geriatrРоссийский журнал гериатрической медициныRussian Journal of Geriatric Medicine2686-86362686-8709Сайт издателя10.37586/2686-8636-1-2026-94-106geriatr-610Research ArticleОБЗОРЫREVIEWSЛечение артериальной гипертонии у пациентов с ортостатической артериальной гипотонией: научные данные и мнения экспертовTreatment of Arterial Hypertension in Patients with Orthostatic Hypotension: Scientific Data and Expert Opinionshttps://orcid.org/0000-0002-8505-1848ГиляревскийС. Р.GilyarevskyS. R.

кафедра клинической фармакологии и терапии им. академика Б. Е. Вотчала

Москва

Department of Clinical Pharmacology and Therapy named after Academician  B. E. Votchala

Moscow

gilyarevskii_sr@rgnkc.ruhttps://orcid.org/0000-0002-3981-4031ЩедринаА. Ю.ShchedrinaA. Yu.

Москва

Moscow

ashedrina@rambler.ruhttps://orcid.org/0000-0002-9865-4998ГолдшмидМ. В.GolshmidM. V.

кафедра клинической фармакологии и терапии им. академика Б. Е. Вотчала

Москва

Department of Clinical Pharmacology and Therapy named after Academician  B. E. Votchala

Moscow

golshmid@yandex.ruhttps://orcid.org/0000-0002-1695-9107ЛузинаА. В.LuzinaA. V.

Москва

Moscow

alexalav@mail.ruhttps://orcid.org/0000-0003-0048-268XЕруслановаК. А.YeruslanovaK. A.

Москва

Moscow

eruslanova_ka@rgnkc.ruhttps://orcid.org/0009-0005-5507-5071РыбаулинаА. Ю.RybaulinaА. Yu.

Москва

Moscow

rybaulina_ay@rgnkc.ruhttps://orcid.org/0009-0007-9112-842XАлибековаЛ. Я.AlibekovaL. Ya.

Москва

Moscow

alibekova.lejla@mail.ruРНИМУ им. Н. И. Пирогова Минздрава России (Пироговский Университет), ОСП «Российский геронтологический научно-клинический центр»; РМАНПО Минздрава РоссииРоссияPirogov Russian National Research Medical University of the Ministry of Health of Russia (Pirogov University), Branch «Russian Gerontological Scientific Clinical Center»; Russian Medical Academy of Continuous Professional Education of the Ministry of Health of RussiaRussian FederationРНИМУ им. Н. И. Пирогова Минздрава России (Пироговский Университет), ОСП «Российский геронтологический научно-клинический центр»РоссияPirogov Russian National Research Medical University of the Ministry of Health of Russia (Pirogov University), Branch «Russian Gerontological Scientific Clinical Center»Russian FederationРМАНПО Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional Education of the Ministry of Health of RussiaRussian FederationРНИМУ им. Н. И. Пирогова Минздрава России (Пироговский Университет), ОСП «Российский геронтологический научно-клинический центр»РоссияPirogov Russian National Research Medical University of the Ministry of Health of Russia (Pirogov University), Branch «Russian Gerontological Scientific Clinical Center»Russian Federation2026130420260194106Copyright © Гиляревский С.Р., Щедрина А.Ю., Голдшмид М.В., Лузина А.В., Ерусланова К.А., Рыбаулина А.Ю., Алибекова Л.Я., 20262026Гиляревский С.Р., Щедрина А.Ю., Голдшмид М.В., Лузина А.В., Ерусланова К.А., Рыбаулина А.Ю., Алибекова Л.Я.Gilyarevsky S.R., Shchedrina A.Y., Golshmid M.V., Luzina A.V., Yeruslanova K.A., Rybaulina А.Y., Alibekova L.Y.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geriatr-news.com/jour/article/view/610

Статья посвящена проблеме лечения артериальной гипертонии (АГ) у пациентов с ортостатической артериальной гипотонией (ОАГ). В течение многих лет считалось, что лечение АГ может увеличивать риск развития ОАГ у лиц пожилого и старческого возраста. Однако появляется все больше источников доказательной информации, которые свидетельствуют о том, что более интенсивные режимы антигипертензивной терапии с достижением более низких целевых уровней артериального давления сопровождаются снижением риска развития ОАГ. В статье подробно обсуждаются такие источники. Приводятся данные о патофизиологических звеньях развития ОАГ, а также о подходах к ее диагностике в клинической практике. Рассматривается проблема выбора оптимальной антигипертензивной терапии у пациентов с ОАГ. Обсуждается проблема лечения АГ при наличии ОАГ у пожилых пациентов со старческой астенией. В статье представлены мнения экспертов по поводу тактики обследования и лечения пациентов с АГ и ОАГ, которые отражены в современных клинических рекомендациях.

The article addresses the issue of treating arterial hypertension (AH) in patients with orthostatic arterial hypotension (OH). For many years, it was believed that treating AH might increase the risk of developing OH in elderly and senile patients. However, an increasing body of evidence-based data indicates that more intensive antihypertensive therapy regimens, achieving lower target blood pressure levels, are associated with a reduced risk of developing OH. The article discusses these sources in detail. It provides information about the pathophysiological mechanisms underlying the development of OH, as well as approaches to its diagnosis in clinical practice. The problem of selecting optimal antihypertensive therapy for patients with OH is examined. The article also addresses the issue of treating AH in the presence of OH in elderly patients with frailty syndrome. Expert opinions on the examination and treatment strategies for patients with AH and OH, as reflected in modern clinical guidelines, are presented in the article.

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