Лечение артериальной гипертензии у пожилых: терапевтическая стратегия и особенности медикаментозной терапии
Обзор литературы посвящен проблемам лечения артериальной гипертензии (АГ) у пожилых и старых больных. Рассмотрены особенности обследования больных старшего возраста, целей и стратегии лечения. Проанализированы данные литературы о рекомендуемых для лечения старших возрастных групп антигипертензивных препаратов, имеющаяся доказательная база. Основное внимание в обзоре уделено использованию индапамида как препарата из группы диуретиков, имеющего оптимальное соотношение эффективности и безопасности. Именно этот препарат имеет оптимальный класс рекомендаций для лечения пожилых по системе FORTA. Для индапамида, по данным мета-анализов, характерны более высокая эффективность снижения систолического артериального давления (САД; -5.1 мм рт.ст. по сравнению с гипотиазидом) и более низкий риск электролитных нарушений, особенно в неретардированной форме. Подробно описаны кардио-, нефро- и ангиопротективные свойства индапамида. Рассмотрены возможности профилактики деменции и возможные механизмы нейропротекции при лечении индапамидом.Минушкина Л.О.
Ключевые слова
артериальная гипертензия
старческая астения
деменция
диуретики
индапамид
Список литературы
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Об авторах / Для корреспонденции
Автор для связи: Лариса Олеговна Минушкина, д.м.н., профессор кафедры терапии, кардиологии и функциональной диагностики,
Центральная государственная медицинская академия Управления делами Президента РФ, Москва, Россия; minushkina@mail.ru; ORCID:
https://orcid.org/0000-0002-4203-3586
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