ÐÇå»ñïáÝdzÛÇ µ³ñÓñ éÇëÏÇ ÑÇí³Ý¹Ý»ñÇ ... · 2016-10-13 · ÓÄÊ...
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ÓÄÊ 616.12-008.331.1]-085.224.036.8
ÐÇå»ñïáÝdzÛÇ µ³ñÓñ éÇëÏÇ ÑÇí³Ý¹Ý»ñÇ ëï³ïÇݳÛÇÝ Ã»ñ³ådzÝ, Ñݳñ³íáñ
ûñ·³Ý³å³ßïå³ÝÇã ³½¹»óáõÃÛáõÝÝ»ñÁ : ²µëïñ³Ïï
î.Ü. êáÉáÙ»ÝãáõÏ, Ü.². êɳµ³, ¶.ì. âÝ·ñÛ³Ý, º.Ú. ÎÉÇÙÏáíÇã,
ú.Ø. êɳµÇ, ².². ´»¹½³Û
àõëáõÙݳëÇñí»É ¿ éá½áõí³ëï³ïÇÝÇ ÑÇåáÉÇ-åǹ³ÛÇÝ ¨ ûñ·³Ý³å³ßïå³ÝÇã ³½¹»óáõÃÛáõÝÁ
½³ñÏ»ñ³Ï³ÛÇÝ ÑÇå»ñï»Ý½Ç³Ûáí ¨ ³Ã»ñá·»Ý ¹ÇëÉÇåǹ»Ù³Ûáí ÑÇí³Ý¹Ý»ñÇ Ùáï: лﳽáïí»É
»Ý 43-67 ï³ñ»Ï³Ý 59 I-II ÷áõÉÇ ÑÇå»ñï»Ý½Ç³-Ûáí ¨ µ³ñÓñ ËïáõÃÛ³Ý ÉÇåáåñáï»ÇÝÝ»ñáí (´ÊÈ>3,0ÙÙáÉ/É) ÑÇí³Ý¹Ý»ñ, áñáÝù µ³Å³Ýí»É »Ý 2 ËÙµÇ:
I ËáõÙµÁ Ý»ñ³é»É ¿ 36 Ñá·Ç, áíù»ñ ëï³ó»É »Ý éá½áõí³ëï³ïÇÝ 10-20 Ù·/ûñ (ÙÇçÇÝ
¹»Õ³ã³÷Áª 12,2Ù·/ûñ)ª ѳٳÏóí³Í é»ÝÇÝ-³Ý·ÇáûݽÇÝ - ³É¹áëï»ñáݳÛÇÝ Ñ³Ù³Ï³ñ·Ç
ÇÝÑǵÇïáñÝ»ñÇ (è²²Æ) Ñ»ï, II ËÙµÇ ÑÇí³Ý¹Ý»ñÁ ëï³ó»É »Ý è²²Æ ³é³Ýó ëï³ïÇÝÇ
ûñ³ådzÛÇ: àñáßí»É ¿ ³ñÛ³Ý ×ÝßÙ³Ý, ÉÇåǹ³ÛÇÝ åñáýÇÉÇ, ÉÇåǹݻñÇ å»ñáùëǹ³óÙ³Ý
ٳϳñ¹³ÏÁ, ÁݹѳÝáõñ ýÇ-µñÇÝá·»ÝÁ, C-é»Ï³ïÇí ëåÇï³ÏáõóÁ, ·ÉÇÏáÉÇ-½³óí³Í
Ñ»Ùá·ÉáµÇÝÁ, ÏÍÇϳÛÇÝ ýÇÉïñ³ódzÛÇ ³ñ³·áõÃÛáõÝÁ, Ïá×Õáõë³ÛÇÝ Çݹ»ùëÁ:
ä³ñ½í»É ¿, áñ ÉÇåǹݻñÇ Ù³Ï³ñ¹³ÏÇ Ï³ñ·³-íáñáõÙÇó µ³óÇ éá½áõí³ëï³ïÇÝÁ óáõó³µ»ñáõÙ ¿
ѳϳµáñµáù³ÛÇÝ ¨ ѳϳûùëǹ³Ýï³ÛÇÝ ³½¹»-óáõÃÛáõÝ, Ýå³ëï»Éáí ½³ñÏ»ñ³Ï³ÛÇÝ ×ÝßÙ³Ý
Çç»óÙ³ÝÁ ¨ »ñÇϳٳÛÇÝ ýÇÉïñ³óÇáÝ ýáõÝÏ-ódzÛÇ áõ ͳÛñ³Ù³ë³ÛÇÝ ³ñÛ³Ý ßñç³Ý³éáõ-
ÃÛ³Ý íÇ׳ÏÇ µ³ñ»É³íÙ³ÝÁ:
Ìåäèöèíñêèé Âåñòíèê Ýðåáóíè, 2013, 4(56), 34-41
¶ñ³Ï³ÝáõÃÛáõÝ1. ÂÎÇ: Èíôîðìàöèîííûé áþëëåòåíü N°317 (ìàðò 2013 ð.) Ðåæèì äîñòóïà: http://
www.who.int/mediacentre/factsheets/fs31 7/ru/2. Óíіêîâàíèé êëіíі÷íèé ïðîòîêîë ïåðâèííîї, åêñòðåíîї òà âòîðèííîї (ñïåöіàëіçîâàíîї) ìåäè÷íîї
äîïîìîãè Àðòåðіàëüíà ãèïåðòåíçèÿ. Íàêàç ÌÎÇ Óêðàїíè âіä 24.05.2012 ð. № 384 Ïðî çàòâåðäæåííÿ
òà âïðîâàäæåííÿ ìåäèêî-òåõíîëîãі÷íèõ äîêóìåíòіâ çі ñòàíäàðòèçàöії ìåäè÷íîї äîïîìîãè ïðè
àðòåðéàëüíéé ãéïåð-òåíçéé Ðåæèì äîñòóïà: www.moz.gov.ua3. Àðòåðіàëüíà ãéïåðòåíçéÿ. Îíîâëåíà òà àäàïòî-âàíà êëéíé÷íà íàñòàíîâà, çàñíîâàíà íà äîêàçàõ.
Äîäàòîê äî Íàêàçó ÌÎÇ Óêðàїíè № 384 âéä 24.05.2012 ð. Ïðî çàòâåðäæåííÿ òà âïðîâàäæåííÿ
ìåäèêî-òåõíîëîãi÷íèõ äîêó-ìåíòiâ çi ñòàíäàðòèçàöiї ìåäè÷íîї äîïîìîãè ïðè àðòåðiàëüíié ãiïåðòåíçiї
[Åëåêòðîííèé ðåñóðñ] Ðåæèì äîñòóïà: www.moz.gov.ua
4. Sever P.S., Dahlöf B., Poulter N.R. et al ASCOT investigators) Prevention of coronary and
stroke events with atorvastatin in hypertensive patients who have average or lower-than-
average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial—Lipid
Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet, 2003, Vol.361
(9364), p. 1149 – 1158.
5. Downs J.R., Clearfield M., Weis S. et al. for the AFCAPS/ TexCAPS Research Group. Primaryprevention of acute coronary events with lovastatin in men and women with averagecholesterol levels. JAMA, 1998, Vol. 279, p. 1615–1622.
6. 7. Psaty B.M., Lumley T; Furberg C.D. et al. Health Outcomes Associated With VariousAntihypertensive Therapies Used as First-Line Agents. A Network Meta-analysis. JAMA, 2003,Vol. 289 (19), p. 2534-2544.
7. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the
management of arterial hypertension of the European Society of Hypertension (ESH) and of the
European Society of Cardiology (ESC). Journal of Hypertension, 2013, Vol. 31, p. 1281–1357.
8. Reiner Z., Catapano A.L., De Backer G. et al. ESC/EAS Guidelines for the management of
dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society
of Cardiology ESC) and the European Atherosclerosis Society (EAS). Eur. Heart. J., 2011, Vol. 32,
p.1769–1818.
9. Perk J., De Baker G., Gohlke H. et al. European Guidelines on Cardiovascular disease prevention inclinical practice (version 2012). The Fifth Joint Task Force of the European Society of
Cardiology and Other Societies on Cardivascu-lar Disease Prevention in Clinical Practice
(constituted by representatives of nine societies and by invited experts). Developed with the
Ò.Í. Ñîëîìåí÷óê, Í.À. Ñëàáà, Ã.Â. ×íãðÿí, Å.Þ. Êëèìêîâè÷, Î.Ì. Ñëàáûé, À.À. Áåäçàé
special contribution of the European Association
for cardiovascular Prevention & Rehabilitation
(EACPR). European Heart J., 2012, Vol. 33, p.
1635-1701.
10. Norgren L., Hiatt W.R., Dormandy J.A. et al
Inter–Society Consensus for the Management of
Peripheral Arterial Disease (TASC II). J. Vasc
Surg. 2007, Vol. 45, p.S5–67.
11. Ðîãîçà À.Í., Áàëàõîíîâà Ò.Â., ×èõëàäçå Í.Ì.
Ìåòîäû îïðåäåëåíèÿ ëîäûæå÷íî-ïëå÷åâîãî
èíäåêñà ñèñòîëè÷åñêîãî äàâëåíèÿ ïðè ìàññî-
âûõ îáñëåäîâàíèÿõ. Consilium medicum, 2009,№ 10, ñ. 66-71.
12. Jones P.H., Davidson M.H., Stein E.A., Bays
H.E., McKenney J.M., Miller E., Cain V.A.,
Blasetto J.W. Comparison of the efficacy and
safety of rosuvastatin versus atorvastatin, sim-
vastatin, and pravastatin across doses
(STELLAR* Trial). Am. J. Cardiol., 2003, Vol.
92 (2), p.152-60.
13. Rosenson R.S., Otvos J.D., Hsia J. Effects of
Rosuvastatin and Atorvastatin on LDL and HDL
Particle Concentrations in Patients With Meta-
bolic Syndrome. Diabetes Care. 2009, Vol.
32(6), p. 1087–1091 (COMETS).
14. Âèçèð Â.À., Áåðåçèí À.Å. Êëèíè÷åñêîå çíà÷å-
íèå òåðàïåâòè÷åñêîãî ñèíåðãèçìà àíòèãèïåð-
òåíçèâíûõ ëåêàðñòâåííûõ ñðåäñòâ è ñòàòèíîâ.Íîâîñòè ìåäèöèíû è ôàðìàöèè. 2007, № 216,
Ñ. 21-22.
15. Barreto-Filho J.A., Consolim-Colombo F.M.,
Guerra-Riccio G.M. Hypercholesterolemia
blunts forearm vasorelaxation and enhances the
pressor response during acute systemic hypoxia.
Arterioscler. Thromb. Vasc. Biol., 2003, Vol.
23, Ð. 1660-1666.16. Ridker P.M., Danielson E., Fonseca F.A. et al.
JUPITER Study Group. Rosuvastatin to prevent
vascular events in men and women with eleva-
ted C-reactive protein. N. Engl. J. Med., 2008,
Vol.359, p. 2195–2207.
17. Sposito A.C. Emerging insights into hyperten-
sion and dyslipidaemia synergies. European
Heart Journal Supplements. 2004, Vol. 6 (Sup-
plement G), p. G8–G12.18. Borghi C., Prandin M.G., Costa F.V. et al. Use
of statins and blood pressure control in treated
hypertensive patients with hypercholesterole-
mia. Cardiovasc, Pharmacol., 2000, Vol.35, Ð.
549-555.
19. Strazzullo P., Kerry S.M., Barbato À. et al. Do
Statins Reduce Blood Pressure? Hypertension,
2007, V. 49, p. 792-798.20. Seijo P., Paz L., Ameijeiras H. et al. Effects of
Rosuvastatin on Blood Pressure in Hypertensive
Subjects With Dyslipidemia. Journal of Hyper-
tension. 2010. Vol. 28, p e230
21. Seki S., Hashimoto K., Taniguchi I., Yoshimura
M., Takeda N. Effect of rosuvastatin on syste-
mic blood pressure in patients with hypercholes-
terolemia. Exp. Clin. Cardiol., 2012, Vol. 17(4),
p. 221–225.22. Kamberi L.S., Bakalli A.B., Budima N.M. et al.
Pleiotropic and Lipid–lowering Effects of Sta-
tins in Hypertension. Mater Sociomed., 2012,
Vol.24 (2),p. 84–86.23. Igase M., Kohara K., Tabara Y. et al. Low-dose
Rosuvastatin Improves the Functional and
Morphological Markers of Atherosclerosis in
Asymptomatic Postmenopausal Women With
Dyslipidemia. Menopause, 2012, Vol. 19 (12),
p. 1294-1299.
24. Guofu L., Longliang Z., Jiaqiong Z., Yang Y.,
Lin Z. Influence of Rosuvastatin on high sensiti-
vity C reactive protein and ankle brachial index
of patients with hypertension dyslipidemia.
China Medical Herald, 2012, Vol.24, p. 90-92.
25. Vidt D.G., Cressman M.D., Harris S., Pears J.S.,
Hutchinson H.G. Rosuvastatin-induced arrest in
progression of renal disease. Cardiology, 2004,
Vol. 102 (1), p. 52-60.26. Stein E.A., Vidt D.G., Shepherd J. et al. Renal
safety of intensive cholesterol-lowering treat-
ment with rosuvastatin: a retrospective analysis
of renal adverse events among 40,600 parti-
cipants in the rosuvastatin clinical development
program. Atherosclerosis, 2012, Vol. 221 (2),
p.471-7.27. Liu Y.Z., Liu M., Zhang Y.M. et al. Protective
Effects of Rosuvastatin in Experimental Renal
Failure Rats via Improved Endothelial Function.
Biol Res Nurs. 2013, Vol. 15 (3), p. 356-64.
28. de Barros E.P., Garcia-Pinto A.B., Machado
P.Y., dos Santos Pereira M.J., de Carvalho J.J.
Rosuvastatin beneficially alters the glomerular
structure of kidneys from spontaneouslyhypertensive rats (SHRs). J. Mol. Histol., 2011,
Vol.42 (4), p. 323-31.
Ñòàòèíîòåðàïèÿ ïðè àðòåðèàëüíîé ãèïåðòåíçèè âûñîêîãî ðèñêà: âîçìîæíîñòè äîïîëíèòåëüíîé îðãàíîïðîòåêöèè