Статья
ВЛИЯНИЕ СЕРДЕЧНО-СОСУДИСТЫХ ПРЕПАРАТОВ НА КОСТНУЮ ТКАНЬ И ВОЗМОЖНОСТЬ ИХ ИСПОЛЬЗОВАНИЯ ДЛЯ ПРОФИЛАКТИКИ ОСТЕОПОРОЗА
Широкое использование в клинической практике антигипертензивных и липидснижающих препаратов определяют необходимость знаний их плейотропных эффектов. Представлены результаты исследований по влиянию кардиологических препаратов, и, в первую очередь, из групп бета-адреноблокаторов, ингибиторов АПФ, диуретиков и статинов на костную ткань. Обсуждаются их механизмы действия на минеральную плотность кости, маркеры костного обмена и, в итоге, влияние на частоту переломов, связанных с остеопорозом. В настоящее время приведено недостаточно доказательств позитивного влияния этих препаратов на костную ткань, полученных в рандомизированных контролируемых исследованиях. Это не позволяет рекомендовать обсуждаемые группы кардиологических препаратов для профилактики остеопороза и переломов, а также регистрировать у них новые показания. Однако знания о дополнительном влиянии на костный метаболизм препаратов, назначаемых при заболеваниях сердечно-сосудистой системы, позволят врачам подобрать оптимальную схему лечения артериальной гипертонии и нарушений липидного обмена, учитывая состояние костной ткани, и одновременно проводить профилактику остеопороза у лиц с начальными признаками снижения костной массы или имеющих факторы риска остеопороза.
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