenkins T. et al. Mapping tissue angiotensin-converting enzyme and angiotensin AT1, AT2 and AT4 receptors. J Hypertens 1998; 16: 2027-37.
24. Matsusaka T., Ichikawa I. Biological functions of angiotensin and its receptors. Annu Rev Physiol 1997; 59: 395-412.
25. Williams G.H. Converting-enzyme inhibitors in the treatment of hypertension. N Ensl J Med 1988; 319: 1517-25.
26. Kostis J.B. Angiotensin-converting enzyme inhibitors. Emerging differences and new compounds. Am J Hypertens 1989; 2: 57-64.
27. Brown N.J., Vaughan D.E. Angiotensin-converting enzyme inhibitors. Circulation 1998; 97: 1411-20.
28. Dzau V.J., Bernstein K., Celermajer D. et al. The relevance oftissue angiotensin-converting enzyme: manifesiations in mechanistic and endpoint data. Am J Cardiol 2001; 88(9A): 1-20.
29. Dzau V.J. Theodore Cooper Lecture: Tissue angiotensin and pathobiology of vascular disease: a unifying hypothesis. Hypertension 2001; 37(4): 1047-52.
30. Klingbeil A.U., Schneider M., Martus P. et al. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med. 2003; 115(1): 41-6.
31. Brugts J.J., Ferrari R., Simoons M.L. Angiotensin-converting enzyme inhibition by perindopril in the treatment of cardiovascular disease. Expert Rev Cardiovasc Ther 2009; 7(4): 345-60.
32. Horning B., Landmesser U., Kohler C. et al. Comparative effects of ace inhibition and angiotensin II type receptor antagonism on bioavailability of nitric oxide in patients with coronary heart disease: role of superoxide dismutase. Circulation 2001; 103: 799-805.
33. Jackson E.K. Renin and angiotensin. In: Hardman JG, Limbird LE, Editors. The pharmacological basis of therapeutics. 10th Ed. New York; 2001: pp. 809-41.
34. Forclaz A., Maillard M., Nussberger J. et al. Angiotensin II receptor blockade: is there truly a benefit of adding an ACE inhibitor? Hypertension 2003; 41: 31-6.
35. Paul M., Mehr A.P., Kreutz R. Physiology of local renin-angiotensin systems. Physiol Rev 2006; 86: 747-803.
36. Морозова Т.Е., Вартанова О.А., Михайлова Н.В. Возможности коррекции коронарного и миокардиального резервов у больных ишемической болезнью сердца ингибитором ангиотензин-превращающего фермента периндоприлом. Кардиология. 2008; 48(8): 9-15.
37. Klotz S., Danser A.H., Foronjy R.F. et al. The impact of angiotensin-converting enzyme inhibitor therapy on the extracellular collagen matrix during left ventricular assist device support in patients with end-stage heart failure. JACC 2007; 49(11): 1175-7.
38. Galderisi M., de Divitiis O. Risk factor-induced cardiovascular remodeling and the effects of angiotensin-converting enzyme inhibitors. J Cardiovasc Pharmacol 2008; 51(6): 523-31.
39. Weir M.R. Effects of renin-angiotensin system inhibition on endorgan protection: can we do better? Clin Ther 2007; 29(9): 1803-24.
40. Peng H., Carretero, O. Vuljaj N. et al. Angiotensin-Converting Enzyme Inhibitors: A New Mechanism of Action. Circulation 2005; 112(16): 2436-45.
41. Deblois D., Tea B.S., Beaudry D., Hamet P. Regulation of therapeutic apoptosis: a potential target in controlling hypertensive organ damage. Can J Physiol Pharmacol 2005; 83(1): 29-41.
42. Matsuda H., Hayashi K., Wakino S. et al. Role of endothelium-derived hyperpolarizing factor in ACE inhibitor-induced renal vasodilation in vivo. Hypertension 2004; 43(3): 603-9. Epub 2004 Feb 9.
43. Levey A.S., Coresh J., Balk E. et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003; 139: 137-47.
44. Jacoby D.S., Rader D.J. Renin-angiotensin system and atherothrombotic disease: from genes to treatment. Arch Inter Med 2003;163(10): 1155-64.
45. Dagenais G.R., Pogue J., Fox K. et al. Angiotensin-converting-enzyme inhibitors in stable vascular disease without left ventricular systolic dysfunction or heart failure: a combined analysis of three trials. Lancet 2006; 368 (9535): 581-8.
46. Chobanian A.V., Bakris G.L., Black H.R. et al. The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. JAMA 2003; 289: 2560-72.
47. Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet 2003; 362: 1527-35.
48. Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events in individuals with and without diabetes mellitus: results of prospectively-designed overviews of randomised trials. Arch Intern Med 2005; 165: 1410-9.
49. Maschio G., Alberti D., Locatelli F. et al. The ACE Inhibition in Progressive Renal Insufficiency (AIPRI) Study Group Angiotensin-converting enzyme inhibitors and kidney protection: the AIPRI trial J Cardiovasc Pharmacol 1999; 33 Suppl 1: S16-20.
50. EUCLID Study Group. Randomised placebo-controlled trial of lisinopril in normotensive patients with insulin dependent diabetes and normalbuminuria. Lancet 1997; 349: 1787-92.
51. Chaturvedi N., Sjolie A.K., Stephenson J.M. et al. Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. The EUCLID Study Group. EURODIAB Controlled Trial of Lisinopril in Insulin-Dependent Diabetes Mellitus. Lancet 1998; 351(9095): 28-31.
52. Agardh C.D., Garcia-Puig J., Charbonnei В. et al. Greater reduction of urinary albumin excretion in hypertensive type II diabetic patients with incipient nephropathy by lisinopril than by nifedipine. J Hum Hypertens 1996; 10: 185-92.
53. Lewis E.J., Hunsicker L., Вain R. et al. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med 1993; 329: 1456-62.
54. Diercks G.F., Janssen W.M., van Boven A.J. Rationale, design, and baseline characteristics of a trial of prevention of cardiovascular and renal disease with fosinopril and pravastatin in nonhypertensive, nonhypercholesterolemic subjects with microalbuminuria (the Prevention of REnal and Vascular ENdstage Disease Intervention Trial). Am J Cardiol 2000; 86(6): 635-8.
55. Ruggenenti Р., Perna A., Gherardi G. et al. Renoprotective properties of АСЕ inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet 1999; 354: 359-64.
56. Ruggenenti Р., Реrnа А., Gherardi G. et al. Renal function and requirement for dialysis in chronic nephropathy patients on long-term ramipril: REIN follow-up. Lancet 1998; 352: 1252-6.
57. Bosch J., Yusuf S., Pogue J. et al. HOPE Investigators. Use of ramipril in preventing stroke: double blind randomised trial. BMJ 2002; 324: 699-702.
58. Wood D., De Backer G., Faergeman O. et al. for the Second Joint Task Force of European and other Societies-ton Coronary Prevention: European Society of Cardiology, European Atherosclerosis Society, European Society of Hypertension, International Society of Behavioural Medicine, European Society of General Practice/Family Medicine, European Network. Prevention of coronary heart disease in clinical practice. Eur Heart J 1 998: 19: 1434-503.
59. De Backer G., Ambrosioni E., Borch-Johnses K. et al. European guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2003; 24: 1601-10.
60. Collaborative Group Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 1033-41.
61. Wing L.M., Reid C.M., Ryan P. et al. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N Engf J Med 2003; 348(7): 583-92.
62. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. JAMA 2002; 288: 2981-97.
63. Rossing P., Parvingan H.-H., de Zeeuw D. Renoprotection by blocking the RAAS in diabetic nephropathy-fact or fiction? Nephrology Dialysis Transplantation 2006; 21(9): 2354-7.
64. Сидоренко Б.А., Преображенский Д.В. Блокаторы АТ-ангиотензиновых рецепторов. Москва 2001. Карпов ЮА. Блокаторы ангиотензиновых рецепторов: обоснование нового направления терапии в современной кардиологии. РМЖ 2000; 5.
65. Карпов Ю.А. Блокаторы ангиотензиновых рецепторов: обоснование нового направления терапии в современной кардиологии. РМЖ 2000; 5. http://www.rmj.ru/articles_1568.htm
66. De Gasparo M., Levens N. Does blockade of angiotensin II receptors offer clinical benefits over inhibition of angioten-converting enzyme? Pharmacol Toxicol 1998; 82: 257-71.
67. Barone F.C., Coatney R.W., Chandra S. et al. Eprosartan reduces cardiac hypertrophy, protects heart and kidney, and prevents early mortality in severely hypertensive stroke-prone rats. Cardiovasc Res 2001; 50(3): 525-37.
68. Kjeldsen S.E., Lyle P.A., Kizer J.R. et al. Fixed combination of losartan and hydrochlorothiazide and reduction of risk of stroke. Vasc Health Risk Manag 2007; 3(3): 299-305.
69. Hoieggen A., Alderman M.H., Kjeldsen S.E. et al. The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int 2004; 66(4): 1714-5.
70. Dahlof B., Devereux R.B., Kjeldsen S.E. et al. Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002; 359: 995-1003.
71. Pohl M.A., Blumenthal S., Cordonnier D.J. et al. Independent and additive impact of blood pressure control and angiotensin II receptor blockade on renal outcomes in the irbesartan diabetic nephropathy trial: clinical implications and limitations. J Am Soc Nephrol 2005; 16(10): 3027-37.
72. Persson F., Rossing P., Hovind P. et al. Irbesartan treatment reduces biomarkers of inflammatory activity in patients with type 2 Diabetes and microalbuminuria: an IRMA 2 substudy. Diabetes 2006; 55(12): 3550-5.
73. Lozano J.V., Llisterri J.L., Aznar J. et al. Losartan reduces microalbuminuria in hypertensive microalbuminuric type 2 diabetics. Nephrol Dial Transplant 2001; 16(Suppl 1): 85-9.
74. Remuzzi G., Ruggenenti P., Perna A. et al; RENAAL Study Group. Continuum of renoprotection with losartan at all stages of type 2 diabetic nephropathy: a post hoc analysis of the RENAAL trial results. J Am Soc Nephrol 2004; 15(12): 3117-25.
75. Eijkelkamp W.B., Zhang Z., Remuzzi G. et al. Albuminuria is a target for renoprotective therapy independent from blood pressure in patients with type 2 diabetic nephropathy: post hoc analysis from the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) trial. J Am Soc Nephrol 2007; 18(5): 1540-6.
76. Viberti G., Wheeldon N.M. MicroAlbuminuria Reduction With VALsartan (MARVAL) Study Investigators Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus: a blood pressure-independent effect. Circulation 2002; 106: 672-8.
77. Julius S., Kjeldsen S.E., Weber M. et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022-31.
78. Ridker P.M., Danielson E., Rifai N., Glynn R.J. Valsartan, Blood Pressure Reduction, and C-Reactive Protein Primary Report of the Val-MARC Trial. Hypertension 2006; 48: 73-9.