arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2022-28-2-126-146arthyper-2114Research ArticleОБЗОРREVIEWВедение артериальной гипертензии у женщин после родов (обзор литературы)Management of arterial hypertension in women after delivery (a literature review)https://orcid.org/0000-0002-3920-8234ГайсинИ. Р.GaisinI. R.

Гайсин Ильшат Равилевич — доктор медицинских наук, профессор кафедры госпитальной терапии с курсами кардиологии и функциональной диагностики, факультет повышения квалификации и профессиональной переподготовки

ул. Ленина, д.87б, г. Ижевск, 426009

Ilshat R. Gaisin, MD, PhD, DSc, Professor, Department of Internal Diseases with the Courses of Cardiology and Functional Diagnostics

87b Lenina street, Izhevsk, 426009

igaisin@mail.ruhttps://orcid.org/0000-0002-2360-6182ИсхаковаА. С.IskhakovaA. S.

Исхакова Альфия Сабитовна — врач-кардиолог отделения артериальной гипертонии специализированной поликлиники

ул. Ленина, д.87б, г. Ижевск, 426009

Alfiya S. Iskhakova, MD, Cardiologist, Outpatient Department of Arterial Hypertension

Izhevsk

ishakovaalfia@yandex.ruСмирноваЕ. С.SmirnovaE. S.

Смирнова Екатерина Сергеевна — врач-кардиолог женского кардиологического отделения

ул. Ленина, д.87б, г. Ижевск, 426009

Ekaterina S. Smirnova, MD, Cardiologist, Department of Women’s Cardiology

Izhevsk

Федеральное государственное бюджетное образовательное учреждение высшего образования «Ижевская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияIzhevsk State Medical AcademyRussian FederationБюджетное учреждение здравоохранения «Республиканский клинико-диагностический центр» Министерства здравоохранения Удмуртской РеспубликиРоссияClinical Diagnostic Centre of the Udmurt RepublicRussian Federation202211032022282126146Copyright © Гайсин И.Р., Исхакова А.С., Смирнова Е.С., 20222022Гайсин И.Р., Исхакова А.С., Смирнова Е.С.Gaisin I.R., Iskhakova A.S., Smirnova E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2114

Проведен обзор литературы по краткосрочному и долгосрочному ведению женщин с артериальной гипертензией (АГ) после родов. Приводятся риски для будущего здоровья женщин, перенесших гипертензивные состояния во время беременности (гестационную АГ, преэклампсию). Рассматриваются немедикаментозные и лекарственные методы управления сердечно-сосудистыми рисками у женщин с неблагоприятными исходами беременности. Приводятся особенности межгестационного ухода за женщинами с АГ. Перечисляются причины прекращения грудного вскармливания у матерей с АГ. Рассматриваются медицинские, этические и юридические вопросы принятия решения об использовании антигипертензивных лекарств во время лактации. Перечисляются источники получения информации о совместимости лекарственных средств и грудного вскармливания. Приводятся данные о допустимости приема антигипертензивных препаратов при лактации, предоставляемые базой LactMed и производителями оригинальных лекарственных средств, продаваемых в России. Рассматривается актуальность атерогенной дислипидемии у женщин с АГ после родов и оценивается возможность и необходимость назначения гиполипидемических препаратов (статинов, эзетимиба и ингибиторов PCSK9) при лактации. Приводятся доказанные (аспирин, кальций) и исследуемые (метформин, статины, гидроксихлорохин) меры профилактики преэклампсии. Сообщается о создании мультидисциплинарных клиник материнского здоровья для женщин с анамнезом АГ беременности.

We present a literature review on short-/long-term management of women with postpartum hypertension (HTN). Future health risks for women with a history of hypertensive disorders of pregnancy (preeclampsia and gestational HTN) are listed. Nonpharmacological therapy and medications for cardiovascular risk management in women with adverse pregnancy outcomes are considered. Inter-pregnancy care details for women with HTN are given.Hypertension-related reasons to discontinue breastfeeding are listed. Medical, ethical and legal issues of a decision-making process in hypertension management during lactation are considered. Sources of reliable information on compatibility of medications and breastfeeding, as well as the information about the use of antihypertensive medications during lactation from LactMed database and package leaflets are given. Dyslipidaemia in women with postpartum HTN is considered and approaches to lipid-lowering medication during breastfeeding (statins, ezetimibe and PCSK9 inhibitors) are discussed. Both known (aspirin, calcium) and investigated (metformin, statins, hydroxychloroquine) prevention modalities in preeclampsia are presented. The implementation of multidisciplinary maternal health clinics for women with a history of HTN pregnancy is reported.

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