cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1594Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONИспользование статинов при лечении пациентов с артериальной гипертензиейStatins in arterial hypertension treatmentТкачеваО. Н.TkachevaO. N.

Руководитель терапевтического отделения Научного центра акушерства, гинекологии и перинатологии

Москва

Moscow

ШарашкинаН. В.SharashkinaN. V.

Врач-терапевт терапевтического отделения Научного центра акушерства, гинекологии и перинатологии

Москва

Moscow

sharashkina@inbox.ruБарабашкинаА. В.BarabashkinaA. B.

Клинический фармаколог Владимирской областной больницы

Москва

Moscow

НовиковаИ. М.NovikovaI. M.

Врач-кардиолог терапевтического отделения Научного центра акушерства, гинекологии и перинатологии

Москва

Moscow

МишинаИ. Е.MishinaI. E.

Заведующий кафедрой госпитальной терапии. ГОУ ВПО ИвГМА Росздрава

Москва

Moscow

ФГУ “Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова Росмедтехнологий”V.I. Kulakov Scientific Centre for Obstetrics, Gynaecology, and Perinatology200901011970874348Copyright © Ткачева О.Н., Шарашкина Н.В., Барабашкина А.В., Новикова И.М., Мишина И.Е., 19701970Ткачева О.Н., Шарашкина Н.В., Барабашкина А.В., Новикова И.М., Мишина И.Е.Tkacheva O.N., Sharashkina N.V., Barabashkina A.B., Novikova I.M., Mishina I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1594Цель

Цель. Анализ кардиоваскулярного риска у пациентов с артериальной гипертонией (АГ) и оценка эффективности использования аторвастатина у больных АГ без сердечно-сосудистых осложнений (ССО).

Материал и методы

Материал и методы. Обследованы 612 пациентов с АГ без ССО с оценкой риска кардиоваскулярной смерти по шкале SCORE. 38 пациентов с кардиоваскулярным риском 5-9% получали аторвастатин в дозе 10 мг/сут. на фоне адекватной антигипертензивной терапии (АГТ) в сравнении с обычной терапией АГ. Оценивалось влияние лечения на уровень артериального давления, липидный спектр, эндотелий-зависимую вазодилатацию (ЭЗВД) в пробе с реактивной гиперемией плечевой артерии, величину комплекса интима-медиа (КИМ) общих сонных артерий, уровень С-реактивного белка (СРБ), вариабельность сердечного ритма (ВСР).

Результаты

Результаты. По окончании исследования в группе аторвастатина получено достоверное снижение общего холестерина и холестерина липопротеидов низкой плотности, уровня СРБ, повышение ЭЗВД. В группе аторвастатина отмечено более значимое снижение симпатической составляющей спектра ВСР низких частот и значительно более выраженное снижение показателей очень низких частот ритма. Терапия аторвастатином в дозе 10 мг/сут. у пациентов с АГ без ССО на фоне адекватной АГТ эффективно корригирует липидные нарушения, а также нормализует нейрогормональную и уменьшает симпатоадреналовую активность, оказывает противовоспалительный эффект.

Заключение

Заключение. Большинство больных АГ относятся к группе высокого и очень высокого риска и требуют комплексного подхода к коррекции факторов сердечно-сосудистого риска.

Aim

Aim. To analyse cardiovascular risk levels in patients with arterial hypertension (AH); to assess atorvastatin effectiveness in AH patients without cardiovascular events (CVE).

Material and methods

Material and methods. In total, 612 CVE-free patients with AH were examined. The participants with SCORE risk level of 5-9% received atorvastatin (10 mg/d) and standard antihypertensive therapy. The authors examined the effects of atorvastatin on blood pressure levels, lipid profile, endothelium-dependent vasodilatation (EDVD) in the brachial artery reactive hyperemia test, intima-media thickness (IMT) of common carotid arteries, C-reactive protein (CRP) concentration, and heart rate variability (HRV).

Results

Results. At the end of the study, the atorvastatin group demonstrated a significant decrease in mean levels of total cholesterol (CH), low-density lipoprotein CH and CRP was observed, as well as an increase in EDVD. In addition, in the atorvastatin group, the reduction of sympathetic component of low-frequency and especially very low-frequency HRV was more manifested than in the standard therapy group. In CVE-free patients with AH, atorvastatin therapy (10 mg/d) effectively normalised lipid profile, neuro-humoral and sympatho-adrenal activity parameters, and also demonstrated anti-inflammatory effect.

Conclusion

Conclusion. The majority of AH patients have high and very high risk levels and, therefore, require a complex approach towards cardiovascular risk factor modification.

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