CardioSomaticsCardioSomaticsCardioСоматика2221-71852658-5707Eco-Vector4497510.26442/CS44975ArticlesСтатьиOsobennosti kardioprotektivnogo deystviyazofenoprila vo vtorichnoy profilaktikeserdechno-sosudistykh zabolevaniyОсобенности кардиопротективного действиязофеноприла во вторичной профилактикесердечно-сосудистых заболеванийVaulinNikolay AleksandrovichВаулинНиколай Александрович

Городская клиническая больница №29 им. Баумана, Москва

Городская клиническая больница №29 им. Баумана, Москва1503201121NO1 (2011)ТОМ 2, №1 (2011)556324092020Copyright ©; 2011, Eco-VectorCopyright ©; 2011, ООО "Эко-Вектор"2011Eco-VectorООО "Эко-Вектор"https://creativecommons.org/licenses/by-nc-sa/4.0https://cardiosomatics.ru/2221-7185/article/view/44975

Summary. Zofenopril is one of the most recent ACE inhibitors; it shows a high lipophilicity. This property determines its high and rapid absorption, a considerable proportion of excretion with bile and improved tissue permeability associated with the prolonged effect of tissue ACE inhibition. This property must underlie some effects of zofenopril, which are absent in other drugs of this class. Thus, the combination of lipophilicity and antioxidant activity ensures the optimal antihypertensive efficacy along with antiatherogenic activity. These two latter properties most probably make a major contribution to a reduction in death rates after myocardial infarction, as conclusively demonstrated in a series of SMILE clinical trials. The above properties of zofenopril support once again the idea that not all ACE inhibitors are equally effective in the treatment of arterial hypertension and in secondary prevention after myocardial infarction.

Резюме. Зофеноприл - один из последних появившихся в арсенале ингибиторов ангиотензинпревра- щающего фермента (ИАПФ) препарат - обладает высокой липофильностью. Это свойство обусловливает высокую и быструю абсорбцию, существенную долю экскреции с желчью и улучшенную проницаемость тканей, ассоциированную с пролонгированным эффектом ингибирования АПФ в тканях организма. Это же свойство, вероятно, лежит в основе некоторых эффектов зофеноприла, которыми не обладают дру- гие препараты класса. Так, липофильность в сочетании с антиоксидантной активностью обеспечивают оп- тимальную антигипертензивную эффективность наряду с антиатерогенным действием. Эти два последних свойства, по всей видимости, вносят основной вклад в снижение смертности после инфаркта миокарда (ИМ), убедительно продемонстрированное в серии клинических исследований SMILE. Рассмотренные здесь свойства зофеноприла еще раз подтверждают идею о том, что не все ИАПФ одинако- во эффективны в лечении артериальной гипертензии и вторичной профилактике после ИМ.

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