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Дифференцированный подход к первичной профилактике сердечно-сосудистых заболеваний
Дифференцированный подход к первичной профилактике сердечно-сосудистых заболеваний
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Аннотация
В данном обзоре литературы приводится современный анализ к медикаментозным подходам в рамках первичной профилактики сердечно-сосудистых заболеваний. Обсуждается целесообразность применения с этой целью антиагрегантов и статинов, а также новые данные о возможностях профилактики инсульта и инфаркта при включении в схемы антигипертензивной терапии антагониста кальция амлодипина.
Ключевые слова: профилактика сердечно-сосудистых заболеваний, антиагрегантная терапия, гиполипидемическая терапия, антигипертензивная терапия, амлодипин.
Key words: prevention of cardiovascular disease, antiaggregant therapy, cholesterol-lowering treatment, antihypertensive therapy, amlodipine.
Ключевые слова: профилактика сердечно-сосудистых заболеваний, антиагрегантная терапия, гиполипидемическая терапия, антигипертензивная терапия, амлодипин.
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Key words: prevention of cardiovascular disease, antiaggregant therapy, cholesterol-lowering treatment, antihypertensive therapy, amlodipine.
Полный текст
Список литературы
1. European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2012; 33: 1635–701.
2. Berger JS, Lala A, Krantz MJ et al. Aspirin for the prevention of cardiovascular events in patients without clinical cardiovascular disease: a meta-analysis of randomized trials. Am Heart J 2011; 162: 115–24 e2.
3. Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 150: 405–10.
4. Shaink A. The Effectiveness of statins for primary prevention: a rapid review. 2013; p. 1–23.
5. Mills EJ, Rachlis B, Wu P et al. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65 000 patients. J Am Coll Cardiol 2008; 52 (22): 1769–81.
6. Brugts J, Yetgin T, Hoeks S et al. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: Meta-analysis of randomised controlled trials. BMJ 2009; 7711: 36.
7. Taylor F, Ward K, Moore TH et al. Statins for the primary prevention of cardiovascular disease. Cochrane database of systematic reviews 2011; CD004816.
8. Fretheim A, Odgaard-Jensen J, Brors O et al. Comparative effectiveness of antihypertensive medication for primary prevention of cardiovascular disease: systematic review and multiple treatments meta-analysis. BMC Medicine 2012; 10: 33.
9. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group, Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA 2002; 288: 2981–97.
10. Julius S, Kjeldsen SE, Weber M et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022–31.
11. Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895–906.
12. Pitt B, Byington RP, Furberg CD et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. Circulation 2000; 102: 1503–10.
13. Nissen SE, Tuzcu EM, Libby P et al for the CAMELOT Investigators. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure. The CAMELOT study: a randomized controlled trial, JAMA 2004; 292: 2217–26.
14. Wang JG, Li Y, Franklin SS, Safar M. Prevention of stroke and myocardial infarction by amlodipine and angiotensin receptor blockers: aquantitative overview. Hypertension 2007; 50: 181–8.
2. Berger JS, Lala A, Krantz MJ et al. Aspirin for the prevention of cardiovascular events in patients without clinical cardiovascular disease: a meta-analysis of randomized trials. Am Heart J 2011; 162: 115–24 e2.
3. Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 150: 405–10.
4. Shaink A. The Effectiveness of statins for primary prevention: a rapid review. 2013; p. 1–23.
5. Mills EJ, Rachlis B, Wu P et al. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65 000 patients. J Am Coll Cardiol 2008; 52 (22): 1769–81.
6. Brugts J, Yetgin T, Hoeks S et al. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: Meta-analysis of randomised controlled trials. BMJ 2009; 7711: 36.
7. Taylor F, Ward K, Moore TH et al. Statins for the primary prevention of cardiovascular disease. Cochrane database of systematic reviews 2011; CD004816.
8. Fretheim A, Odgaard-Jensen J, Brors O et al. Comparative effectiveness of antihypertensive medication for primary prevention of cardiovascular disease: systematic review and multiple treatments meta-analysis. BMC Medicine 2012; 10: 33.
9. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group, Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA 2002; 288: 2981–97.
10. Julius S, Kjeldsen SE, Weber M et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022–31.
11. Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895–906.
12. Pitt B, Byington RP, Furberg CD et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. Circulation 2000; 102: 1503–10.
13. Nissen SE, Tuzcu EM, Libby P et al for the CAMELOT Investigators. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure. The CAMELOT study: a randomized controlled trial, JAMA 2004; 292: 2217–26.
14. Wang JG, Li Y, Franklin SS, Safar M. Prevention of stroke and myocardial infarction by amlodipine and angiotensin receptor blockers: aquantitative overview. Hypertension 2007; 50: 181–8.
2. Berger JS, Lala A, Krantz MJ et al. Aspirin for the prevention of cardiovascular events in patients without clinical cardiovascular disease: a meta-analysis of randomized trials. Am Heart J 2011; 162: 115–24 e2.
3. Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 150: 405–10.
4. Shaink A. The Effectiveness of statins for primary prevention: a rapid review. 2013; p. 1–23.
5. Mills EJ, Rachlis B, Wu P et al. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65 000 patients. J Am Coll Cardiol 2008; 52 (22): 1769–81.
6. Brugts J, Yetgin T, Hoeks S et al. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: Meta-analysis of randomised controlled trials. BMJ 2009; 7711: 36.
7. Taylor F, Ward K, Moore TH et al. Statins for the primary prevention of cardiovascular disease. Cochrane database of systematic reviews 2011; CD004816.
8. Fretheim A, Odgaard-Jensen J, Brors O et al. Comparative effectiveness of antihypertensive medication for primary prevention of cardiovascular disease: systematic review and multiple treatments meta-analysis. BMC Medicine 2012; 10: 33.
9. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group, Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA 2002; 288: 2981–97.
10. Julius S, Kjeldsen SE, Weber M et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022–31.
11. Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895–906.
12. Pitt B, Byington RP, Furberg CD et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. Circulation 2000; 102: 1503–10.
13. Nissen SE, Tuzcu EM, Libby P et al for the CAMELOT Investigators. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure. The CAMELOT study: a randomized controlled trial, JAMA 2004; 292: 2217–26.
14. Wang JG, Li Y, Franklin SS, Safar M. Prevention of stroke and myocardial infarction by amlodipine and angiotensin receptor blockers: aquantitative overview. Hypertension 2007; 50: 181–8.
________________________________________________
2. Berger JS, Lala A, Krantz MJ et al. Aspirin for the prevention of cardiovascular events in patients without clinical cardiovascular disease: a meta-analysis of randomized trials. Am Heart J 2011; 162: 115–24 e2.
3. Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 150: 405–10.
4. Shaink A. The Effectiveness of statins for primary prevention: a rapid review. 2013; p. 1–23.
5. Mills EJ, Rachlis B, Wu P et al. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65 000 patients. J Am Coll Cardiol 2008; 52 (22): 1769–81.
6. Brugts J, Yetgin T, Hoeks S et al. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: Meta-analysis of randomised controlled trials. BMJ 2009; 7711: 36.
7. Taylor F, Ward K, Moore TH et al. Statins for the primary prevention of cardiovascular disease. Cochrane database of systematic reviews 2011; CD004816.
8. Fretheim A, Odgaard-Jensen J, Brors O et al. Comparative effectiveness of antihypertensive medication for primary prevention of cardiovascular disease: systematic review and multiple treatments meta-analysis. BMC Medicine 2012; 10: 33.
9. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group, Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA 2002; 288: 2981–97.
10. Julius S, Kjeldsen SE, Weber M et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022–31.
11. Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895–906.
12. Pitt B, Byington RP, Furberg CD et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. Circulation 2000; 102: 1503–10.
13. Nissen SE, Tuzcu EM, Libby P et al for the CAMELOT Investigators. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure. The CAMELOT study: a randomized controlled trial, JAMA 2004; 292: 2217–26.
14. Wang JG, Li Y, Franklin SS, Safar M. Prevention of stroke and myocardial infarction by amlodipine and angiotensin receptor blockers: aquantitative overview. Hypertension 2007; 50: 181–8.
Авторы
Д.А.Напалков
ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России
dminap@mail.ru
dminap@mail.ru
ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России
dminap@mail.ru
________________________________________________
dminap@mail.ru
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