Статья
Артериальная жесткость как мишень для терапии: от патофизиологических механизмов к выбору антигипертензивного препарата
Настоящий обзор посвящен современным представлениям о роли артериальной жесткости в развитии сердечно-сосудистых заболеваний и ее значении для клинической практики. В статье подробно проанализированы основные патофизиологические механизмы сосудистого ремоделирования, лежащие в основе повышения ригидности сосудистой стенки. Показан вклад ключевых факторов риска в увеличение сосудистой жесткости, обсуждается прогностическая значимость этого показателя. Особое внимание уделено взаимосвязи между жесткостью артерий и параметрами артериального давления (АД), включая его вариабельность. Рассмотрена проблема коморбидности у пациентов с артериальной гипертензией (АГ), в том числе влияние хронического болевого синдрома и приема нестероидных противовоспалительных препаратов на состояние сосудистой стенки и эффективность антигипертензивной терапии. Проанализированы возможности различных классов антигипертензивных препаратов с точки зрения их способности не только контролировать уровень АД, но и влиять на эластические свойства артерий. Рассмотрены подходы к выбору терапевтических стратегий, направленных на коррекцию сосудистой жесткости для улучшения долгосрочного прогноза у пациентов с высоким сердечно-сосудистым риском.
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