Артериальная гипертония на рабочем месте как вариант стресс-индуцированной артериальной гипертонии
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Ключевые слова: стресс, артериальная гипертония на рабочем месте, рабочая нагрузка, сердечно-сосудистый риск, гиперсимпатикотония, бисопролол.
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The review presents a modern view on stress as a risk factor for the development of arterial hypertension (AH). A variety pathogenic mechanisms responsible for increase of blood pressure during stress exposure are described in detail. The importance of the sympathetic activation as a key link in the development of stress-induced AH and initiation of a cascade of pathophysiological reactions that realize their adverse effects at the level of the whole organism is underlined. Particular attention is paid to worksite AH as a variant of stress-induced hypertension due to its wide prevalence and association with an increased risk of cardiovascular complications, primarily myocardial infarction and stroke. Epidemiological data and results of recent metanalysis are presented, indicating the high significance of job strain as a risk factor for adverse cardiovascular events. The actual psychological stress reduction programs are described. Possibilities of using β-blockers in patients with stress-induced hypertension as drugs affecting the central pathogenetic trigger of this disease are considered. The advantages of using bisoprolol as a highly selective β-blocker are considered taking into account the available body of evidence for its effectiveness in patients with worksite AH, as well as its metabolic neutrality and target-organ protective properties.
Keywords: stress, worksite hypertension, job strain, cardiovascular risk, sympathetic activation, bisoprolol.
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1 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет), Москва Россия
________________________________________________
O.D. OSTROUMOVA 1,2, A.I. KOCHETKOV 1
1 A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia;
2 I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov First Moscow State Medical University), Moscow, Russia