geriatrРоссийский журнал гериатрической медициныRussian Journal of Geriatric Medicine2686-86362686-8709Сайт издателя10.37586/2686-8636-1-2026-124-130geriatr-749Research ArticleОБЗОРЫREVIEWSТелмисартан у коморбидных пациентов с ожирением и артериальной гипертензиейTelmisartan in comorbid patients with obesity and arterial hypertensionhttps://orcid.org/0000-0003-4027-3727ЗакиевВ. Д.ZakievV. D.

Москва

Moscow

zakiev_vd@rgnkc.ruhttps://orcid.org/0000-0002-1628-5093КотовскаяЮ. В.KotovskayaYu. V.

Москва

Moscow

ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России (Пироговский Университет), ОСП «Российский геронтологический научно-клинический центр»РоссияRussian Gerontological Clinical and Research Center, Pirogov Russian National Research Medical UniversityRussian Federation20261304202601124130Copyright © Закиев В.Д., Котовская Ю.В., 20262026Закиев В.Д., Котовская Ю.В.Zakiev V.D., Kotovskaya Y.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geriatr-news.com/jour/article/view/749

На фоне глобального роста распространенности избыточной массы тела и доказанной связи ожирения с активацией ренин-ангиотензин-альдостероновой системы (РААС) и артериальной гипертензией для коморбидного пациента критически важен выбор антигипертензивного препарата, способного воздей-

ствовать на общие звенья патогенеза этих состояний. В статье анализируется терапевтический потенциал телмисартана — высокоселективного блокатора рецепторов к ангиотензину II, обладающего уникальными фармакокинетическими свойствами. Благодаря выраженной липофильности препарат обеспечивает эффективную блокаду тканевой РААС, что обуславливает его высокую органопротективную активность. Особое внимание уделено специфическому механизму действия телмисартана как частичного агониста гамма-рецепторов, активируемых пролифератором пероксисом (PPAR-γ). Данное свойство позволяет препарату выступать в роли метаболического модулятора: способствовать перераспределению жировой ткани, уменьшению площади висцерального жира, снижению уровня триглицеридов и улучшению чувствительности тканей к инсулину. Представленные данные позволяют сделать вывод, что использование телмисартана является патогенетически обоснованным и рациональным выбором для лечения коморбидных пациентов с сочетанием артериальной гипертензии и ожирения, а также кардио-рено-гепато-метаболическим синдромом, позволяя достигать целевых значений артериального давления при одновременной коррекции метаболических нарушений.

Against the backdrop of the rising global prevalence of overweight and the established link between obesity, activation of the renin-angiotensin-aldosterone system (RAAS), and hypertension, selecting an antihypertensive agent capable of targeting the common pathogenetic pathways of these conditions is critical for comorbid patients. This article analyzes the therapeutic potential of telmisartan, a highly selective angiotensin II receptor blocker with unique pharmacokinetic properties. Due to its pronounced lipophilicity, the drug ensures effective blockade of tissue RAAS, which accounts for its high organoprotective activity. Particular attention is given to the specific mechanism of telmisartan as a partial agonist of peroxisome proliferator-activated receptor gamma (PPAR-γ). This property allows the drug to function as a metabolic modulator: promoting adipose tissue redistribution, reducing visceral fat area, lowering triglyceride levels, and improving insulin sensitivity. The presented data lead to the conclusion that the use of telmisartan is a pathogenetically justified and rational choice for treating comorbid patients with concomitant hypertension and obesity as well as cardiovascular-renal-hepatic-metabolic syndrome, enabling the achievement of target blood pressure levels while simultaneously correcting metabolic disturbances.

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