medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-5-26-32medsovet-2348Research ArticleИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦАISHEMIC HEART DISEASEНе до конца осознанные возможности профилактики атеросклерозаNot fully informed possibilities for prevention of atherosclerosisГиляревскийС. Р.GilyarevskyS. R.

д.м.н., профессор

MD, Prof.

ГолшмидМ. В.GolshmidM. V.

к.м.н.

PhD in medicine

КузьминаИ. М.KuzminaI. M.

к.м.н.

PhD in medicine

БендилианиН. Г.BendilianiN. G.

д.м.н.

MD

Российская медицинская академия непрерывного профессионального образования Минздрава России, МоскваРоссияRussian Medical Academy of Continuing Postgraduate Education of the Ministry of Health of Russia, MoscowRussian FederationНаучно-исследовательский институт скорой помощи им. Н.В. Склифосовского, МоскваРоссияSklifosofsky Research Institute for Emergency Care, MoscowRussian FederationНациональный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева Минздрава России, МоскваРоссияBakulev National Medical Research Centre for Cardiovascular Surgery of the Ministry of Health of Russia, MoscowRussian Federation201810042018052632Copyright © Гиляревский С.Р., Голшмид М.В., Кузьмина И.М., Бендилиани Н.Г., 20182018Гиляревский С.Р., Голшмид М.В., Кузьмина И.М., Бендилиани Н.Г.Gilyarevsky S.R., Golshmid M.V., Kuzmina I.M., Bendiliani N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2348

В статье обсуждаются новые возможности снижения риска развития осложнений сердечно-сосудистых заболеваний, обусловленных атеросклерозом, у широкого круга лиц с целью первичной и вторичной профилактики. Приводятся данные наиболее важных клинических исследований, как рандомизированных, так и обсервационных, которые в ближайшее время могут стать основанием для пересмотра целевых и пороговых уровней холестерина ( ХС) липопротеинов низкой плотности (ЛПНП) в крови. Кроме того, рассматривается обоснованность более широкого применения комбинированных препаратов, содержащих статины и антиагрегант, с целью повышения приверженности к терапии в условиях вынужденной полифармакотерапии у широкого круга больных с сердечно-сосудистыми заболеваниями. В последние годы в гиполипидемической терапии имеются две основные тенденции: 1) поиски уровня липидов в крови, и в первую очередь холестерина липопротеинов низкой плотности (ЛПНП), при котором прекращается прогрессирование или отмечается регрессирование атероск лероза; 2) получение доказательств улучшения прогноза больных с сердечно- сосудистыми заболеваниями, обусловленными атеросклерозом (ССЗОА), при снижении концентрации ХС ЛПНП в крови до более низких уровней по сравнению с принятыми ранее. В данной статье мы хотели напомнить о результатах наиболее важных исследований, которые отражают такие современные тенденции в липидологии. 

The article discusses new opportunities for reducing the risk of complications of cardiovascular diseases caused by atherosclerosis in a wide range of people for the purposes of primary and secondary prevention. The article provides for the data of the most important clinical studies, both randomized and observational, which can become the basis for revising the target and threshold blood levels of low-density lipoprotein (LDL) cholesterol (CS) in the near future. In addition, the rational for the wider use of combination drugs containing statins and antiplatelet agents is considered to increase adherence to therapy in conditions of induced polypharmacotherapy in a wide range of patients with cardiovascular diseases. In recent years, lipid-lowering therapy has got two main trends: 1) determining the lipid levels in the blood, and especially lowdensity lipoprotein (LDL) cholesterol, which stops progression or regression of atherosclerosis; 2) obtaining evidence on improvement of the prognosis for patients with cardiovascular diseases caused by atherosclerosis (CVDCA), with a decrease in the concentration of LDL-C in the blood to lower levels compared with those that were previously accepted. In this article, we wanted to recall the results of the most important studies that reflect these modern trends in lipidology.

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