References

mrj

Современная ревматология

Modern Rheumatology Journal

1996-70122310-158X

IMA-PRESS, LLC

10.14412/1996-7012-2018-2-64-72

mrj-827

Research Article

ОБЗОРЫ

REVIEWS

Дестабилизация артериальной гипертензии как осложнение терапии нестероидными противовоспалительными препаратами: значение проблемы

Destabilized hypertension as a complication of therapy with nonsteroidal anti-inflammatory drugs: the importance of the problem

Каратеев

А. Е.

Karateev

A. E.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

aekarat@yandex.ru

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation

2018

06062018

1226472

2018

Каратеев А.Е.

Karateev A.E.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://mrj.ima-press.net/mrj/article/view/827

Нестероидные противовоспалительные препараты (НПВП) – наиболее востребованный инструмент борьбы с болью. К сожалению, НПВП могут вызывать различные нежелательные реакции, среди которых одной из самых частых является развитие или дестабилизация артериальной гипертензии (АГ). По данным контролируемых и наблюдательных исследований, прием НПВП сопровождается повышением уровня артериального давления (АД) в среднем на 2–3 мм рт. ст., а стойкая АГ отмечается у 2–25% больных. Кроме того, НПВП способны снижать эффективность практически всех классов антигипертензивных средств, за исключением блокаторов кальциевых каналов. Клиническое значение АГ, возникшей на фоне приема НПВП, определяется существенным повышением риска развития кардиоваскулярных катастроф – инфаркта, ишемического инсульта и внезапной смерти от кардиоваскулярных причин. Все НПВП (и неселективные «традиционные» препараты, и коксибы) способны оказывать негативное влияние на АД. Поэтому при назначении любых НПВП следует учитывать наличие исходной АГ, проводить регулярный контроль АД и корригировать по необходимости антигипертензивную терапию.

В настоящем обзоре рассмотрены ключевые аспекты проблемы НПВП-ассоциированной АГ.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most popular tool to combat pain. Unfortunately, NSAIDs can cause various adverse reactions, among these one of the most common ones is the development or destabilization of hypertension. Controlled and observational studies have shown that the use of NSAIDs is accompanied by an average 2–3 mm Hg increase in blood pressure (BP) and persistent hypertension is noted in 2–25% of patients. In addition, NSAIDs are able to reduce the efficacy of almost all classes of antihypertensive agents with the exception of calcium channel blockers. The clinical significance of NSAID-induced hypertension is determined by a considerable increase in the risk of cardiovascular accidents, such as infarction, ischemic stroke and sudden cardiovascular death. All NSAIDs (and nonselective traditional drugs and coxibs) can negatively affect BP. Therefore, when prescribing any NSAIDs, it is necessary to take into account the presence of baseline hypertension, to monitor BP regularly, and to correct antihypertensive therapy as needed. This review deals with the key aspects of the problem with NSAID-related hypertension.

нестероидные противовоспалительные препаратыосложненияартериальная гипертензиякардиоваскулярные осложненияантигипертензивная терапия

nonsteroidal anti-inflammatory drugscomplicationshypertensioncardiovascular eventsantihypertensive therapy

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The authors declare that there are no conflicts of interest present.