rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2026-3277EJQZIBrpcardio-3277Research ArticleREVIEWSОБЗОРЫThe effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on serum uric acid levels in adult patients with arterial hypertension: A systematic reviewВлияние ингибиторов ангиотензинпревращающего фермента и блокаторов рецепторов ангиотензина II на уровень мочевой кислоты в крови у пациентов с артериальной гипертензией: систематический обзорhttps://orcid.org/0000-0002-3748-8180МорозоваТ. Е.MorozovaT. E.

Морозова Татьяна Евгеньевна 

Большая Пироговская ул., 2, стр. 4, Москва, 119435 

Tatiana E. Morozova 

Bolshaya Pirogovskaya str., 2-4, Moscow, 119435 

morozova_t_e@staff.sechenov.ruhttps://orcid.org/0000-0001-5113-2108ВолнухинА. В.VolnukhinA. V.

Волнухин Артем Витальевич 

Большая Пироговская ул., 2, стр. 4, Москва, 119435 

Artem V. Volnukhin 

Bolshaya Pirogovskaya str., 2-4, Moscow, 119435 

volnukhin_a_v@staff.sechenov.ruhttps://orcid.org/0000-0002-7677-1544ВласоваА. В.VlasovaA. V.

Власова Анна Васильевна 

Большая Пироговская ул., 2, стр. 4, Москва, 119435 

Anna V. Vlasova 

Bolshaya Pirogovskaya str., 2-4, Moscow, 119435 

vlasova_a_v@staff.sechenov.ruhttps://orcid.org/0000-0001-6550-2915СамохинаЕ. О.SamokhinaE. O.

Самохина Елена Олеговна 

Большая Пироговская ул., 2, стр. 4, Москва, 119435 

Elena O. Samokhina 

Bolshaya Pirogovskaya str., 2-4, Moscow, 119435 

samokhina_e_o_1@staff.sechenov.ruhttps://orcid.org/0000-0003-4087-3351ВасильевичМ. А.ManzyukA. V.

Манзюк Алексей Васильевич  

Большая Пироговская ул., 2, стр. 4, Москва, 119435 

Alexey V. Manzyuk 

Bolshaya Pirogovskaya str., 2-4, Moscow, 119435 

aleksej-manzyuk@yandex.ruhttps://orcid.org/0000-0002-3324-5472ГерцогА. А.GertsogA. A.

Герцог Анна Алексеевна  

Большая Пироговская ул., 2, стр. 4, Москва, 119435 

Anna A. Gertsog 

Bolshaya Pirogovskaya str., 2-4, Moscow, 119435 

gertsog_a_a@staff.sechenov.ruhttps://orcid.org/0000-0002-0087-1848ШихН. В.ShikhN. V.

Ших Надежда Валерьевна 

Большая Пироговская ул., 2, стр. 4, Москва, 119435 

Nadejda V. Shikh 

Bolshaya Pirogovskaya str., 2-4, Moscow, 119435 

shikh_n_v@staff.sechenov.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет)РоссияSechenov First Moscow State Medical UniversityRussian Federation2026110420262219098Copyright © Morozova T.E., Volnukhin A.V., Vlasova A.V., Samokhina E.O., Manzyuk A.V., Gertsog A.A., Shikh N.V., 20262026Морозова Т.Е., Волнухин А.В., Власова А.В., Самохина Е.О., Васильевич М.А., Герцог А.А., Ших Н.В.Morozova T.E., Volnukhin A.V., Vlasova A.V., Samokhina E.O., Manzyuk A.V., Gertsog A.A., Shikh N.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/3277Aim

Aim. To summarize the available data on the effects of first-line antihypertensive agents – angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) – on serum uric acid (UA) levels in adults with (arterial hypertension) AH, with the goal of optimizing pharmacotherapy in patients with AH and asymptomatic hyperuricemia.

Material and methods

Material and methods. A comprehensive search was conducted in PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) within the Cochrane Library, eLIBRARY, Google Scholar, and the National Institutes of Health clinical trials registry ClinicalTrials.gov. The systematic review was prepared in accordance with PRISMA guidelines. No restrictions were placed on the year of publication during the search and analysis.

Results

Results. Analysis of nine randomized controlled trials of ACEIs showed that enalapril, captopril, and fosinopril demonstrated neutrality with respect to UA levels, whereas other drugs in this class may increase UA concentrations. Analysis of eleven randomized controlled trials of ARBs showed that only losartan exhibits a uricosuric effect, while irbesartan, valsartan, and eprosartan are metabolically neutral.

Conclusion

Conclusion. Among ACEIs, enalapril, low-dose ramipril, and fosinopril exhibit the most favorable safety profile and the greatest neutrality regarding UA levels. ARBs are generally metabolically neutral with respect to UA, with the exception of losartan, which possesses a uricosuric effect.

Цель

Цель. Обобщить данные о влиянии антигипертензивных препаратов – ингибиторов ангиотензинпревращающего фермента (иАПФ) и блокаторов рецепторов ангиотензина II (БРА) - на уровень мочевой кислоты (МК) у взрослых пациентов с артериальной гипертензией (АГ) с целью оптимизации фармакотерапии АГ в сочетании с бессимптомной гиперурикемией.

Материал и методы

Материал и методы. Поиск осуществлялся в PubMed, Кокрейновском центральном регистре контролируемых исследований (CENTRAL) в Кокрейновской библиотеке Cochrane Library, eLIBRARY, сервисе Google Scholar и в базе текущих исследований Национальных институтов здравоохранения США ClinicalTrials.gov. Систематический обзор представлен в соответствии с рекомендациями PRISMA. При поиске и анализе статей не устанавливались ограничения по году публикации. Результаты. Анализ 9 рандомизированных контролируемых исследований иАПФ показал, что эналаприл, каптоприл и фозиноприл продемонстрировали нейтральность в отношении уровня МК, в то время как другие препараты этого класса могут повышать ее уровень. Анализ 11 рандомизированных контролируемых исследований БРА показал, что только лозартан обладает урикозурическим эффектом, тогда как ирбесартан, валсартан и эпросартан метаболически нейтральны.

Заключение

Заключение. Среди иАПФ хорошим профилем безопасности и наибольшей нейтральностью в отношении МК обладают эналаприл, рамиприл в малых дозах, фозиноприл. БРА в целом метаболически нейтральны в отношении МК, за исключением лозартана, обладающего урикозурическим эффектом.

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