Статья
НЕБИВОЛОЛ –ОСОБЫЙ БЕТА-АДРЕНОБЛОКАТОР
Хотя в Европе небиволол используется в течение почти 10 лет, этот β-блокатор лишь недавно попал на рынок США. Как и карведилол, небиволол относится к третьему поколению β-блокаторов, обладающих наряду с адреноблокирующими свойствами прямым вазодилатирующим действием. Небиволол имеет наивысшее сродство к β1-рецепторам среди других β-блокаторов и, что особенно существенно, уменьшает эндотелиальную дисфункцию за счёт выраженного стимулирующего влияния на эндотелиальную синтазу оксида азота и антиоксидантных свойств. Поскольку нарушение функции эндотелия играет ключевую роль в патофизиологии артериальной гипертонии, ишемической болезни сердца и хронической сердечной недостаточности, предполагается, что влияние на эндотелий обеспечивает небивололу дополнительное преимущество. У пациентов с хронической обструктивной болезнью лёгких или импотенцией, принимающих небиволол, побочные эффекты, характерные для β-блокаторов, отмечались реже. Однако в целом побочные эффекты небиволола и противопоказания к его применению такие же, как и для других β-блокаторов. Показаны гипотензивный и антиишемический эффект этого препарата и его положительное влияние на гемодинамику и прогноз у пациентов с хронической сердечной недостаточностью. Дальнейшие исследования должны быть направлены на изучение преимуществ небиволола по сравнению с другими препаратами того же класса и, что более важно, на оценку его влияния на прогноз пациентов с артериальной гипертонией.Перевод и публикация статьи осуществлены с разрешения American College of Cardiology и под контролем экспертов ВНОК. Статья Műnzel T, Gori T. Nebivolol. The somewhat-different β-adrenergic receptor blocker впервые опубликована в J Am Coll Cardiol 2009;54:1491–9 © 2009 by the American College of Cardiology Foundation
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