perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2019-64-1-15-24perinatology-815Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSЛечение артериальной гипертензии у детей и подростковTreatment of hypertension in children and adolescentshttps://orcid.org/0000-0002-5273-6859ЛеонтьеваИ. В.LeontyevaI. V.

Леонтьева Ирина Викторовна – доктор медицинских наук,  профессор, главный научный сотрудник отдела  детской  кардиологии и аритмологии.

125412 Москва,  ул. Талдомская, д. 2.

Moscow.

Научно-исследовательский клинический институт педиатрии им. академика Ю.Е. Вельтищева РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияVeltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical UniversityRussian Federation2019070320196411524Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20192019Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/815

Представлены данные о современных подходах к немедикаментозному и медикаментозному лечению артериальной гипертензии у детей и подростков. Проанализированы рекомендации по лечению артериальной гипертензии Американской ассоциации сердца (2017 г.) и Европейского общества гипертензии (2016 г.). Изложены возможности немедикаментозного воздействия путем изменения диетического рациона и повышения уровня физической  активности. Освящены данные многоцентровых рандомизированных клинических исследований по применению основных групп гипотензивных препаратов у детей и подростков, рекомендации по целевому уровню артериального давления при лечении артериальной гипертензии. Представлены  показания и противопоказания к назначению гипотензивных препаратов: ингибиторов ангиотензинпревращающего фермента, блокаторов рецепторов ангиотензина, блокаторов кальциевых каналов. Пересмотрены  представления о применении β-адреноблокаторов для лечения артериальной гипертензии. Рассматриваются возможности лечения рефрактерной артериальной гипертензии, особенности лечения гипертензии при протеинурии, метаболическом синдроме, дислипидемии.

The article presents the data on modern approaches to non-drug and drug treatment of hypertension in children and adolescents. The article analyzes the recommendations of the American Heart Association (2017) and the European Society of Hypertension (2016) for the treatment of arterial hypertension. The authors describe the possibilities of non-drug treatment by changing the diet and increasing the level of physical activity. The article presents data on multicenter randomized clinical studies on the use of the main groups of antihypertensive drugs in children and adolescents, recommendations on the target level of blood pressure in the treatment of hypertension. The authors present indications and contraindications to the prescription of antihypertensive drugs: angiotensinconverting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers. The concept of using β-blockers for the treatment of arterial hypertension is revised. The authors consider the treatment of refractory arterial hypertension and treatment of hypertension with proteinuria, metabolic syndrome, dyslipidemia.

детиподросткиартериальная гипертензиялечениеингибиторы ангиотензинпревращающего ферментаблокаторы рецепторов ангиотензинаблокаторы кальциевых каналовβ-адреноблокаторырефрактерная артериальная гипертензиядиетафизическая активностьchildrenadolescentsarterial hypertensiontreatmentangiotensin-converting enzyme inhibitorsangiotensin receptor blockerscalcium channel blockersβ-blockersrefractory arterial hypertensiondietphysical activityReferencesThe fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114 (2 suppl): 555–576.The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114 (2 suppl): 555–576.Flynn J.T., Kaelber D.C., Baker-Smith C.M., Blowey D., Carroll A.E., Daniels S.R. et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017; 140(3): e20171904. 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The authors declare that there are no conflicts of interest present.