cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1037Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONВлияние терапии эналаприлом на развитие тромботических и воспалительных изменений при гипертонической болезниEnalapril therapy and thrombotic and inflammatory abnormalities in essential arterial hypertensionМоисееваО. М.MoiseevaO. M.omoiseeva@front.ruБерковичО. А.BerkovichO. A.omoiseeva@front.ruВиллевальдеС. В.VillevaldeS. V.omoiseeva@front.ruЕмельяновИ. В.EmelyanovI. V.omoiseeva@front.ruНаучно-исследовательский институт кардиологии им. В.А. Алмазова МЗ и РС РФ, Санкт-ПетербургРоссияV.A. Almazov Research Institute of Cardiology, Federal Agency for Health and Social Development, St. PetersburgRussian Federation20052012200546, ч.II3237Copyright © Моисеева О.М., Беркович О.А., Виллевальде С.В., Емельянов И.В., 20052005Моисеева О.М., Беркович О.А., Виллевальде С.В., Емельянов И.В.Moiseeva O.M., Berkovich O.A., Villevalde S.V., Emelyanov I.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1037

Цель. Оценить на фоне терапии эналаприлом перспективы коррекции факторов, предопределяющих развитие артериальных тромбозов и воспалительных изменений в сосудистой стенке у больных гипертонической болезнью (ГБ). Материал и методы. Обследован 21 мужчина с ГБ II стадии. Оценивались результаты ультразвукового исследования сердца, реологические свойства крови, функциональная активность лейкоцитов, уровень фактора Виллебранда и межклеточных молекул адгезии в плазме крови. Повторное обследование больных ГБ выполнено через 24 недели терапии эналаприлом в дозе 10-40 мг/сут. Результаты. На фоне терапии эналаприлом наблюдалось улучшение реологических свойств крови, снижение функциональной активности лейкоцитов, уменьшение концентрации фактора Виллебранда и межклеточных молекул адгезии в плазме крови. Антигипертензивный эффект эналаприла сопровождался регрессом гипертрофии левого желудочка (ГЛЖ). Заключение. У больных ГБ на фоне длительной терапии эналаприлом происходит регресс ГЛЖ и подавление процессов тромбо- и атерогенеза.

Aim. During enalapril therapy in essential arterial hypertension (EAH) patients, to assess correction of the factors determining arterial thrombosis and inflammatory changes in arterial wall. Material and methods. The study included 21 males with Stage II EAH. The authors analyzed cardiac ultrasound data, blood rheology, white blood cell (WBC) functional activity, plasma levels of von Willebrand factor (vWF) and intercellular adhesion molecules (ICAM). The second examination was performed after 24-week enalapril therapy (10-40 mg/d). Results. Enalapril therapy was associated with blood rheology improvement, WBC functional activity decrease, decline in vWF and ICAM plasma levels. Enalapril antihypertensive effect was combined with left ventricular hypertrophy (LVH) regression. Conclusion. In EAH patients, long-term enalapril therapy was associated with LVH regression, thrombo- and atherogenesis suppression.

гипертоническая болезньфункциональная активность клеток кровиэндотелиальная дисфункцияэналаприлessential arterial hypertensionblood cell functional activityendothelial dysfunctionenalaprilReferencesШальнова С.А., Деев А.Д., Оганов Р.Г. и др. Роль систолического и диастолического давления для прогноза смертности от сердечно–сосудистых заболеваний. Кардиоваск тер профил 2002; 1: 10-5Шальнова С.А., Деев А.Д., Оганов Р.Г. и др. Роль систолического и диастолического давления для прогноза смертности от сердечно–сосудистых заболеваний. Кардиоваск тер профил 2002; 1: 10-5Flack JM, Neaton J, Grimm R, et al. Blood Pressure and Mortality Among Men With Prior Myocardial Infarction. Circulation 1995; 92: 2437-45.Flack JM, Neaton J, Grimm R, et al. Blood Pressure and Mortality Among Men With Prior Myocardial Infarction. Circulation 1995; 92: 2437-45.JNC-VII: The seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure. JAMA 2003; 289: 2560-71.JNC-VII: The seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure. JAMA 2003; 289: 2560-71.Lip GY, Blann AD. Does hypertension confer a prothrombotic state? Virchow’s triad revisited. Circulation 2000; 101: 218-20.Lip GY, Blann AD. Does hypertension confer a prothrombotic state? Virchow’s triad revisited. Circulation 2000; 101: 218-20.Lip GY, Blann A. Von Willebrand factor: a marker of endothelial dysfunction in vascular disorders? Cardiovasc Res 1997; 34: 255-65.Lip GY, Blann A. Von Willebrand factor: a marker of endothelial dysfunction in vascular disorders? Cardiovasc Res 1997; 34: 255-65.Becker BF, Heindl B, Kupatt C, Zahler S. Endothelial function and hemostasis. Z Kardiol 2000; 89: 160-7.Becker BF, Heindl B, Kupatt C, Zahler S. Endothelial function and hemostasis. Z Kardiol 2000; 89: 160-7.Lip GYH. Target organ damage and the prothrombotic state in hypertension. Hypertension 2000; 36: 975-7.Lip GYH. Target organ damage and the prothrombotic state in hypertension. Hypertension 2000; 36: 975-7.DeSouza CA, Dengel DR, Macko RF, et al. Elevated levels of circulating cell adhesion molecules in uncomplicated essential hypertension. Am J Hypertens 1997; 10: 1335-41.DeSouza CA, Dengel DR, Macko RF, et al. Elevated levels of circulating cell adhesion molecules in uncomplicated essential hypertension. Am J Hypertens 1997; 10: 1335-41.Bots ML, Hoes AW, Koudstaal PJ, et al. Common carotid intimamedia thickness and the risk of stroke and myocardial infarction: The Rotterdam Study. Circulation 1997; 96: 1432-7.Bots ML, Hoes AW, Koudstaal PJ, et al. Common carotid intimamedia thickness and the risk of stroke and myocardial infarction: The Rotterdam Study. Circulation 1997; 96: 1432-7.Simons PC, Algra A, Bots ML, et al. Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of ARTerial disease). Circulation 1999; 100: 951-7.Simons PC, Algra A, Bots ML, et al. Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of ARTerial disease). Circulation 1999; 100: 951-7.Sander D, Kukla C, Klingelhofer J, et al. Relationship between circadian blood pressure patterns and progression of early carotid atherosclerosis: A 3-year follow-up study. Circulation 2000; 102: 1536-41.Sander D, Kukla C, Klingelhofer J, et al. Relationship between circadian blood pressure patterns and progression of early carotid atherosclerosis: A 3-year follow-up study. Circulation 2000; 102: 1536-41.HOPE Study Investigators. Effects of an angiotensin-converting– enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145-53.HOPE Study Investigators. Effects of an angiotensin-converting– enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145-53.Lonn EM, Yusuf S, Dzavik V, et al. Effects of ramipril and vitamin E on atherosclerosis.The study to evaluate carotid ultrasound changes in patients treated with Ramipril and vitamin E (SECURE). Circulation 2001; 103: 919-25.Lonn EM, Yusuf S, Dzavik V, et al. Effects of ramipril and vitamin E on atherosclerosis.The study to evaluate carotid ultrasound changes in patients treated with Ramipril and vitamin E (SECURE). Circulation 2001; 103: 919-25.Teo KK, Burton JR, Buller CE, et al. Long-term effects of cholesterol lowering and angiotensin-converting enzyme inhibition on coronary atherosclerosis.The simvastatin/enalapril coronary atherosclerosis trial (SCAT). Circulation 2000; 102: 1748-54.Teo KK, Burton JR, Buller CE, et al. Long-term effects of cholesterol lowering and angiotensin-converting enzyme inhibition on coronary atherosclerosis.The simvastatin/enalapril coronary atherosclerosis trial (SCAT). Circulation 2000; 102: 1748-54.MacMahon S, Sharpe N, Gamble G, et al. Randomized, placebo-controlled trial of the angiotensin-converting enzyme inhibitor, ramipril, in patients with coronary or other occlusive arterial disease. PART-2 Collaborative Research Group. Prevention of Atherosclerosis with Ramipril. JACC 2000; 36: 438-43.MacMahon S, Sharpe N, Gamble G, et al. Randomized, placebo-controlled trial of the angiotensin-converting enzyme inhibitor, ramipril, in patients with coronary or other occlusive arterial disease. PART-2 Collaborative Research Group. Prevention of Atherosclerosis with Ramipril. JACC 2000; 36: 438-43.Рекомендации по профилактике, диагностике и лечению артериальной гипертензии. Рекомендации экспертов Всероссийского общества кардиологов (ВНОК). Артериальная гипертензия 2001; 7(приложение 1): 1-16.Рекомендации по профилактике, диагностике и лечению артериальной гипертензии. Рекомендации экспертов Всероссийского общества кардиологов (ВНОК). Артериальная гипертензия 2001; 7(приложение 1): 1-16.Рогоза А.Н., Никольский В.П., Ощепкова Е.В. и др. Суточное мониторирование артериального давления (Методические вопросы). Под ред. Г.Г. Арабидзе, О.Ю.Атькова. Москва 1997; 44с.Рогоза А.Н., Никольский В.П., Ощепкова Е.В. и др. Суточное мониторирование артериального давления (Методические вопросы). Под ред. Г.Г. Арабидзе, О.Ю.Атькова. Москва 1997; 44с.Кобалава Ж.Д., Котовская Ю.В. Мониторирование артериального давления: методические аспекты и клиническое значение. Под ред. В.С.Моисеева. Москва 1999; 234c.Кобалава Ж.Д., Котовская Ю.В. Мониторирование артериального давления: методические аспекты и клиническое значение. Под ред. В.С.Моисеева. Москва 1999; 234c.Devereux RB, Reinchek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977; 55: 613-8.Devereux RB, Reinchek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977; 55: 613-8.Hammond IW, Devereux RB, Alderman MH, et al. Prevalence and correlates of echocardiographic left ventricular hypertrophy among employed patients with uncomplicated hypertension. JACC 1986; 7: 639-50.Hammond IW, Devereux RB, Alderman MH, et al. Prevalence and correlates of echocardiographic left ventricular hypertrophy among employed patients with uncomplicated hypertension. JACC 1986; 7: 639-50.Ашкинази И.Я. Эритроцит и внутреннее тромбопластинобразование. Ленинград «Наука» 1977; 155c.Ашкинази И.Я. Эритроцит и внутреннее тромбопластинобразование. Ленинград «Наука» 1977; 155c.Моисеева О.М., Моисеев С.И., Гуревич В.С. Способ определения деформабельности эритроцитов. Лаб дело 1990; 10: 55-7.Моисеева О.М., Моисеев С.И., Гуревич В.С. Способ определения деформабельности эритроцитов. Лаб дело 1990; 10: 55-7.Wu KK, Hoak JC. A new method for the quantitative detection of platelet aggregates in patients with arterial insufficiency. Lancet 1974; 2: 924-6.Wu KK, Hoak JC. A new method for the quantitative detection of platelet aggregates in patients with arterial insufficiency. Lancet 1974; 2: 924-6.Ley K, Lundgren E, Berger E, Arfors K-E. Shear-dependent inhibition of granulocyte adhesion to cultured endothelium by dextran sulfate. Blood 1989; 73: 1324-30.Ley K, Lundgren E, Berger E, Arfors K-E. Shear-dependent inhibition of granulocyte adhesion to cultured endothelium by dextran sulfate. Blood 1989; 73: 1324-30.Suda K, Rothen-Rutishauser B, Gunthert M, Wunderli-Allenspach H. Phenotypic characterization of human umbilical vein endothelial (ECV304) and urinary carcinoma (T24) cells: endothelial versus epithelial features. In vitro cell dev boil anim 2001; 37: 505-14.Suda K, Rothen-Rutishauser B, Gunthert M, Wunderli-Allenspach H. Phenotypic characterization of human umbilical vein endothelial (ECV304) and urinary carcinoma (T24) cells: endothelial versus epithelial features. In vitro cell dev boil anim 2001; 37: 505-14.Momboli J-V, Vanhoutte PM. Endothelial dysfunction: from physiology to therapy. J Mol Cell Cardiol 1999; 31: 61-74.Momboli J-V, Vanhoutte PM. Endothelial dysfunction: from physiology to therapy. J Mol Cell Cardiol 1999; 31: 61-74.Kikuchi Y, Da QW, Fujino T. Variation in red blood cell deformabilitty and posible consequences for oxygen transpot to tissue. Microvasc Res 1994; 47: 222-31.Kikuchi Y, Da QW, Fujino T. Variation in red blood cell deformabilitty and posible consequences for oxygen transpot to tissue. Microvasc Res 1994; 47: 222-31.Cicco G, Pirrelli A. Red blood cell (RBC) deformability, RBC aggregability and tissue oxygenation in hypertension. Clin Hemorheol Microcirc 1999; 21: 169-77.Cicco G, Pirrelli A. Red blood cell (RBC) deformability, RBC aggregability and tissue oxygenation in hypertension. Clin Hemorheol Microcirc 1999; 21: 169-77.Faller DV. Endothelial responses to hypoxic stress. Clin Exp Pharmacol Physiol 1999; 26: 74-84.Faller DV. Endothelial responses to hypoxic stress. Clin Exp Pharmacol Physiol 1999; 26: 74-84.Ajmani RS. Hypertension and hemorheology. Clin Hemorheol Microcirc 1997; 17: 397-420.Ajmani RS. Hypertension and hemorheology. Clin Hemorheol Microcirc 1997; 17: 397-420.Blann AD, Naqvi T, Waite M, McCollum CN von Willebrand factor and endothelial damage in essential hypertension. J Hum Hypertens 1993; 7: 107-11.Blann AD, Naqvi T, Waite M, McCollum CN von Willebrand factor and endothelial damage in essential hypertension. J Hum Hypertens 1993; 7: 107-11.Blann AD, Nadar S, Lip GY. Pharmacological modulation of platelet function in hypertension. Hypertension 2003; 42: 1-7.Blann AD, Nadar S, Lip GY. Pharmacological modulation of platelet function in hypertension. Hypertension 2003; 42: 1-7.Rosenson RS, Hafner JM. Rheological changes in hypertensive patients treated with ramipril. Clin Hemorheol Microcirc 1997; 17: 41-6.Rosenson RS, Hafner JM. Rheological changes in hypertensive patients treated with ramipril. Clin Hemorheol Microcirc 1997; 17: 41-6.Islim IF, Bareford D, Beevers DS. A single (investigator)-blind randomized control trial comparing the effects of quinapril and nifedipine on platelet function in patients with mild to moderate hypertension. Platelets 2001; 12: 274-8.Islim IF, Bareford D, Beevers DS. A single (investigator)-blind randomized control trial comparing the effects of quinapril and nifedipine on platelet function in patients with mild to moderate hypertension. Platelets 2001; 12: 274-8.Li-Saw-Hee FL, Beevers DG, Lip GY. Effect of antihypertensive therapy using enalapril or losartan on haemostatic markers in essential hypertension: a pilot prospective randomised double-blind parallel group trial. Int J Cardiol 2001; 78: 241-6.Li-Saw-Hee FL, Beevers DG, Lip GY. Effect of antihypertensive therapy using enalapril or losartan on haemostatic markers in essential hypertension: a pilot prospective randomised double-blind parallel group trial. Int J Cardiol 2001; 78: 241-6.Urata H, Kinoshita A, Misono FM, et al. Identification of a highly specific chymase as the major angiotensin II-forming enzyme in the human heart. J Biol Chem 1990; 265: 22348-57.Urata H, Kinoshita A, Misono FM, et al. Identification of a highly specific chymase as the major angiotensin II-forming enzyme in the human heart. J Biol Chem 1990; 265: 22348-57.Фрейдлин И.С., Тотолян А.А. Клетки иммунной системы. Санкт-Петербург «Наука» 2001; III-V: 390с.Фрейдлин И.С., Тотолян А.А. Клетки иммунной системы. Санкт-Петербург «Наука» 2001; III-V: 390с.Mombouli JV, Vanhoutte PM. Kinins and endothelial control of vascular smooth muscle. Ann Rev Pharmacol Toxicol 1995; 35: 679-705.Mombouli JV, Vanhoutte PM. Kinins and endothelial control of vascular smooth muscle. Ann Rev Pharmacol Toxicol 1995; 35: 679-705.Hornig B, Kohler C, Drexler H. Role of bradykinin in mediating vascular effects of angiotensin-converting enzyme inhibitors in humans. Circulation 1997; 95: 1115-8.Hornig B, Kohler C, Drexler H. Role of bradykinin in mediating vascular effects of angiotensin-converting enzyme inhibitors in humans. Circulation 1997; 95: 1115-8.Liebson PR, Grandits GA, Dianzumba S, et al. Comparison of five antihypertensive monotherapies and placebo for change in left ventricular mass in patients receiving nutritional-hygienic therapy in the treatment of mild hypertension study (TOMHS). Circulation 1995; 91: 698-706.Liebson PR, Grandits GA, Dianzumba S, et al. Comparison of five antihypertensive monotherapies and placebo for change in left ventricular mass in patients receiving nutritional-hygienic therapy in the treatment of mild hypertension study (TOMHS). Circulation 1995; 91: 698-706.Schmieder RE, Martus P, Klingbeil A. Reversal of left ventricular hypertrophy in essential hypertension. A meta-analysis of randomized double-blind studies JAMA 1996; 275: 1507-13.Schmieder RE, Martus P, Klingbeil A. Reversal of left ventricular hypertrophy in essential hypertension. A meta-analysis of randomized double-blind studies JAMA 1996; 275: 1507-13.

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