Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum94343ArticlesСтатьиResearch ArticleObstructive sleep apnea syndrome and arterial hypertension: bidirectional relationshipСиндром обструктивного апноэ сна и артериальная гипертония: двунаправленная взаимосвязьLitvinA. YuЛитвинАлександр Юрьевич

д-р мед. наук, рук. лаб. апноэ сна, отд. гипертонии ИКК им. А.Л.Мясникова ФГБУ РКНПК

alelitvin@yandex.ruMikhailovaO. OМихайловаОксана Олеговна

аспирант отд. гипертонии ИКК им. А.Л.Мясникова ФГБУ РКНПК

ElfimovaE. MЕлфимоваЕвгения Михайловна

лаборант-исследователь, лаб. апноэ сна, отд. гипертонии ИКК им. А.Л.Мясникова ФГБУ РКНПК

BugaevT. DБугаевТимофей Дмитриевич

аспирант отд. гипертонии ИКК им. А.Л.Мясникова ФГБУ РКНПК

ChazovaI. EЧазоваИрина Евгеньевна

чл.-кор. РАН, д-р мед. наук, проф., дир. ИКК им. А.Л.Мясникова ФГБУ РКНПК

A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian FederationИнститут клинической кардиологии им. А.Л.Мясникова ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России151020151710VOL 17, NO10 (2015)ТОМ 17, №10 (2015)343928122021Copyright ©; 2015, Consilium MedicumCopyright ©; 2015, ООО "Консилиум Медикум"2015Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/94343

Arterial hypertension (AH) is a modifiable wide-spread risk factor for common cardiovascular diseases. The large number of observations during several studies showed that obstructive sleep apnea syndrome (OSA) was an independent risk factor for AH. This article deals with OSA pathogenetic mechanisms, considering the model of bidirectional relationship between OSA and AH, as well as the effect of CPAP-therapy (Constant Positive Airway Pressure, CPAP) on blood pressure in hypertensive patients. There are many open questions concerning the pathogenesis of OSA, its effect on the cardiovascular system and prognosis, nowadays. Despite the fact that the decrease in blood pressure during CPAP-therapy in patients with OSA is usually small, a small drop in blood pressure, even a few mm Hg can significantly reduce the cardiovascular risk, but the combination of drug therapy and CPAP-therapy can result in significant decrease in blood pressure, especially in people with poorly controlled AH. Patients who have been attended clinics, specializing in the diagnosis and treatment of hypertension should be examined for the presence or absence of OSA as a possible modifiable risk factor.

Артериальная гипертония (АГ) - модифицируемый широко распространенный фактор риска сердечно-сосудистых заболеваний. В ряде исследований с большим количеством наблюдений предполагается, что синдром обструктивного апноэ сна (СОАС) - независимый фактор риска АГ. В этой статье обсуждаются патогенетические механизмы СОАС, рассматриваются модель двунаправленной взаимосвязи между СОАС и АГ, а также влияние СИПАП-терапии (от англ. Constant Positive Airway Pressure, CPAP) на артериальное давление у пациентов с гипертонической болезнью. В настоящее время существует много открытых вопросов, касающихся патогенеза СОАС, его влияния на сердечно-сосудистую систему и прогноз. Несмотря на то, что снижение артериального давления при СИПАП-терапии у пациентов с СОАС обычно невелико, снижение всего лишь на несколько мм рт. ст. может значительно снизить сердечно-сосудистый риск, а комбинация медикаментозной терапии с СИПАП-терапией может приводить к более существенному снижению артериального давления, особенно у лиц с трудно контролируемой АГ. Пациенты, направленные в клинику, специализирующуюся на диагностике и лечении гипертонии, должны быть обследованы на предмет наличия или отсутствия СОАС как возможного модифицируемого фактора риска.

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