medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-21-51-57medsovet-5474Research ArticleКАРДИОЛОГИЯCARDIOLOGYКонцепция сосудистого возраста: роль в оценке риска и выборе терапииVascular age concept: role in assessing risk and choosing therapyhttps://orcid.org/0000-0002-8505-1848ГиляревскийC. Р.GilyarevskyS. R.

Гиляревский Сергей Руджерович, д.м.н., профессор кафедры клинической фармакологии и терапии

125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1

Sergey R. Gilyarevsky, Dr. of Sci. (Med.), Professor of the Department of Clinical Pharmacology and Therapy

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia

sgilarevsky@rambler.ruhttps://orcid.org/0000-0002-9865-4998ГолшмидМ. В.GolshmidM. V.

Голшмид Мария Владимировна, к.м.н., доцент кафедры клинической фармакологии и терапии

125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1

Maria V. Golshmid, Cand. of Sci. (Med.), Associate Professor of the Department of Clinical Pharmacology and Therapy

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia

golshmid@yandex.ruhttps://orcid.org/0000-0003-3102-1958БенделианиН. Г.BendelianiN. G.

Бенделиани Нана Георгиевна, д.м.н., старший научный сотрудник научно-консультативного отделения Института коронарной и сосудистой хирургии консультативно-диагностического центра

119049, Россия, Москва, Ленинский проспект, д. 8, корп. 4

Nana G. Bendeliani, Dr. of Sci. (Med.), Senior Researcher of Scientific Advisory Department

8, Bldg. 4, Leninskiy Prospect, Moscow, 119049, Russia

n.bendo@mail.ruhttps://orcid.org/0000-0001-9458-7305КузьминаИ. М.KuzminaI. M.

Кузьмина Ирина Михайловна, к.м.н., заведующая научным отделением неотложной кардиологии

129090, Россия, Москва, Б. Сухаревская пл., д. 3, стр. 21

Irina M. Kuzmina, Cand. of Sci. (Med.), Leading Researcher, Department of Emergency Cardiology

3, Bldg. 21, B. Sukharevskaya Pl., Moscow, 129090, Russia

kuzmina.sklif@gmail.comhttps://orcid.org/0000-0002-2548-8511ЗахароваГ. Ю.ZaharovaG. Y.

Захарова Галина Юрьевна, к.м.н., доцент кафедры клинической фармакологии и терапии

125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1

Galina Y. Zaharova, Cand. of Sci. (Med.), Associate Professor of the Department of Clinical Pharmacology and Therapy

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia

gyzakharova@mail.ruhttps://orcid.org/0000-0002-9177-6642СиницинаИ. И.SinitcinaI. I.

Синицина Ирина Ивановна, д.м.н., профессор кафедры клинической фармакологии и терапии

125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1

Irina I. Sinitcina, Dr. of Sci. (Med.), Professor of the Department of Clinical Pharmacology and Therapy

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia

sinitsina-irina@mail.ruРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuing Postgraduate EducationRussian FederationИнститут коронарной и сосудистой хирургии Национального медицинского исследовательского центра сердечно-сосудистой хирургии им. А.Н. БакулеваРоссияInstitute for Coronary and Vascular Surgery of A.N. Bakulev National Medical Research Center of Cardiovascular SurgeryRussian FederationНаучно-исследовательский институт скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovskiy Research Institute for Emergency MedicineRussian Federation2019250120200215157Copyright © Гиляревский C.Р., Голшмид М.В., Бенделиани Н.Г., Кузьмина И.М., Захарова Г.Ю., Синицина И.И., 20202020Гиляревский C.Р., Голшмид М.В., Бенделиани Н.Г., Кузьмина И.М., Захарова Г.Ю., Синицина И.И.Gilyarevsky S.R., Golshmid M.V., Bendeliani N.G., Kuzmina I.M., Zaharova G.Y., Sinitcina I.I.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/5474

В статье обсуждается концепция сосудистого возраста, а также современные подходы к оценке сосудистого возраста. Приводятся данные о современных методах измерения жесткости артерий (аппланационная тонометрия или допплеровское исследование) как наиболее часто используемого показателя, отражающего сосудистый возраст. Обсуждается роль антигипертензивной терапии и статинов в профилактике увеличения сосудистого возраста, а также соотношение между ролью достижения более низких уровней артериального давления и выбором определенных антигипертензивных средств для уменьшения жесткости артерий и обеспечения оптимального сосудистого возраста. Приводятся данные о том, что повышенная жесткость артерий может быть маркером риска развития тяжелых осложнений сердечно-сосудистых заболеваний, в частности результаты метаанализа, которые свидетельствовали о том, что после учета известных факторов риска развития осложнений сердечно-сосудистых заболеваний более высокая жесткость сонных артерий сопровождалась увеличением риска развития инсульта. Указывается, что, помимо биологического возраста, сосудистый возраст может увеличиваться за счет кумулятивного эффекта таких факторов риска, как повышенный уровень артериального давления, нарушенный гомеостаз глюкозы, ожирение и гиперхолестеринемия. Обсуждаются современные подходы к сохранению и поддержанию сосудистого возраста. Рассматривается ключевая роль достижения более низких уровней артериального давления. Отмечается усиление роли комбинированных препаратов для профилактики осложнений сердечно-сосудистых заболеваний, а также рассматриваются подходы к выбору оптимальных компонентов таких комбинированных препаратов. Обсуждается связь между повышенной жесткостью артерий и развитием когнитивных расстройств. Приводятся данные о роли статинов, а также об эффективности сочетанного применения статинов и комбинированной антигипертензивной терапии для снижения скорости пульсовой волны.

The article discusses the vascular age concept and modern approaches to assessing vascular age. It describes modern methods for measuring arterial stiffness (applanation tonometry or ultrasonic Doppler examination) as the most frequently used index of vascular age. The authors discuss the role of antihypertensive therapy and statins in preventing early vascular aging, and the relationship between the role of achieving lower blood pressure levels and the choice of certain antihypertensive agents to reduce arterial stiffness and ensure optimal vascular age. Increased arterial stiffness has been reported to be a marker of risk for developing severe complications of cardiovascular diseases, in particular, a meta-analysis showed that after taking into account the known risk factors for developing cardiovascular complications, higher carotid stiffness was associated with an increased risk of stroke. It is stated that in addition to biological age, vascular age may increase due to the cumulative effect of such risk factors as high blood pressure, impaired glucose homeostasis, obesity and hypercholesterolemia. Modern approaches to the preservation and maintenance of vascular age are discussed. The key role of achieving lower blood pressure levels is considered. It is emphasized that the role of combination drugs in preventing complications of cardiovascular diseases is strengthened, and approaches to choosing the optimal components of such combination drugs are also considered. The relationship between increased arterial stiffness and the development of cognitive disorders is discussed. The article describes the role of statins and effectiveness of the concomitant use of statins and combination antihypertensive therapy in reducing the pulse wave velocity.

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