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Артериальная гипертензия

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Возможности применения менопаузальной гормональной терапии у женщин высокого сердечно-сосудистого риска

https://doi.org/10.18705/1607-419X-2022-28-4-357-375

Аннотация

В обзорной статье представлены этапы применения менопаузальной гормональной терапии (МГТ) с позиций первичной и вторичной профилактики риска развития ишемической болезни сердца (ИБС) и смертельных исходов. На основании полученных данных был обновлен ряд рекомендаций и согласительных документов, отражающих необходимость соблюдения «временной гипотезы» при назначении МГТ в целях улучшения прогноза. Показаны аргументы возможного применения МГТ как в первичной профилактике сердечно-сосудистых заболеваний у женщин с кардиоваскулярными факторами риска, так и у пациенток с ИБС в анамнезе, перенесенными инфарктами миокарда, при развитии хронической сердечной недостаточности и фибрилляции предсердий. В 2021 году было выдвинуто предложение определять выбор МГТ в зависимости от групп сердечно-сосудистого риска (ССР). Однако такой подход к выбору МГТ исключает персонификацию и индивидуализацию возможности применения данного метода лечения при наличии отдельных факторов низкого, промежуточного ССР, таких как АГ, гиперхолестеринемия, сахарный диабет 2-го типа и других, особенно при их хорошем контроле. Поэтому принятие клинических решений о применении МГТ в условиях высокого ССР и наличии индивидуальных клинически значимых факторов риска должно осуществляться мультидисциплинарной командой, что позволит исключить как немотивированные запреты, так и назначения при наличии противопоказаний.

Об авторах

С. В. Миронова
Пермский государственный медицинский университет имени академика Е.А. Вагнера Министерства здравоохранения Российской Федерации
Россия

Миронова Снежана Владимировна — кандидат медицинских наук, ассистент кафедры пропедевтики внутренних болезней № 2 Пермский ГМУ им. акад. Е.А. Вагнера.

Пермь.



Н. А. Козиолова
Пермский государственный медицинский университет имени академика Е.А. Вагнера Министерства здравоохранения Российской Федерации
Россия

Козиолова Наталья Андреевна — доктор медицинских наук, профессор, заведующая кафедрой пропедевтики внутренних болезней № 2 ВПО Пермский ГМУ им. акад. Е.А. Вагнера.

ул. Петропавловская, д. 26, Пермь, 614000.



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Рецензия

Для цитирования:


Миронова С.В., Козиолова Н.А. Возможности применения менопаузальной гормональной терапии у женщин высокого сердечно-сосудистого риска. Артериальная гипертензия. 2022;28(4):357-375. https://doi.org/10.18705/1607-419X-2022-28-4-357-375

For citation:


Mironova S.V., Koziolova N.A. The use of menopausal hormone therapy in women at high cardiovascular risk. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2022;28(4):357-375. (In Russ.) https://doi.org/10.18705/1607-419X-2022-28-4-357-375

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ISSN 1607-419X (Print)
ISSN 2411-8524 (Online)