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Кардиоваскулярная терапия и профилактика

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Антигипертензивные препараты в профилактике когнитивных нарушений и деменции: фокус на антагонисты кальция и диуретики

https://doi.org/10.15829/1728-8800-2018-5-79-91

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Аннотация

Артериальная гипертония ассоциирована с повышенным риском снижения когнитивных функций и развития сосудистой деменции и болезни Альцгеймера. В этом контексте антигипертензивная терапия может иметь профилактический эффект. Представленные в настоящем обзоре литературные данные свидетельствуют о том, что, несмотря на наличие некоторых противоречий в результатах исследований, антигипертензивные препараты, особенно дигидропиридиновые антагонисты кальция, диуретики и некоторые блокаторы ренин-ангиотензин-альдостероновой системы, обладают церебропротективными свойствами, причем не только за счет снижения артериального давления, но также и посредством дополнительных специфических нейропротективных механизмов. Это позволяет рассматривать антагонисты кальция и диуретики в качестве важного компонента лечения артериальной гипертонии, в т.ч. у пациентов пожилого и старческого возрастов, для профилактики снижения когнитивных функций и развития разных типов деменции.

Нитрендипин среди антагонистов кальция и индапамид среди диуретиков обладают наибольшей доказательной базой, свидетельствующей о наличии у них выраженных церебропротективных свойств.

Об авторах

О. Д. Остроумова
ФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И. Евдокимова Минздрава России; ФГАОУ ВО Первый Московский государственный медицинский университет им. И. М. Сеченова Минздрава России (Сеченовский Университет)
Россия

Профессор, доктор медицинских наук, профессор кафедры факультетской терапии и профболезней МГМСУ им. А.И. Евдокимова, РФпрофессор кафедры клинической фармакологии и пропедевтики внутренних болезней ЦГМАУДП.

Тел.: +7 (903) 169-68-28



М. С. Черняева
ФГБУ ДПО Центральная государственная медицинская академия Управления делами Президента Российской Федерации
Россия

Кандидат медицинских наук, доцент кафедры внутренних болезней и профилактической медицины.

Москва




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Для цитирования:


Остроумова О.Д., Черняева М.С. Антигипертензивные препараты в профилактике когнитивных нарушений и деменции: фокус на антагонисты кальция и диуретики. Кардиоваскулярная терапия и профилактика. 2018;17(5):79-91. https://doi.org/10.15829/1728-8800-2018-5-79-91

For citation:


Ostroumova O.D., Chernyaeva M.S. Antihypertension drugs in prevention of cognition disorder and dementia: focus on calcium channel blockers and diuretics. Cardiovascular Therapy and Prevention. 2018;17(5):79-91. (In Russ.) https://doi.org/10.15829/1728-8800-2018-5-79-91

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)