urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2022-21-4-93-100urmj-1039Research ArticleОБЗОР ЛИТЕРАТУРЫГипотензивная терапия артериальной гипертензии при хронической ишемии конечности и острой тромботической окклюзииHypotensive therapy of arterial hypertension in chronic limb ischemia and acute thrombotic occlusionhttps://orcid.org/0000-0003-4259-0945ТепловаН. В.TeplovaN. V.

 Наталия Вадимовна Теплова – доктор медицинских наук 

 Москва 

 Natalija V. Teplova – Doctor of medicine 

 Moscow 

teplova.nv@yandex.ruhttps://orcid.org/0000-0002-4211-0684ВечоркоВ. И.VechorkoV. I.

 Валерий Иванович Вечорко – кандидат медицинских наук 

 Москва 

 Valerij I. Vechorko – MD 

 Moscow 

https://orcid.org/0000-0002-9391-5175БаироваК. И.BairovaK. I.

 Кермен Ивановна Баирова – кандидат медицинских наук 

 Москва 

 Kermen I. Bairova – MD 

 Moscow 

bairova@list.ruЕвсиковЕ. М.EvsikovE. I.

 Евгений Михайлович Евсиков – доктор медицинских наук 

 Москва 

https://orcid.org/0000-0002-1448-9077 

 Evgenij I. Evsikov – Doctor of medicine 

 Moscow 

 https://orcid.org/0000-0002-1448-9077 

dr.Evsikov@gmail.comЖапуеваМ. Х.ZhapuevaM. Kh.

 Марета Хасановна Жапуева – аспирант 

 Москва 

 Mareta Kh. Zhapueva – Postgraduate student 

 Moscow 

zhapueva.mareta@mail.ruhttps://orcid.org/0000-0003-2518-1373ДжексембековА. Г.DzheksembekovA. G.

 Айдар Габитович Джексембеков – аспирант 

 Москва 

 Ajdar G. Dzheksembekov – Postgraduate student 

 Moscow 

dzheksembekov1@mail.ruФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian FederationГородская клиническая больница № 15 им. О. М. ФилатоваРоссияMunicipal Clinical Hospital No. 15 named after O.M. FilatovRussian FederationФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России; Городская клиническая больница № 15 им. О. М. ФилатоваРоссияPirogov Russian National Research Medical University; Municipal Clinical Hospital No. 15 named after O.M. FilatovRussian Federation20220609202221493100Copyright © Теплова Н.В., Вечорко В.И., Баирова К.И., Евсиков Е.М., Жапуева М.Х., Джексембеков А.Г., 20222022Теплова Н.В., Вечорко В.И., Баирова К.И., Евсиков Е.М., Жапуева М.Х., Джексембеков А.Г.Teplova N.V., Vechorko V.I., Bairova K.I., Evsikov E.I., Zhapueva M.K., Dzheksembekov A.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.umjusmu.ru/jour/article/view/1039

Цель исследования – оценить эффективность и безопасность лечения синдрома артериальной гипертензии у больных с заболеваниями периферических артерий нижних и верхних конечностей и проанализировать эффективность воздействия оперативной реваскуляризации артерий конечностей на характер течения артериальной гипертензии. Материалы и методы. Поиск литературных источников глубиной 15 лет проведен в электронных ресурсах Pubmed.com, Sciencedirect.com, Library.ru. Результаты и обсуждение. Гипотензивная терапия у больных с поражением периферических артерий и локальными «атеротромботическими» механизмами острой тромботической окклюзии основными группами препаратов, обеспечивающими метаболическую безопасность длительного лечения, может существенно влиять на риск развития повторных артериальных тромбозов и критической ишемии, в том числе после проведения реконструктивных сосудистых операций. Международные методические материалы и рекомендации практически не освещают вопросы перспективы гипотензивной терапии больных с эмболическим характером острой артериальной окклюзии при хронической ишемии нижних конечностей. Отдельно эти категории больных в контролируемых проспективных исследованиях не выделяются, поэтому требуется планирование дополнительных работ по изучению вопроса. Заключение. Адекватно подобранная гипотензивная терапия и контроль за уровнем артериального давлении у больных с периферическим атеросклерозом нижних конечностей позволяет не только обеспечить целевой уровень снижения артериального давления, но и уменьшить риск развития тромботических осложнений, в том числе приводящих к развитию критической ишемии и гангрены конечностей.

The aim of the investigation was to evaluate the efficacy and safety of the treatment of arterial hypertension syndrome in patients with peripheral arterial disease of the lower and upper extremities and to analyze the efficiency of the effect of operative revascularization of the limb arteries on the course of arterial hypertension. Materials and methods. Literature sources were searched for 15 years in electronic resources of Pubmed. com, Sciencedirect.com, eLibrary.ru. Results and discussion. Hypotensive therapy, in patients with peripheral arterial disease and local "atherothrombotic" mechanisms of acute thrombotic occlusion, the main groups of drugs providing metabolic safety of long-term treatment can significantly affect the risk of repeated arterial thrombosis and critical ischemia, including, after reconstructive vascular surgery. International methodological materials and recommendations practically do not cover the issues of perspective hypotensive therapy of patients with embolic character of acute arterial occlusion in chronic lower limb ischemia. These categories of patients were not singled out separately in the controlled prospective studies, therefore, planning of additional works on the study of the issue is required. Conclusion. Adequately selected hypotensive therapy and blood pressure control in patients with lower limb peripheral atherosclerosis allows not only to provide the target level of blood pressure reduction, but also to reduce the risk of thrombotic complications, including those leading to critical limb ischemia and gangrene.

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