Novye paradigmy vs starye predstavleniya o farmakoterapii arterial'noy gipertenzii u lits s vysokim serdechno-sosudistym riskom i metabolicheskimi narusheniyami


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Abstract

In recent years, much attention is paid to the metabolic risk factors which have important prognostic value in the development of cardiovascular disease and type 2 diabetes mellitus. According to WHO experts, significant increase of metabolic disorders is expected. In combination with arterial hypertension (AH), they increase the risk of cardiovascular complications. In the literature, the metabolic effects of antihypertensive drugs are discussed actively. It is found that angiotensin-converting enzyme (ACE) inhibitors, sartans, calcium channel blockers (CCBs) and long-acting Il-imidazoline receptor agonists have no negative impact on metabolic risk factors, whereas thiazide diuretics and в-blockers may worsen the prognosis. In low doses and in combination with other drugs, however, diuretics and в-blockers can also be used in patients with arterial hypertension and metabolic disorders. If it is necessary, safe combination therapy (ACEI + CCB, angiotensin II receptor blocker + CCB), and combination with diuretics at lower therapeutic doses can also be used, that favorably affect the prognosis due to a good antihypertensive effect.

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M. N Mamedov

Email: mmamedov@gnicpm.ru

Z. A Toguzova

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