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Кардиоваскулярная терапия и профилактика

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

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Аннотация

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.

Об авторах

G. L. Bakris
Hypertensive Diseases Unit, Department of Medicine, University of Chicago Medical Center
Соединённые Штаты Америки
Chicago


J. N. Basile
Seinsheimer Cardiovascular Health Program, College of Medicine, Medical University of South Carolina, Ralph H. Johnson VA Medical Center
Соединённые Штаты Америки
Charleston


T. D. Giles
Department of Medicine, Tulane University School of Medicine
Соединённые Штаты Америки
New Orleans


A. A. Taylor
Departments of Medicine, Pharmacology, and Molecular Physiology, Baylor College of Medicine
Соединённые Штаты Америки
Houston


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Для цитирования:


Bakris G.L., Basile J.N., Giles T.D., Taylor A.A. Роль оксида азота в улучшении функции эндотелия и сердечно-сосудистого здоровья: фокус на небиволол. Кардиоваскулярная терапия и профилактика. 2011;10(2):116-121.

For citation:


Bakris G.L., Basile J.N., Giles T.D., Taylor A.A. The role of nitric oxide in improving endothelial function andcardiovascular health: focus on nebivolol. Cardiovascular Therapy and Prevention. 2011;10(2):116-121. (In Russ.)

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