clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2025-103-10-11-753-759clinmed-1311Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSАнализ показателей ренин-ангиотензин-альдостероновой системы и электролитного состава сыворотки крови у мужчин с гипертонической болезнью и фибрилляцией предсердийAnalysis of the renin-angiotensin-aldosterone system in men with hypertension and atrial fibrillationhttps://orcid.org/0000-0002-7811-1371БобылеваТ. А.BobylevaT. A.

Бобылева Татьяна Александровна — канд. мед. наук, доцент кафедры клинической физиологии и функциональной диагностики ФГБОУ ДПО РМАНПО Минздрава России; доцент кафедры терапии неотложных состояний филиала ФГБВОУ ВО «ВМедА им. С.М. Кирова» Минобороны России в г. Москве.

Москва

Tatyana A. Bobyleva — Candidate of Medical Sciences, Associate Professor of the Department of Clinical Physiology and Functional Diagnostics of the Russian Medical Academy of Continuous Professional Education; Associate Professor of the Department of Emergency Medicine of the Branch of the Military Medical Academy of S.M. Kirov in Moscow.

Moscow

medicina51@mail.ruhttps://orcid.org/0000-0003-3417-5530ТкаченкоС. Б.TkachenkoS. B.

Ткаченко Сергей Борисович — д-р мед. наук, профессор, член-корреспондент РАН, заведующий кафедрой клинической физиологии и функциональной диагностики ФГБОУ ДПО РМАНПО Минздрава России.

Москва

Sergey B. Tkachenko — Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Clinical Physiology and Functional Diagnostics of the Russian Medical Academy of Continuous Professional Education.

Moscow

https://orcid.org/0000-0001-6528-1059КазаковС. П.KazakovS. P.

Казаков Сергей Петрович — д-р мед. наук, профессор кафедры клинической лабораторной диагностики, медицинской микробиологии и патологической анатомии, Академия постдипломного образования ФГБУ ФНКЦ ФМБА; начальник центра клинической лабораторной диагностики ФГБУ «ГВКГ им. Н.Н. Бурденко» Минобороны России.

Москва

Sergey P. Kazakov — Doctor of Medical Sciences, Professor of the Department of Clinical Laboratory Diagnostics, Medical Microbiology and Pathological Anatomy Academy of Postgraduate Education FRCC of the FMBA; Head of the Center for Clinical Laboratory Diagnostics of the Main Military Clinical Hospital named after academician N.N. Burdenko.

Moscow

https://orcid.org/0000-0003-0542-4278ПутковС. Б.PutkovS. B.

Путков Станислав Борисович — заведующий лаборатории отделения клинических инфекционно-иммунологических исследований центра клинической лабораторной диагностики ФГБУ «ГВКГ им. Н.Н. Бурденко Минобороны России.

Москва

Stanislav B. Putkov — M.D. Head of Dept, of Clinical and Infectious-Immunological Research of Centre for Clinical Laboratory Diagnostics of the Main Military Clinical Hospital named after academician N.N. Burdenko.

Moscow

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России; Филиал ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России в г. МосквеРоссияRussian Medical Academy of Continuous Professional Education; Branch of the Military Medical Academy of S.M. Kirov of the Russian Ministry of Defense In MoscowRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationФГБУ «Главный военный клинический госпиталь им. академика Н.Н. Бурденко» Минобороны России; ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства»РоссияMain Military Clinical Hospital named after academician N.N. Burdenko of the Ministry of Defense of the Russia; Federal Research and Clinical Center of Specialized Types of Health Care and Medical Technology of the Federal Medical and Biological AgencyRussian FederationФГБУ «Главный военный клинический госпиталь им. академика Н.Н. Бурденко» Минобороны РоссииРоссияMain Military Clinical Hospital named after academician N.N. Burdenko of the Ministry of Defense of the RussiaRussian Federation20251402202610310-11753759Copyright © Бобылева Т.А., Ткаченко С.Б., Казаков С.П., Путков С.Б., 20262026Бобылева Т.А., Ткаченко С.Б., Казаков С.П., Путков С.Б.Bobyleva T.A., Tkachenko S.B., Kazakov S.P., Putkov S.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/1311

Обследована группа мужчин с гипертонической болезнью (ГБ). Пациенты были разделены на три группы с: пароксизмальной формой фибрилляции предсердий (ФП), персистирующей формой ФП, ишемической болезнью сердца (ИБС) (стенокардией 2–3 ФК). При анализе показателей ренин-ангиотензин-альдостероновой системы выявлено, что у пациентов с ГБ и ФП чаще встречаются высокорениновые артериальные гипертензии (АГ) (до 50%), а у пациентов с ГБ и ИБС — норморениновые АГ (60%). Среди пациентов с высокорениновыми АГ достоверно более высокие значения ренина отмечены в группах с персистирующей формой ФП и ИБС. На фоне приема антигипертензивных препаратов терапии (бета-блокаторов и блокаторов ангиотензиновых рецепторов) уровень альдостерона был в пределах нормы у всех обследованных пациентов. Высокий уровень ангиотензина II в группе лиц с высокорениновыми АГ и ФП требует дальнейшего изучения. Гипокалиемия выявлена только у пациентов с ГБ и пароксизмальной формой ФП в 13,4% случаев. Необходимо отметить, что низкий уровень К+ от 3,5–3,9 ммоль/л был выявлен у 34,2% пациентов с пароксизмальной формой и у 30% в группе с персистирующей формой ФП. Корреляционной зависимости между показателями ренин-ангиотензин-альдостероновой системы и уровнем К+ не выявлено.

A group of men with hypertension (HT) was examined. The patients were divided into three groups: those with paroxysmal atrial fibrillation (AF), those with persistent AF, and those with coronary artery disease (CAD) (2–3 FC angina).When analyzing the parameters of the renin-angiotensin-aldosterone system, it was revealed that patients with GB and AF are more likely to have high–grade arterial hypertension (AH) (up to 50%), and in patients with GB and CHD — normorenin hypertension (60%). Among patients with high-RH hypertension, significantly higher renin values were noted in the group with persistent AF and coronary artery disease. Against the background of taking antihypertensive therapy (b-blockers and BAR), the level of aldosterone was within the normal range in all examined patients. The high level of angiotensin II in the group of persons with high-renin AH and AF requires further study. Hypokalemia was detected only in patients with hypertension and paroxysmal AF in 13.4% of cases. It should be noted that a low level of K+ from 3.5 to 3.9 mmol/L was detected in 34.2% of patients with paroxysmal AF and in 30% of patients with persistent AF. No correlation was found between the renin-angiotensin-aldosterone system and the K+ level.

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The authors declare that there are no conflicts of interest present.