cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2018-6-69-76cardiovascular-1286Research ArticleМНЕНИЕ ПО ПРОБЛЕМЕOPINION ON A PROBLEMЛечение артериальной гипертензии у пациентов с ожирением: фокус на телмисартанTreatment of hypertension in obese patients: focus on telmisartanhttps://orcid.org/0000-0001-9847-7349ДенекаИ. Э.DenekaI. E.

Денека Ирина Эдуардовна — аспирантка кафедры факультетской терапии № 1.

denekairina@gmail.comhttps://orcid.org/0000-0003-1565-5440РодионовА. В.RodionovA. V.

Родионов Антон Владимирович — кандидат медицинских наук, доцент кафедры факультетской терапии № 1 Первого МГМУ им. И. М. Сеченова

avrodion@mail.ruhttps://orcid.org/0000-0002-2682-4417ФоминВ. В.FominV. V.

Фомин Виктор Викторович — доктор медицинских наук, профессор, заведующий кафедрой факультетской терапии № 1 лечебного факультета, проректор по лечебной работе

fomin@mma.ruФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский университет)I.M. Sechenov First Moscow State Medical University2018201220181766976Copyright © Денека И.Э., Родионов А.В., Фомин В.В., 20182018Денека И.Э., Родионов А.В., Фомин В.В.Deneka I.E., Rodionov A.V., Fomin V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1286

В статье обсуждается роль телмисартана, блокатора рецепторов ангиотензина II 1-го типа второго поколения, обладающего уникальными плейотропными эффектами за счет частичного сродства к рецепторам, активирующим пролиферацию пероксисом подтипа у (PPARy), расположенным в жировой ткани, в лечении артериальной гипертензии у пациентов с метаболическим синдромом. Подробно описана взаимосвязь метафламации — специфического хронического воспалительного процесса с патогенетическими механизмами развития сердечно-сосудистых заболеваний, включая артериальную гипертензию. Рассматривается роль пептида из семейства адипоки-нов адипонектина, синтез которого стимулируется частичными агонистами рецепторов PPARy, к которым относится телмисартан, обладающего положительным влиянием на жировой и углеводный обмены, а также кардиопротективными свойствами. В заключении приводятся результаты многочисленных рандомизированных исследований и мета-анализов, подтверждающих высокую эффективность телмисартана при лечении артериальной гипертензии у пациентов с морбидным ожирением, обусловленную не только его непосредственными антигипертензивными свойствами, но и благотворным влиянием на метаболические процессы в жировой ткани в качестве селективного модулятора рецепторов PPARy.

The article discusses the role of telmisartan in the treatment of arterial hypertension in patients with metabolic syndrome. Telmisartan is second-generation type 1 angiotensin II receptor blocker, which has unique pleiotropic effects due to partial affinity for receptors that activate the proliferation of subtype y peroxisomes (PPARy) located in adipose tissue. The interrelation of metaflamation, a specific chronic inflammatory process with pathogenetic mechanisms of development of cardiovascular diseases, including arterial hypertension, is also described in study. The role of the adiponectin peptide is considered, which synthesis is stimulated by partial PPARy receptor agonists (as mentioned above — telmisartan). It has a positive effect on fat and carbohydrate metabolism, as well as cardioprotective properties. The conclusion contains the results of numerous randomized studies and meta-analyzes confirming the high efficacy of telmisartan in the treatment of arterial hypertension in patients with morbid obesity.

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