Консенсус экспертов Российского медицинского общества по артериальной гипертонии. Артериальная гипертония и эректильная дисфункция
Консенсус экспертов Российского медицинского общества по артериальной гипертонии. Артериальная гипертония и эректильная дисфункция
Алексеева Т.А., Литвин А.Ю., Елфимова Е.М., Михайлова О.О., Ларина В.Н., Шпоть Е.В., Подзолков В.И., Чазова И.Е. Консенсус экспертов Российского медицинского общества по артериальной гипертонии. Артериальная гипертония и эректильная дисфункция. Системные гипертензии. 2021; 18 (2): 69–79.
DOI: 10.26442/2075082X.2021.2.200836
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Alekseeva TA, Litvin AYu, Elfimova EM, Mikhailova OO, Larina VN, Shpot EV, Podzolkov VI, Chazova IE. Consensus of experts from the Russian Medical Society of Arterial Hypertension. Arterial hypertension and erectile dysfunction. Systemic Hypertension. 2021; 18 (2): 69–79. DOI: 10.26442/2075082X.2021.2.200836
Консенсус экспертов Российского медицинского общества по артериальной гипертонии. Артериальная гипертония и эректильная дисфункция
Алексеева Т.А., Литвин А.Ю., Елфимова Е.М., Михайлова О.О., Ларина В.Н., Шпоть Е.В., Подзолков В.И., Чазова И.Е. Консенсус экспертов Российского медицинского общества по артериальной гипертонии. Артериальная гипертония и эректильная дисфункция. Системные гипертензии. 2021; 18 (2): 69–79.
DOI: 10.26442/2075082X.2021.2.200836
________________________________________________
Alekseeva TA, Litvin AYu, Elfimova EM, Mikhailova OO, Larina VN, Shpot EV, Podzolkov VI, Chazova IE. Consensus of experts from the Russian Medical Society of Arterial Hypertension. Arterial hypertension and erectile dysfunction. Systemic Hypertension. 2021; 18 (2): 69–79. DOI: 10.26442/2075082X.2021.2.200836
Сексуальное здоровье является неотъемлемой частью здоровья в целом, и активная и здоровая сексуальная жизнь – важный аспект хорошего качества жизни. Сердечно-сосудистые заболевания и нарушения сексуального здоровья имеют общие факторы риска (артериальная гипертония, сахарный диабет, дислипидемия, ожирение и курение) и общие патогенетические механизмы развития (эндотелиальная дисфункция, воспаление и атеросклероз). Все это привело к размышлениям о патофизиологии и возможностях лечения сексуальных нарушений. Применение препаратов из группы ингибиторов фосфодиэстеразы 5-го типа произвело революцию в лечении эректильной дисфункции (ЭД) у мужчин. Эта статья будет посвящена ЭД и ее связи с артериальной гипертонией. Данный документ создан экспертами Российского медицинского общества по артериальной гипертонии при участии члена рабочей группы по сексуальной дисфункции и артериальной гипертонии Европейского общества по артериальной гипертонии. Группа экспертов была очень активна в последние годы в ознакомлении специалистов по гипертонии и смежным специальностям с проблемой ЭД посредством многочисленных лекций на национальных и международных конгрессах. Было отмечено, что ЭД предшествует развитию ишемической болезни сердца. Гипотеза диаметра артерий была предложена как возможное объяснение данного наблюдения. Клинические проявления атеросклеротического поражения и/или эндотелиальной дисфункции артерий полового члена могут предшествовать соответствующим проявлениям в более крупных артериях. Больные гипертонией, получающие гипотензивную терапию, чаще страдают нарушениями сексуального характера по сравнению с нелечеными пациентами. Возникновение ЭД, по-видимому, связано с нежелательными эффектами гипотензивных препаратов на ткани полового члена. Имеется информация, указывающая на различные эффекты гипотензивных препаратов на эректильную функцию.
Sexual health is an essential part of overall health, and an active and healthy sex life is an important aspect of a good quality of life. Cardiovascular diseases and sexual health disorders have common risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, obesity and smoking) and common pathogenesis (endothelial dysfunction, inflammation and atherosclerosis). All this led to speculations about the pathophysiology and treatment options for sexual dysfunctions. The use of phosphodiesterase type 5 inhibitors has revolutionized the treatment of erectile dysfunction (ED) in men. This article focuses on ED and its relationship with hypertension. This document was created by experts from the Russian Medical Society of Arterial Hypertension with the participation of a member of the European Society of Hypertension Working Group on Sexual Dysfunction and Arterial Hypertension. In recent years, the expert group was very active in educating hypertension specialists and related specialties physicians about ED via numerous lectures at national and international congresses. It has been noted that ED precedes the development of coronary heart disease. The artery diameter hypothesis has been proposed as a possible explanation for this observation. Clinical manifestations of atherosclerotic lesions and/or endothelial dysfunction of the penile arteries may precede those in larger arteries. Patients with hypertension who receive antihypertensive drugs are more likely to suffer from sexual dysfunctions compared to untreated patients. The occurrence of ED appears to be related to the undesirable effects of antihypertensive drugs on the penile tissues. There is information about various effects of antihypertensive drugs on erectile function.
Keywords: adherence to antihypertensive therapy, arterial hypertension, erectile dysfunction, treatment of erectile dysfunction, cardiovascular diseases
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1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
3 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*t-a86@mail.ru
________________________________________________
Tatiana A. Alekseeva*1, Alexander Yu. Litvin1,2, Eugenia M. Elfimova1, Oxana O. Mikhailova1, Vera N. Larina2, Eugeny V. Shpot3, Valery I. Podzolkov3, Irina E. Chazova1
1 National Medical Research Center of Cardiology, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia;
3 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*t-a86@mail.ru