Препараты сердечно-сосудистого профиля и состояние тканей пародонта

Лица с сердечно-сосудистыми заболеваниями (ССЗ), в основном старше 50 лет, регулярно принимают такие лекарства, как бета-блокаторы (ББ), ингибиторы ангиотензинпревращающего фермента (иАПФ), блокаторы кальциевых каналов (БКК), блокаторы рецепторов ангиотензина II (БРА), статины и ацетилсалициловую кислоту (АСК). Болезни тканей пародонта (БТП) встречаются в возрастной группе 35–44 лет в 60% случаев, в группе людей 65–74 лет – около 70%, т. е. в том периоде жизни, когда начинают развиваться и прогрессировать ССЗ. Некоторые кардиопротекторные препараты, такие как антигипертензивные средства, вызывают ксеростомию. Медикаментозная ксеростомия является одной из распространенных причин проблем, связанных со здоровьем полости рта у пожилых людей, которые находятся на длительной лекарственной терапии. Ксеростомия является распространенным изнурительным состоянием, которое вызывает такие проблемы, как дисфагия, потеря вкуса и боль в полости рта, а также увеличивает риск кариеса зубов и инфекции полости рта. Лекарственно-индуцированное разрастание десен (ЛИРД) представляет собой патологическую гипертрофию десны, которая может быть вызвана рядом лекарственных препаратов, в т. ч. и БКК. ЛИРД характеризуется накоплением соединительной ткани, которое в первую очередь поражает передние отделы верхней и нижней челюсти, а также вызывает проблемы с поддержанием гигиены полости рта, что приводит к восприимчивости к инфекциям и заболеваниям пародонта и может привести к потере зубов. Антикоагулянты, используемые при ССЗ ввиду риска развития кровоточивости, требуют особых подходов при профилактике и терапии БТП. Рассматриваются возможности использования статинов при БТП за счет плейотропных свойств, не зависящих от гиполипидемического действия. Обзорная статья посвящена влиянию препаратов сердечно-сосудистого профиля на состояние тканей пародонта и механизмов развития побочных эффектов, а также возможностям использования статинов с учетом их плейотропных эффектов. 

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