cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2011-3-15-21cardiovascular-1797Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONЗофеноприл в терапии больных с артериальной гипертонией и стабильной ишемической болезнью сердца. Влияние на окислительный стресс и поток-зависимую вазодилатациюZofenopril in the treatment of patients with arterial hypertension and stable coronary heart disease: effects on oxidative stress and flowdependent vasodilatationАгеевФ. Т.AgeevF. T.

руководитель научно-диспансерного отдела

Москва, Тел./факс: (495) 414-66-12  

ageev@cardio.ruОвчинниковА. Г.OvchinnikovA. G.

старший научный сотрудник отдела

Москва

ПлисюкА. Г.PlisyukA. G.

врач-кардиолог отдела

Москва

АрзамасцеваН. Е.ArzamastsevaN. E.

младший научный сотрудник отдела

Москва

КулевБ. Д.KulevB. D.

научный сотрудник отдела

Москва

КузьминаА. Е.Kuz’minaA. E.

старший научный сотрудник отдела

Москва

ПатрушеваИ. Ф.PatrushevaI. F.

старший научный сотрудник отдела

Москва

НИИ кардиологии им. А.Л. Мясникова ФГУ “РКНПК Минздравсоцразвития”A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical complex2011200620111031521Copyright © Агеев Ф.Т., Овчинников А.Г., Плисюк А.Г., Арзамасцева Н.Е., Кулев Б.Д., Кузьмина А.Е., Патрушева И.Ф., 20112011Агеев Ф.Т., Овчинников А.Г., Плисюк А.Г., Арзамасцева Н.Е., Кулев Б.Д., Кузьмина А.Е., Патрушева И.Ф.Ageev F.T., Ovchinnikov A.G., Plisyuk A.G., Arzamastseva N.E., Kulev B.D., Kuz’mina A.E., Patrusheva I.F.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/1797

Цель. Сравнить влияние ИАПФ зофеноприла и периндоприла на функцию эндотелия и показатели окислительного стресса (ОС) у больных со стабильной ИБС и АГ. Материалы и методы. 40 больных со стабильной ИБС и АГ 1-2 степени (ст.) в течение 12 нед. Принимали зофеноприл 7,5-30 мг/сут. (средняя доза — 18,6±8,8 мг/сут.; n=17) или периндоприл 2-8 мг/сут. (средняя доза — 4,1±2,1 мг/сут.; n=23). Исходно и в конце исследования у всех больных была выполнена проба с реактивной гиперемией (ПРГ) для оценки потокозависимой вазодилатации плечевой артерии и определено содержание показателей ОС: малонового диальдегида (МДА) в липопротеинах низкой плотности (МДАЛНП) и антиокислительной системы (АОС) – активность супероксиддисмутазы (СОД) и глутатионпероксидазы (ГПО) в эритроцитах. Результаты. В обеих группах (гр.) отмечалось сопоставимое достоверное снижение систолического и диастолического артериального давления. В гр. зофеноприла выявлено достоверное увеличение прироста диаметра плечевой артерии при ПРГ, а также достоверное повышение активности ГПО и тенденция к снижению содержания МДАЛНП, что свидетельствует об активизации АОС и уменьшении выраженности ОС. В гр. периндоприла отсутствовало сколько-нибудь значимое изменение указанных показателей. Заключение. У больных со стабильной ИБС и АГ зофеноприл, в отличие от периндоприла, уменьшал ст. выраженности ОС и активизировал АОС, что ассоциировалось с улучшением вазодилатирующих свойств сосудистого эндотелия.

Aim

Aim. To compare the effects of ACE inhibitors zofenopril and perindopril on endothelial function and oxidative stress (OS) in patients with stable CHD and AH. Material and methods. In total, 40 patients with stable CHD (Functional Class II-III effort angina) and Stage 1-2 AH received zofenopril (7,5-30 mg/d; mean dose 18,6±8,8 mg/d; n=17) or perindopril (2-8 mg/d; mean dose 4,1±2,1 mg/d; n=23) for 12 weeks. At baseline and in the end of the study, all patients underwent reactive hyperemia test (RHT), to assess flow-dependent vasodilatation of brachial artery, and the measurement of OS parameters (malone dialdehyde, MDA, in low-density lipoproteins, MDALDL) and antioxidant parameters (superoxide dismutase (SOD) and glutathione peroxidase (GPO) activity in erythrocytes).

Results

Results. In both groups, a similar reduction in systolic and diastolic blood pressure levels was observed. In the zofenopril group, a significant elevation in brachial artery diameter increase during RHT, a significant increase in GPO activity, and some reduction in MDALDL levels were observed, which points to antioxidant system (AOS) activation and OS reduction. No similar changes of these parameters were observed in the perindopril group. Conclusion. In patients with stable CHD and AH, zofenopril, but not perindopril, reduced OS severity and increased AOS system activity, which was associated with improved endothelial-dependent vasodilatation.

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