Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya70771110.26442/00403660.2026.07.203747ConsensunsКонсенсусReview ArticleAldosterone: mechanisms of normal and impaired regulation and the possibility of their correction in arterial hypertension. Consensus of Russian Medical Society on Arterial Hypertension (RSH) expertsАльдостерон: механизмы нормальной и нарушенной регуляции и возможности их коррекции при артериальной гипертонии. Консенсус экспертов Российского медицинского общества по артериальной гипертонии (РМОАГ)https://orcid.org/0000-0002-8826-9690ChikhladzeNovella M.ЧихладзеНовелла Михайловна
Russian Federation

д-р мед. наук, проф., вед. науч. сотр. отд. гипертонии

nat-cardio1@ya.ruhttps://orcid.org/0000-0001-5215-4894BlinovaNataliya V.БлиноваНаталия Владимировна
Russian Federation

канд. мед. наук, ст. науч. сотр. отд. гипертонии

nat-cardio1@ya.ruhttps://orcid.org/0000-0002-5820-1759TrushinaOlga Iu.ТрушинаОльга Юрьевна
Russian Federation

проф. РАН, д-р мед. наук, проф. каф. факультетской терапии №1 Института клинической медицины им. Н.В. Склифосовского

nat-cardio1@ya.ruhttps://orcid.org/0000-0002-0758-5609PodzolkovValery I.ПодзолковВалерий Иванович
Russian Federation

д-р мед. наук, проф., зав. каф. факультетской терапии №2 Института клинической медицины им. Н.В. Склифосовского

nat-cardio1@ya.ruhttps://orcid.org/0000-0002-2699-1610BraginaAnna E.БрагинаАнна Евгеньевна
Russian Federation

д-р мед. наук, проф. каф. факультетской терапии №2

nat-cardio1@ya.ruhttps://orcid.org/0000-0002-9822-4357ChazovaIrina E.ЧазоваИрина Евгеньевна
Russian Federation

акад. РАН, д-р мед. наук, проф., зам. ген. дир. по научно-экспертной работе, рук. отд. гипертонии Института клинической кардиологии им. А.Л. Мясникова

nat-cardio1@ya.ruChazov National Medical Research Center of CardiologyФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава РоссииSechenov First Moscow State Medical University (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)31072026987Vario (various)Vario (разное)3914122105202629052026Copyright ©; 2026, Consilium MedicumCopyright ©; 2026, ООО "Консилиум Медикум"2026Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/707711

In recent years, studies have been carried out that have expanded the understanding of the role of pathophysiological mechanisms underlying impaired regulation of aldosterone and activation of mineralocorticoid receptors in arterial hypertension. The aim of this consensus is to consider the association between aldosterone dysregulation and the development of cardiovascular complications, as well as to assess the effectivity and safety of novel nonsteroidal mineralocorticoid receptor antagonists, to expand the understanding of their potential in ensuring the prevention of target organ damage and cardiovascular complications in the treatment of patients with hypertension, to analyze the potential of a new class of drugs – aldosterone synthase inhibitors – in ensuring the suppression of genomic and non-genomic effects of aldosterone and their adverse effects in patients with hypertension, to assess the efficacy of drug therapy including nonsteroidal mineralocorticoid receptor antagonists and aldosterone synthase inhibitors in the category of patients at high cardiovascular risk – in hypertension due to primary hyperaldosteronism.

В последние годы проведены исследования, которые расширили представление о роли патофизиологических механизмов, лежащих в основе нарушенной регуляции альдостерона и активации минералокортикоидных рецепторов (МКР) при артериальной гипертонии (АГ). Цель консенсуса – рассмотреть связь между дисрегуляцией альдостерона и развитием сердечно-сосудистых осложнений, оценить эффективность и безопасность новых нестероидных антагонистов МКР, расширить представление об их возможности в обеспечении профилактики поражения органов-мишеней и сердечно-сосудистых осложнений при лечении пациентов с АГ, проанализировать потенциал нового класса препаратов – ингибиторов альдостеронсинтазы – в обеспечении подавления геномных и негеномных эффектов альдостерона и их неблагоприятных последствий у пациентов с АГ, исследовать эффективность медикаментозной терапии, включающей нестероидные антагонисты МКР и ингибиторы альдостеронсинтазы, у категории пациентов высокого сердечно-сосудистого риска – при АГ, обусловленной первичным гиперальдостеронизмом.

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