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Ацетилсалициловая кислота у больных артериальной гипертонией высокого риска
Ацетилсалициловая кислота у больных артериальной гипертонией высокого риска
Воробьева Н.М. Ацетилсалициловая кислота у больных артериальной гипертонией высокого риска. Consilium Medicum. 2015; 1: 22–26. DOI: 10.26442/2075-1753_2015.1.22-26
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Аннотация
В обзорной статье обсуждается целесообразность применения ацетилсалициловой кислоты у больных артериальной гипертонией высокого риска с целью первичной профилактики сердечно-сосудистых заболеваний. Подробно рассмотрены результаты исследования НОТ, выполненного у больных артериальной гипертонией и показавшего преимущества низких доз ацетилсалициловой кислоты в сравнении с плацебо в отношении первичной профилактики инфаркта миокарда и снижения частоты комбинированной конечной точки (инфаркт миокарда, инсульт, сердечно-сосудистая смерть).
Ключевые слова: артериальная гипертония, ацетилсалициловая кислота, первичная профилактика, инфаркт миокарда, высокий риск, шкала риска SCORE.
Ключевые слова: артериальная гипертония, ацетилсалициловая кислота, первичная профилактика, инфаркт миокарда, высокий риск, шкала риска SCORE.
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The following review discusses the efficacy of aspirin in hypertensive patients at high risk for primary prevention of cardiovascular disease. Considered in detail are the results of the study of NOT, performed in hypertensive patients and the benefits of low-dose aspirin versus placebo for the primary prevention of myocardial infarction and reduce the incidence of the combined endpoint (myocardial infarction, stroke, cardiovascular death) are presented.
Key words: arterial hypertension, acetylsalicylic acid, primary prevention of myocardial infarction, high risk, SCORE risk scale.
Key words: arterial hypertension, acetylsalicylic acid, primary prevention of myocardial infarction, high risk, SCORE risk scale.
Полный текст
Список литературы
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4. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351: 1755–62.
5. Zanchetti A, Hansson L, Dahlof B et al, on behalf of the HOT Study Group. Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk. J Hypertens 2002; 20: 2301–7.
6. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension. Eur Heart J 2013; 34: 2159–219.
7. Диагностика и лечение артериальной гипертонии. Клинические рекомендации. М., 2013. / Diagnostika i lechenie arterial'noy gipertonii. Klinicheskie rekomendatsii. M., 2013. http://cardioweb.ru/klinicheskie-rekomendatsii [in Russian]
8. Conroy RM, Pyorala K, Fitzgerald AP et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987–1003.
9. Национальные рекомендации по кардиоваскулярной профилактике. Кардиоваск. терапия и профилактика. 2011; 10 (6), Прил. 2. / Natsional'nye rekomendatsii po kardiovaskulyarnoy profilaktike. Kardiovask. terapiya i profilaktika. 2011; 10 (6), Pril. 2. [in Russian]
10. Функциональное состояние почек и прогнозирование сердечно-сосудистого риска. Рекомендации ВНОК. Кардиоваск. терапия и профилактика. 2008; 7 (6), Прил. 3. / Funktsional'noe sostoyanie pochek i prognozirovanie serdechno-sosudistogo riska. Rekomendatsii VNOK. Kardiovask. terapiya i profilaktika. 2008; 7 (6), Pril. 3. [in Russian]
11. Juul-Moller S, Edvardsson N, Jahnmatz B et al. Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet 1992; 340: 421–5.
12. Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. The RISK Group. Lancet 1990; 336: 827–30.
13. Swedish Aspirin Low Dose Trial (SALT) of 75 mg aspirin in secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group. Lancet 1991; 338: 1345–9.
14. Lindblad B, Persson NH, Takolander R, Bergqvist D. Does low dose acetylsalicylic acid prevent stroke after carotid surgery? A double-blind, placebo-controlled randomized trial. Stroke 1993; 24 (8): 1125–8.
15. Pearson TA, Blair SN, Daniels SR et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patient without Coronary or other Atherosclerotic Vascular Diseases. Circulation 2002; 106: 388–91.
16. Баркаган ЗС, Котовщикова ЕФ. Сравнительный анализ основных и побочных эффектов различных форм ацетилсалициловой кислоты. Клин. фармакология и терапия. 2004; 13 (3): 1–4. / Barkagan ZS, Kotovshchikova EF. Sravnitel'nyy analiz osnovnykh i pobochnykh effektov razlichnykh form atsetilsalitsilovoy kisloty. Klin. farmakologiya i terapiya. 2004; 13 (3): 1–4. [in Russian]
17. Верткин А.Л., Аристархова О.Ю., Адонина Е.В. и др. Безопасность и фармакоэкономическая эффективность применения различных препаратов ацетилсалициловой кислоты у пациентов с ИБС. РМЖ 2009; 17 (9): 570–5. / Vertkin A.L., Aristarkhova O.Yu., Adonina E.V. i dr. Bezopasnost' i farmakoekonomicheskaya effektivnost' primeneniya razlichnykh preparatov atsetilsalitsilovoy kisloty u patsientov s IBS. RMZh 2009; 17 (9): 570–5. [in Russian]
18. Яковенко Э.П., Краснолобова Л.П., Яковенко А.В. и др. Влияние препаратов ацетилсалициловой кислоты на морфофункциональное состояние слизистой оболочки желудка у кардиологических пациентов пожилого возраста. Сердце. 2013; 12 (3): 145–50. / Yakovenko E.P., Krasnolobova L.P., Yakovenko A.V. i dr. Vliyanie preparatov atsetilsalitsilovoy kisloty na morfofunktsional'noe sostoyanie slizistoy obolochki zheludka u kardiologicheskikh patsientov pozhilogo vozrasta. Serdtse. 2013; 12 (3): 145–50. [in Russian]
2. Peto R, Gray R, Collins R et al. Randomised trial of prophylactic daily aspirin in British male doctors. BMJ 1988; 296: 313–6.
3. Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med 1989; 321: 129–35.
4. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351: 1755–62.
5. Zanchetti A, Hansson L, Dahlof B et al, on behalf of the HOT Study Group. Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk. J Hypertens 2002; 20: 2301–7.
6. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension. Eur Heart J 2013; 34: 2159–219.
7. Diagnostika i lechenie arterial'noy gipertonii. Klinicheskie rekomendatsii. M., 2013. http://cardioweb.ru/klinicheskie-rekomendatsii [in Russian]
8. Conroy RM, Pyorala K, Fitzgerald AP et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987–1003.
9. Natsional'nye rekomendatsii po kardiovaskulyarnoy profilaktike. Kardiovask. terapiya i profilaktika. 2011; 10 (6), Pril. 2. [in Russian]
10. Funktsional'noe sostoyanie pochek i prognozirovanie serdechno-sosudistogo riska. Rekomendatsii VNOK. Kardiovask. terapiya i profilaktika. 2008; 7 (6), Pril. 3. [in Russian]
11. Juul-Moller S, Edvardsson N, Jahnmatz B et al. Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet 1992; 340: 421–5.
12. Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. The RISK Group. Lancet 1990; 336: 827–30.
13. Swedish Aspirin Low Dose Trial (SALT) of 75 mg aspirin in secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group. Lancet 1991; 338: 1345–9.
14. Lindblad B, Persson NH, Takolander R, Bergqvist D. Does low dose acetylsalicylic acid prevent stroke after carotid surgery? A double-blind, placebo-controlled randomized trial. Stroke 1993; 24 (8): 1125–8.
15. Pearson TA, Blair SN, Daniels SR et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patient without Coronary or other Atherosclerotic Vascular Diseases. Circulation 2002; 106: 388–91.
16. Barkagan ZS, Kotovshchikova EF. Sravnitel'nyy analiz osnovnykh i pobochnykh effektov razlichnykh form atsetilsalitsilovoy kisloty. Klin. farmakologiya i terapiya. 2004; 13 (3): 1–4. [in Russian]
17. Vertkin A.L., Aristarkhova O.Yu., Adonina E.V. i dr. Bezopasnost' i farmakoekonomicheskaya effektivnost' primeneniya razlichnykh preparatov atsetilsalitsilovoy kisloty u patsientov s IBS. RMZh 2009; 17 (9): 570–5. [in Russian]
18. Yakovenko E.P., Krasnolobova L.P., Yakovenko A.V. i dr. Vliyanie preparatov atsetilsalitsilovoy kisloty na morfofunktsional'noe sostoyanie slizistoy obolochki zheludka u kardiologicheskikh patsientov pozhilogo vozrasta. Serdtse. 2013; 12 (3): 145–50. [in Russian]
2. Peto R, Gray R, Collins R et al. Randomised trial of prophylactic daily aspirin in British male doctors. BMJ 1988; 296: 313–6.
3. Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med 1989; 321: 129–35.
4. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351: 1755–62.
5. Zanchetti A, Hansson L, Dahlof B et al, on behalf of the HOT Study Group. Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk. J Hypertens 2002; 20: 2301–7.
6. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension. Eur Heart J 2013; 34: 2159–219.
7. Диагностика и лечение артериальной гипертонии. Клинические рекомендации. М., 2013. / Diagnostika i lechenie arterial'noy gipertonii. Klinicheskie rekomendatsii. M., 2013. http://cardioweb.ru/klinicheskie-rekomendatsii [in Russian]
8. Conroy RM, Pyorala K, Fitzgerald AP et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987–1003.
9. Национальные рекомендации по кардиоваскулярной профилактике. Кардиоваск. терапия и профилактика. 2011; 10 (6), Прил. 2. / Natsional'nye rekomendatsii po kardiovaskulyarnoy profilaktike. Kardiovask. terapiya i profilaktika. 2011; 10 (6), Pril. 2. [in Russian]
10. Функциональное состояние почек и прогнозирование сердечно-сосудистого риска. Рекомендации ВНОК. Кардиоваск. терапия и профилактика. 2008; 7 (6), Прил. 3. / Funktsional'noe sostoyanie pochek i prognozirovanie serdechno-sosudistogo riska. Rekomendatsii VNOK. Kardiovask. terapiya i profilaktika. 2008; 7 (6), Pril. 3. [in Russian]
11. Juul-Moller S, Edvardsson N, Jahnmatz B et al. Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet 1992; 340: 421–5.
12. Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. The RISK Group. Lancet 1990; 336: 827–30.
13. Swedish Aspirin Low Dose Trial (SALT) of 75 mg aspirin in secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group. Lancet 1991; 338: 1345–9.
14. Lindblad B, Persson NH, Takolander R, Bergqvist D. Does low dose acetylsalicylic acid prevent stroke after carotid surgery? A double-blind, placebo-controlled randomized trial. Stroke 1993; 24 (8): 1125–8.
15. Pearson TA, Blair SN, Daniels SR et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patient without Coronary or other Atherosclerotic Vascular Diseases. Circulation 2002; 106: 388–91.
16. Баркаган ЗС, Котовщикова ЕФ. Сравнительный анализ основных и побочных эффектов различных форм ацетилсалициловой кислоты. Клин. фармакология и терапия. 2004; 13 (3): 1–4. / Barkagan ZS, Kotovshchikova EF. Sravnitel'nyy analiz osnovnykh i pobochnykh effektov razlichnykh form atsetilsalitsilovoy kisloty. Klin. farmakologiya i terapiya. 2004; 13 (3): 1–4. [in Russian]
17. Верткин А.Л., Аристархова О.Ю., Адонина Е.В. и др. Безопасность и фармакоэкономическая эффективность применения различных препаратов ацетилсалициловой кислоты у пациентов с ИБС. РМЖ 2009; 17 (9): 570–5. / Vertkin A.L., Aristarkhova O.Yu., Adonina E.V. i dr. Bezopasnost' i farmakoekonomicheskaya effektivnost' primeneniya razlichnykh preparatov atsetilsalitsilovoy kisloty u patsientov s IBS. RMZh 2009; 17 (9): 570–5. [in Russian]
18. Яковенко Э.П., Краснолобова Л.П., Яковенко А.В. и др. Влияние препаратов ацетилсалициловой кислоты на морфофункциональное состояние слизистой оболочки желудка у кардиологических пациентов пожилого возраста. Сердце. 2013; 12 (3): 145–50. / Yakovenko E.P., Krasnolobova L.P., Yakovenko A.V. i dr. Vliyanie preparatov atsetilsalitsilovoy kisloty na morfofunktsional'noe sostoyanie slizistoy obolochki zheludka u kardiologicheskikh patsientov pozhilogo vozrasta. Serdtse. 2013; 12 (3): 145–50. [in Russian]
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2. Peto R, Gray R, Collins R et al. Randomised trial of prophylactic daily aspirin in British male doctors. BMJ 1988; 296: 313–6.
3. Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med 1989; 321: 129–35.
4. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351: 1755–62.
5. Zanchetti A, Hansson L, Dahlof B et al, on behalf of the HOT Study Group. Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk. J Hypertens 2002; 20: 2301–7.
6. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension. Eur Heart J 2013; 34: 2159–219.
7. Diagnostika i lechenie arterial'noy gipertonii. Klinicheskie rekomendatsii. M., 2013. http://cardioweb.ru/klinicheskie-rekomendatsii [in Russian]
8. Conroy RM, Pyorala K, Fitzgerald AP et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987–1003.
9. Natsional'nye rekomendatsii po kardiovaskulyarnoy profilaktike. Kardiovask. terapiya i profilaktika. 2011; 10 (6), Pril. 2. [in Russian]
10. Funktsional'noe sostoyanie pochek i prognozirovanie serdechno-sosudistogo riska. Rekomendatsii VNOK. Kardiovask. terapiya i profilaktika. 2008; 7 (6), Pril. 3. [in Russian]
11. Juul-Moller S, Edvardsson N, Jahnmatz B et al. Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet 1992; 340: 421–5.
12. Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. The RISK Group. Lancet 1990; 336: 827–30.
13. Swedish Aspirin Low Dose Trial (SALT) of 75 mg aspirin in secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group. Lancet 1991; 338: 1345–9.
14. Lindblad B, Persson NH, Takolander R, Bergqvist D. Does low dose acetylsalicylic acid prevent stroke after carotid surgery? A double-blind, placebo-controlled randomized trial. Stroke 1993; 24 (8): 1125–8.
15. Pearson TA, Blair SN, Daniels SR et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patient without Coronary or other Atherosclerotic Vascular Diseases. Circulation 2002; 106: 388–91.
16. Barkagan ZS, Kotovshchikova EF. Sravnitel'nyy analiz osnovnykh i pobochnykh effektov razlichnykh form atsetilsalitsilovoy kisloty. Klin. farmakologiya i terapiya. 2004; 13 (3): 1–4. [in Russian]
17. Vertkin A.L., Aristarkhova O.Yu., Adonina E.V. i dr. Bezopasnost' i farmakoekonomicheskaya effektivnost' primeneniya razlichnykh preparatov atsetilsalitsilovoy kisloty u patsientov s IBS. RMZh 2009; 17 (9): 570–5. [in Russian]
18. Yakovenko E.P., Krasnolobova L.P., Yakovenko A.V. i dr. Vliyanie preparatov atsetilsalitsilovoy kisloty na morfofunktsional'noe sostoyanie slizistoy obolochki zheludka u kardiologicheskikh patsientov pozhilogo vozrasta. Serdtse. 2013; 12 (3): 145–50. [in Russian]
Авторы
Н.М.Воробьева
ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
natalyavorobjeva@mail.ru
ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
natalyavorobjeva@mail.ru
________________________________________________
N.M.Vorobyeva
Russian Cardiology Research and Production Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
natalyavorobjeva@mail.ru
Russian Cardiology Research and Production Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
natalyavorobjeva@mail.ru
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