Роль оксида азота в улучшении функции эндотелия и сердечно-сосудистого здоровья: фокус на небиволол

Согласно современным клиническим рекомендациям, β-адреноблокаторы (β-АБ) показаны для лечения пациентов с артериальной гипертензией (АГ), в особенности, с выраженной сердечно-сосудистой патологией и высоким сердечно-сосудистым риском. Определенную настороженность вызывают данные о связи терапии традиционными β-АБ с неблагоприятными клиническими исходами, по сравнению с другими классами антигипертензивных препаратов (АГП). Прием традиционных β-АБ может ассоциироваться с ухудшением качества жизни, а также липидного и углеводного обменов. β-АБ представляют собой разнородную группу АГП, включающую неселективные препараты, кардиоселективные препараты без вазодилатирующих свойств, а также вазодилатирующие препараты, сочетающие неселективность в отношении β-рецепторов с α-блокирующим действием, либо кардиоселективность с отсутствием α-блокады. В обзоре обсуждаются фармакологические и гемодинамические различия между традиционными β-АБ без вазодилатирующей активности и вазодилатирующими β-АБ, с фокусом на небиволол — кардиоселективный β-АБ с вазодилатирующими свойствами. Данные различия могут иметь важное клиническое значение, в частности, при лечении осложненной АГ (например, у пациентов с сахарным диабетом, кардиометаболическим синдромом, пожилых больных и пациентов афроамериканского происхождения). Таким образом, при выборе того или иного β-АБ следует учитывать механизм его действия.

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