Артериальная гипертензия и бессимптомная гиперурикемия: алгоритм диагностики и ведения больных (описательный обзор)

Цель описательного обзора — определить диагностические критерии бессимптомной гиперурикемии с позиций риска развития сердечно-сосудистых событий, необходимость коррекции антигипертензивной терапии и возможности использования уратснижающей терапии у больных артериальной гипертензией (АГ); предложить алгоритм ведения данной категории пациентов. Стратегия и методология поиска. Поиск информации был проведен с использованием ключевых слов «бессимптомная гиперурикемия» и «артериальная гипертензия» в четырех базах данных: PubMed, Medscape, E-library, Yandex.ru. Результаты. В описательный обзор было включено 79 источников, из них 1 монография, 11 международных и российских рекомендаций, консенсусов, 67 обзоров, наблюдательных, нерандомизированных, рандомизированных клинических исследований, их метаанализов и дополнительных анализов, требований при выполнении анализов на содержание мочевой кислоты (МК) в крови. В описательном обзоре дано определение, представлена распространенность и рассмотрены диагностические критерии бессимптомной гиперурикемии в зависимости от метода ее определения, факторов и причин, влияющих на концентрацию МК, а также патогенетических механизмов ее увеличения. Показана линейная взаимосвязь концентрации МК с риском возникновения АГ, дислипидемии, сердечно-сосудистых заболеваний и осложнений. В обзоре выделены препараты, обусловливающие развитие лекарственно-индуцированной гиперурикемии, продемонстрировано влияние различных антигипертензивных и липиденижающих препаратов на концентрацию МК в крови, рассмотрен вопрос о возможности применения уратснижающей терапии при бессимптомной гиперурикемии. Заключение. На основании представленных в обзоре данных предложен алгоритм ведения больных с бессимптомной гиперурикемией и АГ.

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