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Артериальная гипертония у женщин. Особенности лечения: роль b-блокаторов
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Аннотация
Гендерный подход к изучению артериальной гипертонии выявил особенности патогенеза заболевания у женщин, в основе которых лежат механизмы, ассоциированные с повышенной активностью симпатической нервной системы, гормональными и метаболическими нарушениями. Гемодинамические, вегетативные и метаболические изменения в период беременности и менопаузы сопряжены с увеличением риска развития гипертензивных осложнений и сердечно-сосудистых заболеваний. Необходимость подбора терапии, направленной на коррекцию повышенного тонуса симпатической нервной системы, позволяет сделать выбор в пользу b-адреноблокаторов. Кардиоселективный b-блокатор бисопролол обладает высокой антигипертензивной эффективностью, не влияет на чувствительность тканей к инсулину и метаболизм глюкозы и может быть рекомендован для лечения артериальной гипертонии у женщин в различные периоды жизни. Возможно использование бисопролола при артериальной гипертонии и нарушениях ритма сердца в период беременности.
Ключевые слова: артериальная гипертония у женщин, беременность, бисопролол.
Ключевые слова: артериальная гипертония у женщин, беременность, бисопролол.
________________________________________________
The gender approach to studies of arterial hypertension reveals particularities of the disease pathogenesis in women which are based on mechanisms associated with increased activity of sympathetic nervous system, hormonal and metabolic disorders. Hemodynamic, vegetative and metabolic changes during pregnancy and menopause are associated with increased risk of hypertensive complications and cardiovascular diseases. The necessity to select a therapy which will be targeted on management of increased tone of sympathetic nervous system favours b-blockers. Cardioselective b-blocker bisoprolol has high antihypertensive efficacy, does affect tissue sensitivity to insulin and glucose metabolism, and can be recommended for treatment of arterial hypertension in women in various life periods. Bisoprolol can be used in arterial hypertension and heart rhythm disorders during pregnancy.
Key words: arterial hypertension in women, pregnancy, bisoprolol.
Полный текст
Список литературы
1. Кириченко А.А. Место бисопролола в терапии артериальной гипертензии и ишемической болезни сердца. Фарматека. 2009; 8: 10–7.
2. Кулаков В.И., Сметник В.П. Руководство по климактерию. М.: Мед. информ. агентство, 2001; с. 404–95.
3. Лечебно-диагностическая тактика ведения беременных с артериальной гипертонией в России. М.: Рашин Продакшин, 2007; с. 136.
4. Мартынов А.И., Майчук Е.Ю., Юренева С.В. и др. Артериальная гипертензия у женщин с хирургической менопаузой. Медицина климактерия. Под. ред. В.П.Сметник. M.: Литера, 2006; с. 463–75.
5. Оганов Р.Г., Галкин В.А., Масленникова Г.Я. Артериальная гипертония – проблема поликлиническая. Терапевт. архив, 2006; 1: 6–9.
6. Стрюк Р.И., Брыткова Я.В., Павлова Л.Н., Немировский В.Б. Перинатальные исходы у беременных с артериальной гипертонией, коррегированной бисопрололом и нифедипином SR/GITS. Системные гипертензии. 2011; 2: 28–32.
7. Ткачева О.Н., Мурашко Л.Е., Верткин А.Л., Тумбаев И.В. Антигипертензивная терапия b-блокаторами при артериальной гипертонии беременных: за и против. Кардиоваск. тер. проф. 2003; 6: 77–83.
8. Ткачева О.Н., Прохорович Е.А., Майчук Е.Ю., Галяутдинова А.Ю. Дислипидемия у женщин. М.: Мед. книга, 2007; с. 136.
9. Ткачева О.Н., Рунихина Н.К. Артериальная гипертензия у беременных. Антагонисты кальция. М.: Медпрактика-М, 2010; с. 148.
10. Шилов А.М. B-блокатор второго поколения в практике лечения артериальной гипертонии. Фарматека. 2008; с. 8.
11. Abalos E, Duley L, Steyn DW et al. Antihypertensive drug therapy for mild to moderate hypertension duringpregnancy. Cochrane Database Syst Rev 2007; 24 (1): CD002252.
12. Balamuthusamy S, Molnar J, Adigopula S et al. Comparative analysis of beta-blockers with other antihypertensive agents on cardiovascular outcomes in hypertensive patients with diabetes mellitus: a systematic review and meta-analysis. Am J Ther 2009; 16 (2): 133–42.
13. Bangalore S, Wild D, Parkar S et al. Beta-blockers for primary prevention of heart failure in patients with hypertension. J Amer Coll Cardiol 2008; 52: 1062–72.
14. Bayliss H, Churchill D, Beevers M, Beevers DG. Anti-hypertensive drugs in pregnancy and fetal growth: evidence for «pharmacological programming» in the first trimester? Hypertens Pregnancy 2002; 21: 161–74.
15. Blood Pressure Lowering Treatment Trialists Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet 2003; 362: 1527–35.
16. Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnacy and lactation. 7th edition. A Reference Guide to Fetal and Neonatal Risk. Lippincott Williams & Wilkins 2005; p. 1858.
17. Caetano M, Ornstein M, von Dadelszen P et al. A survey of Canadian practitioners regarding the management of the hypertensive disorders of pregnancy. Hypertens Pregnancy 2003; 23: 61–74.
18. Catalano PM, Nizielski SE, Shao J et al. Downregulated IRS-1 and PPARgamma in obese women with gestational diabetes: relationship to FFA during pregnancy. Am J Physiol Endocrinol Metab 2002; 282: 522–33.
19. Easterling TR, Brateng D et al. Prevention of preeclampsia: a randomized trial of atenolol in hyperdynamic patients before onset of hypertension. Obstet Gynecol 1999; 93 (5, 1): 725–33.
20. Frishman WH, Chesner M. Beta-adrenergic blockers in pregnancy. Am Heart J 1988; 115: 147–52.
21. Fu Q, Levine BD. Hypertension and antihypertensive therapy in elderly women: how much do we really know? Hypertension 2006; 47 (3): 323–4.
22. Fu Q, Vongpatanasin W, Levine BD. Neural and nonneural mechanisms for sex differences in elderly hypertension: can exercise training help? Hypertension 2008; 52 (5): 787–94.
23. Horikiri Y et al. J Pharm Sci 1998; 87: 289.
24. Janka HU et al. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S96.
25. Kinoshita T, Itoh M. Longitudinal variance of fat mass deposition during pregnancy evaluated by ultrasonography: the ratio of visceral fat to subcutaneous fat in the abdomen. Gynecol Obstet Invest 2006; 61: 115–8.
26. Knopp RH, Warth MR, Charles D et al. Lipoprotein metabolism in pregnancy, fat transport to the fetus, and the effects of diabetes. Biol Neonate 1986; 50 (6): 297–317.
27. Koning L, Merchant AT, Pogue J et al. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. European Heart Jornal 2007; 28 (7): 850–8565.
28. Kuti EL, Baker WL, White CM. The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker. Curr Med Res Opin 2007; 23 (6): 1239–44.
29. Lindholm L, Carlberg B, Samuelsson O. Should β-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 366: 1545–53.
30. Lowe SA, Brown MA, Dekker G et al. Guidelines for the management of hypertension disorders of pregnancy, 2008; Society of Obstetric medicine of Australia and New Zealand. Aust N Z J Obstet Gynaecol 2009; 49 (3): 242–6.
31. Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 2003; 3: CD002863.
32. Magee LA, Helewa ME, Moutquin JM et al. Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy. This guideline has been reviewed and approved by the Hypertension Guideline Committee and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada. JOGC 2008; 48.
33. Mercuro G, Zoncu S, Saiu F et al. Menopause induced by oophorectomy reveals a role of ovarian estrogen on the maintenance of pressure homeostasis. Maturitas 2004; 47: 131–8.
34. Narkiewicz K, Phillips BG, Kato M et al. Gender-selective interaction between aging, blood pressure, and sympathetic nerve activity. Hypertension 2005; 45 (4): 522–5.
35. Paradisi G, Biaggi A, Ferrazzani S et al. Abnormal carbohydrate metabolism during pregnancy : association with endothelial dysfunction. Diabetes Care 2002; 25: 560–4.
36. Pepine CJ, Kerensky RA, Lambert CR et al. Some thoughts on the vasculopathy of women with ischemic heart disease. J Am Coll Cardiol 2006; 47 (Suppl. 3): 30–5.
37. Ryan EA, O’Sullivan MJ, Skyler JS. Insulin action during pregnancy. Studies with the euglycemic clamp technique. Diabetes 1985; 34: 380–9.
38. Sattar N, Greer IA. Pregnancy complications and maternal cardiovascular risk: opportunities for interventions and screening? BMJ 2002: 325 (7356): 157–60.
39. Sivan E, Homko CJ, Chen X et al. Effect of insulin on fat metabolism during and after normal pregnancy. Diabetes 1999; 48: 834–8.
40. Stevenson J, Crook D, Godsland I. Influence of age and menopause on serum lipids and lipoproteins in healthy women. Atherosclerosis 1993; 98: 83–90.
41. Waddell TK, Dart AM, Gatzka CD. Women exhibit a greater age-related increase in proximal aortic stiffness than men. J Hypertens 2001; 19: 2205–12.
42. Wellstein A et al. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S41–5.
43. Wichman K, Ryulden G, Karberg BE. A placebo-controlled trial of metoprolol in the treatment of hypertension in pregnancy. Scand J Clin Lab Invest 1984; 169: 90–4.
2. Кулаков В.И., Сметник В.П. Руководство по климактерию. М.: Мед. информ. агентство, 2001; с. 404–95.
3. Лечебно-диагностическая тактика ведения беременных с артериальной гипертонией в России. М.: Рашин Продакшин, 2007; с. 136.
4. Мартынов А.И., Майчук Е.Ю., Юренева С.В. и др. Артериальная гипертензия у женщин с хирургической менопаузой. Медицина климактерия. Под. ред. В.П.Сметник. M.: Литера, 2006; с. 463–75.
5. Оганов Р.Г., Галкин В.А., Масленникова Г.Я. Артериальная гипертония – проблема поликлиническая. Терапевт. архив, 2006; 1: 6–9.
6. Стрюк Р.И., Брыткова Я.В., Павлова Л.Н., Немировский В.Б. Перинатальные исходы у беременных с артериальной гипертонией, коррегированной бисопрололом и нифедипином SR/GITS. Системные гипертензии. 2011; 2: 28–32.
7. Ткачева О.Н., Мурашко Л.Е., Верткин А.Л., Тумбаев И.В. Антигипертензивная терапия b-блокаторами при артериальной гипертонии беременных: за и против. Кардиоваск. тер. проф. 2003; 6: 77–83.
8. Ткачева О.Н., Прохорович Е.А., Майчук Е.Ю., Галяутдинова А.Ю. Дислипидемия у женщин. М.: Мед. книга, 2007; с. 136.
9. Ткачева О.Н., Рунихина Н.К. Артериальная гипертензия у беременных. Антагонисты кальция. М.: Медпрактика-М, 2010; с. 148.
10. Шилов А.М. B-блокатор второго поколения в практике лечения артериальной гипертонии. Фарматека. 2008; с. 8.
11. Abalos E, Duley L, Steyn DW et al. Antihypertensive drug therapy for mild to moderate hypertension duringpregnancy. Cochrane Database Syst Rev 2007; 24 (1): CD002252.
12. Balamuthusamy S, Molnar J, Adigopula S et al. Comparative analysis of beta-blockers with other antihypertensive agents on cardiovascular outcomes in hypertensive patients with diabetes mellitus: a systematic review and meta-analysis. Am J Ther 2009; 16 (2): 133–42.
13. Bangalore S, Wild D, Parkar S et al. Beta-blockers for primary prevention of heart failure in patients with hypertension. J Amer Coll Cardiol 2008; 52: 1062–72.
14. Bayliss H, Churchill D, Beevers M, Beevers DG. Anti-hypertensive drugs in pregnancy and fetal growth: evidence for «pharmacological programming» in the first trimester? Hypertens Pregnancy 2002; 21: 161–74.
15. Blood Pressure Lowering Treatment Trialists Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet 2003; 362: 1527–35.
16. Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnacy and lactation. 7th edition. A Reference Guide to Fetal and Neonatal Risk. Lippincott Williams & Wilkins 2005; p. 1858.
17. Caetano M, Ornstein M, von Dadelszen P et al. A survey of Canadian practitioners regarding the management of the hypertensive disorders of pregnancy. Hypertens Pregnancy 2003; 23: 61–74.
18. Catalano PM, Nizielski SE, Shao J et al. Downregulated IRS-1 and PPARgamma in obese women with gestational diabetes: relationship to FFA during pregnancy. Am J Physiol Endocrinol Metab 2002; 282: 522–33.
19. Easterling TR, Brateng D et al. Prevention of preeclampsia: a randomized trial of atenolol in hyperdynamic patients before onset of hypertension. Obstet Gynecol 1999; 93 (5, 1): 725–33.
20. Frishman WH, Chesner M. Beta-adrenergic blockers in pregnancy. Am Heart J 1988; 115: 147–52.
21. Fu Q, Levine BD. Hypertension and antihypertensive therapy in elderly women: how much do we really know? Hypertension 2006; 47 (3): 323–4.
22. Fu Q, Vongpatanasin W, Levine BD. Neural and nonneural mechanisms for sex differences in elderly hypertension: can exercise training help? Hypertension 2008; 52 (5): 787–94.
23. Horikiri Y et al. J Pharm Sci 1998; 87: 289.
24. Janka HU et al. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S96.
25. Kinoshita T, Itoh M. Longitudinal variance of fat mass deposition during pregnancy evaluated by ultrasonography: the ratio of visceral fat to subcutaneous fat in the abdomen. Gynecol Obstet Invest 2006; 61: 115–8.
26. Knopp RH, Warth MR, Charles D et al. Lipoprotein metabolism in pregnancy, fat transport to the fetus, and the effects of diabetes. Biol Neonate 1986; 50 (6): 297–317.
27. Koning L, Merchant AT, Pogue J et al. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. European Heart Jornal 2007; 28 (7): 850–8565.
28. Kuti EL, Baker WL, White CM. The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker. Curr Med Res Opin 2007; 23 (6): 1239–44.
29. Lindholm L, Carlberg B, Samuelsson O. Should β-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 366: 1545–53.
30. Lowe SA, Brown MA, Dekker G et al. Guidelines for the management of hypertension disorders of pregnancy, 2008; Society of Obstetric medicine of Australia and New Zealand. Aust N Z J Obstet Gynaecol 2009; 49 (3): 242–6.
31. Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 2003; 3: CD002863.
32. Magee LA, Helewa ME, Moutquin JM et al. Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy. This guideline has been reviewed and approved by the Hypertension Guideline Committee and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada. JOGC 2008; 48.
33. Mercuro G, Zoncu S, Saiu F et al. Menopause induced by oophorectomy reveals a role of ovarian estrogen on the maintenance of pressure homeostasis. Maturitas 2004; 47: 131–8.
34. Narkiewicz K, Phillips BG, Kato M et al. Gender-selective interaction between aging, blood pressure, and sympathetic nerve activity. Hypertension 2005; 45 (4): 522–5.
35. Paradisi G, Biaggi A, Ferrazzani S et al. Abnormal carbohydrate metabolism during pregnancy : association with endothelial dysfunction. Diabetes Care 2002; 25: 560–4.
36. Pepine CJ, Kerensky RA, Lambert CR et al. Some thoughts on the vasculopathy of women with ischemic heart disease. J Am Coll Cardiol 2006; 47 (Suppl. 3): 30–5.
37. Ryan EA, O’Sullivan MJ, Skyler JS. Insulin action during pregnancy. Studies with the euglycemic clamp technique. Diabetes 1985; 34: 380–9.
38. Sattar N, Greer IA. Pregnancy complications and maternal cardiovascular risk: opportunities for interventions and screening? BMJ 2002: 325 (7356): 157–60.
39. Sivan E, Homko CJ, Chen X et al. Effect of insulin on fat metabolism during and after normal pregnancy. Diabetes 1999; 48: 834–8.
40. Stevenson J, Crook D, Godsland I. Influence of age and menopause on serum lipids and lipoproteins in healthy women. Atherosclerosis 1993; 98: 83–90.
41. Waddell TK, Dart AM, Gatzka CD. Women exhibit a greater age-related increase in proximal aortic stiffness than men. J Hypertens 2001; 19: 2205–12.
42. Wellstein A et al. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S41–5.
43. Wichman K, Ryulden G, Karberg BE. A placebo-controlled trial of metoprolol in the treatment of hypertension in pregnancy. Scand J Clin Lab Invest 1984; 169: 90–4.
________________________________________________
1. Кириченко А.А. Место бисопролола в терапии артериальной гипертензии и ишемической болезни сердца. Фарматека. 2009; 8: 10–7.
2. Кулаков В.И., Сметник В.П. Руководство по климактерию. М.: Мед. информ. агентство, 2001; с. 404–95.
3. Лечебно-диагностическая тактика ведения беременных с артериальной гипертонией в России. М.: Рашин Продакшин, 2007; с. 136.
4. Мартынов А.И., Майчук Е.Ю., Юренева С.В. и др. Артериальная гипертензия у женщин с хирургической менопаузой. Медицина климактерия. Под. ред. В.П.Сметник. M.: Литера, 2006; с. 463–75.
5. Оганов Р.Г., Галкин В.А., Масленникова Г.Я. Артериальная гипертония – проблема поликлиническая. Терапевт. архив, 2006; 1: 6–9.
6. Стрюк Р.И., Брыткова Я.В., Павлова Л.Н., Немировский В.Б. Перинатальные исходы у беременных с артериальной гипертонией, коррегированной бисопрололом и нифедипином SR/GITS. Системные гипертензии. 2011; 2: 28–32.
7. Ткачева О.Н., Мурашко Л.Е., Верткин А.Л., Тумбаев И.В. Антигипертензивная терапия b-блокаторами при артериальной гипертонии беременных: за и против. Кардиоваск. тер. проф. 2003; 6: 77–83.
8. Ткачева О.Н., Прохорович Е.А., Майчук Е.Ю., Галяутдинова А.Ю. Дислипидемия у женщин. М.: Мед. книга, 2007; с. 136.
9. Ткачева О.Н., Рунихина Н.К. Артериальная гипертензия у беременных. Антагонисты кальция. М.: Медпрактика-М, 2010; с. 148.
10. Шилов А.М. B-блокатор второго поколения в практике лечения артериальной гипертонии. Фарматека. 2008; с. 8.
11. Abalos E, Duley L, Steyn DW et al. Antihypertensive drug therapy for mild to moderate hypertension duringpregnancy. Cochrane Database Syst Rev 2007; 24 (1): CD002252.
12. Balamuthusamy S, Molnar J, Adigopula S et al. Comparative analysis of beta-blockers with other antihypertensive agents on cardiovascular outcomes in hypertensive patients with diabetes mellitus: a systematic review and meta-analysis. Am J Ther 2009; 16 (2): 133–42.
13. Bangalore S, Wild D, Parkar S et al. Beta-blockers for primary prevention of heart failure in patients with hypertension. J Amer Coll Cardiol 2008; 52: 1062–72.
14. Bayliss H, Churchill D, Beevers M, Beevers DG. Anti-hypertensive drugs in pregnancy and fetal growth: evidence for «pharmacological programming» in the first trimester? Hypertens Pregnancy 2002; 21: 161–74.
15. Blood Pressure Lowering Treatment Trialists Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet 2003; 362: 1527–35.
16. Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnacy and lactation. 7th edition. A Reference Guide to Fetal and Neonatal Risk. Lippincott Williams & Wilkins 2005; p. 1858.
17. Caetano M, Ornstein M, von Dadelszen P et al. A survey of Canadian practitioners regarding the management of the hypertensive disorders of pregnancy. Hypertens Pregnancy 2003; 23: 61–74.
18. Catalano PM, Nizielski SE, Shao J et al. Downregulated IRS-1 and PPARgamma in obese women with gestational diabetes: relationship to FFA during pregnancy. Am J Physiol Endocrinol Metab 2002; 282: 522–33.
19. Easterling TR, Brateng D et al. Prevention of preeclampsia: a randomized trial of atenolol in hyperdynamic patients before onset of hypertension. Obstet Gynecol 1999; 93 (5, 1): 725–33.
20. Frishman WH, Chesner M. Beta-adrenergic blockers in pregnancy. Am Heart J 1988; 115: 147–52.
21. Fu Q, Levine BD. Hypertension and antihypertensive therapy in elderly women: how much do we really know? Hypertension 2006; 47 (3): 323–4.
22. Fu Q, Vongpatanasin W, Levine BD. Neural and nonneural mechanisms for sex differences in elderly hypertension: can exercise training help? Hypertension 2008; 52 (5): 787–94.
23. Horikiri Y et al. J Pharm Sci 1998; 87: 289.
24. Janka HU et al. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S96.
25. Kinoshita T, Itoh M. Longitudinal variance of fat mass deposition during pregnancy evaluated by ultrasonography: the ratio of visceral fat to subcutaneous fat in the abdomen. Gynecol Obstet Invest 2006; 61: 115–8.
26. Knopp RH, Warth MR, Charles D et al. Lipoprotein metabolism in pregnancy, fat transport to the fetus, and the effects of diabetes. Biol Neonate 1986; 50 (6): 297–317.
27. Koning L, Merchant AT, Pogue J et al. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. European Heart Jornal 2007; 28 (7): 850–8565.
28. Kuti EL, Baker WL, White CM. The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker. Curr Med Res Opin 2007; 23 (6): 1239–44.
29. Lindholm L, Carlberg B, Samuelsson O. Should β-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 366: 1545–53.
30. Lowe SA, Brown MA, Dekker G et al. Guidelines for the management of hypertension disorders of pregnancy, 2008; Society of Obstetric medicine of Australia and New Zealand. Aust N Z J Obstet Gynaecol 2009; 49 (3): 242–6.
31. Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 2003; 3: CD002863.
32. Magee LA, Helewa ME, Moutquin JM et al. Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy. This guideline has been reviewed and approved by the Hypertension Guideline Committee and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada. JOGC 2008; 48.
33. Mercuro G, Zoncu S, Saiu F et al. Menopause induced by oophorectomy reveals a role of ovarian estrogen on the maintenance of pressure homeostasis. Maturitas 2004; 47: 131–8.
34. Narkiewicz K, Phillips BG, Kato M et al. Gender-selective interaction between aging, blood pressure, and sympathetic nerve activity. Hypertension 2005; 45 (4): 522–5.
35. Paradisi G, Biaggi A, Ferrazzani S et al. Abnormal carbohydrate metabolism during pregnancy : association with endothelial dysfunction. Diabetes Care 2002; 25: 560–4.
36. Pepine CJ, Kerensky RA, Lambert CR et al. Some thoughts on the vasculopathy of women with ischemic heart disease. J Am Coll Cardiol 2006; 47 (Suppl. 3): 30–5.
37. Ryan EA, O’Sullivan MJ, Skyler JS. Insulin action during pregnancy. Studies with the euglycemic clamp technique. Diabetes 1985; 34: 380–9.
38. Sattar N, Greer IA. Pregnancy complications and maternal cardiovascular risk: opportunities for interventions and screening? BMJ 2002: 325 (7356): 157–60.
39. Sivan E, Homko CJ, Chen X et al. Effect of insulin on fat metabolism during and after normal pregnancy. Diabetes 1999; 48: 834–8.
40. Stevenson J, Crook D, Godsland I. Influence of age and menopause on serum lipids and lipoproteins in healthy women. Atherosclerosis 1993; 98: 83–90.
41. Waddell TK, Dart AM, Gatzka CD. Women exhibit a greater age-related increase in proximal aortic stiffness than men. J Hypertens 2001; 19: 2205–12.
42. Wellstein A et al. J Cardiovasc Pharmacol 1986; 8 (Suppl. 11): S41–5.
43. Wichman K, Ryulden G, Karberg BE. A placebo-controlled trial of metoprolol in the treatment of hypertension in pregnancy. Scand J Clin Lab Invest 1984; 169: 90–4.
Авторы
Н.К.Рунихина, О.А.Голубева
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздравсоцразвития РФ
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздравсоцразвития РФ
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N.K.Runihina, O.A.Golubeva
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.