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Артериальная гипертензия при остром инсульте – друг или враг? (Лекция)
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Аннотация
Лекция посвящена спорным вопросам коррекции артериальной гипертензии при остром геморрагическом и ишемическом инсульте. Рассмотрены вопросы патофизиологии, клиники и лечения. Даны рекомендации по ведению пациентов с повышенным артериальным давлением с позиций экспертных оценок и доказательной медицины.
Ключевые слова: острый инсульт, артериальная гипертензия, ауторегуляция мозгового кровотока, Эбрантил.
Ключевые слова: острый инсульт, артериальная гипертензия, ауторегуляция мозгового кровотока, Эбрантил.
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The lecture deals with controversial issues in the correction of arterial hypertension in acute and hemorrhagic stroke.
Its pathophysiology, clinical presentation, and treatment are considered. Recommendations are given for the management of hypertensive patients in the context of expert appraisals and evidence-based medicine.
Key words: acute stroke, arterial hypertension, cerebral circulatory autoregulation, Ebrantil.
Полный текст
Список литературы
1. Ahmed N, Nasman P, Wahlgren NG. Effect of intravenous nimodipine on blood pressure and outcome after acute stroke. Stroke 2000; 31 (6): 1250–5.
2. Anderson CS, Huang Y, Wang JG et al. INTERACT Investigators. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neuro. 2008; 7 (5): 391–9.
3. Barer DH, Cruickshank JM, Ebrahim SB, Mitchell JR. Low dose beta blockade in acute stroke («BEST» trial): an evaluation. Br Med J (Clin Res Ed) 1988; 296 (6624): 737–41.
4. Broderick J, Connolly S, Zuccarello M et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update – A guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke 2007; 38: 2001–23.
5. Brott T, Lu M, Kothari R et al. Hypertension and its treatment in the NINDS rt-PA Stroke Trial Stroke 1998; 29 (8): 1504–9.
6. Castillo J, Leira R, Garcia MM et al. Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke 2004; 35 (2): 520–6.
7. Chamorro A, Vila N, Ascaso C et al. Blood pressure and functional recovery in acute ischemic stroke. Stroke 1998; 29 (9): 1850–3.
8. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Effect of blood pressure and diabetes on stroke in progression. Lancet 1994; 344 (8916): 156–9.
9. Okumura K, Ohya Y, Maehara A et al. Effects of blood pressure levels on case fatality after acute stroke. J Hypertens 2005 (6): 1217–23.
10. Vemmos KN, Tsivgoulis G, Spengos K et al. U-shaped relationship between mortality and admission blood pressure in patients with acute stroke. J Intern Med 2004; 255 (2): 257–65.
2. Anderson CS, Huang Y, Wang JG et al. INTERACT Investigators. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neuro. 2008; 7 (5): 391–9.
3. Barer DH, Cruickshank JM, Ebrahim SB, Mitchell JR. Low dose beta blockade in acute stroke («BEST» trial): an evaluation. Br Med J (Clin Res Ed) 1988; 296 (6624): 737–41.
4. Broderick J, Connolly S, Zuccarello M et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update – A guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke 2007; 38: 2001–23.
5. Brott T, Lu M, Kothari R et al. Hypertension and its treatment in the NINDS rt-PA Stroke Trial Stroke 1998; 29 (8): 1504–9.
6. Castillo J, Leira R, Garcia MM et al. Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke 2004; 35 (2): 520–6.
7. Chamorro A, Vila N, Ascaso C et al. Blood pressure and functional recovery in acute ischemic stroke. Stroke 1998; 29 (9): 1850–3.
8. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Effect of blood pressure and diabetes on stroke in progression. Lancet 1994; 344 (8916): 156–9.
9. Okumura K, Ohya Y, Maehara A et al. Effects of blood pressure levels on case fatality after acute stroke. J Hypertens 2005 (6): 1217–23.
10. Vemmos KN, Tsivgoulis G, Spengos K et al. U-shaped relationship between mortality and admission blood pressure in patients with acute stroke. J Intern Med 2004; 255 (2): 257–65.
Авторы
С.В.Царенко
Лечебно-реабилитационный центр Минздрава РФ, Москва
Лечебно-реабилитационный центр Минздрава РФ, Москва
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S.V.Tsarenko
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