rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2012-8-4-587-594rpcardio-509Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИEFFECT OF CARDIOVASCULAR DRUGS ON BONE HEALTH AND THE POSSIBILITY OF THEIR USE FOR THE PREVENTION OF OSTEOPOROSISВЛИЯНИЕ СЕРДЕЧНО-СОСУДИСТЫХ ПРЕПАРАТОВ НА КОСТНУЮ ТКАНЬ И ВОЗМОЖНОСТЬ ИХ ИСПОЛЬЗОВАНИЯ ДЛЯ ПРОФИЛАКТИКИ ОСТЕОПОРОЗАСкрипниковаИ. А.SkripnikovaI. A.

д.м.н., руководитель отдела профилактики остеопороза

СобченкоК. Е.SobchenkoK. E.

аспирант

malezki@list.ruКосматоваО. В.KosmatovaO, V.

к.м.н., с.н.с. отдела профилактики остеопороза

НебиеридзеД. В.NebieridzeD. V.

д.м.н., профессор, руководитель отдела профилактики метаболических нарушений

Государственный научно-исследовательский центр профилактической медициныРоссияState Research Center for Preventive MedicineRussian Federation20120201201684587594Copyright © Skripnikova I.A., Sobchenko K.E., Kosmatova O.V., Nebieridze D.V., 20152015Скрипникова И.А., Собченко К.Е., Косматова О.В., Небиеридзе Д.В.Skripnikova I.A., Sobchenko K.E., Kosmatova O.V., Nebieridze D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/509

Widespread use of antihypertensive and lipid-lowering agents in clinical practice determines the necessity of knowledge of their pleiotropic effects. Results of studies of the effect of cardiac drugs and, first of all beta-blockers, ACE inhibitors, diuretics, and statins on bone are presented. Mode of action on the bone mineral density , markers of bone turnover and ultimately impact on the incidence of fractures associated with osteoporosis are discussed. At the present time there are no sufficient evidences of positive effect of these medications on bone coming from randomized controlled trials. It is not possible to recommend discussed cardiovascular drugs for prevention of osteoporosis and fractures, as well as registration new indications for them. However , knowledge of additional effects on the bone metabolism in cardiovascular drugs, will allow doctors to choose optimal treatment of hypertension and lipid disorders, taking into account the state of bone tissue. At the same time it will also allow to prevent osteoporosis in patients having osteoporosis risk factors or initial signs of bone loss.

Широкое использование в клинической практике антигипертензивных и липидснижающих препаратов определяют необходимость знаний их плейотропных эффектов. Представлены результаты исследований по влиянию кардиологических препаратов, и, в первую очередь, из групп бета-адреноблокаторов, ингибиторов АПФ, диуретиков и статинов на костную ткань. Обсуждаются их механизмы действия на минеральную плотность кости, маркеры костного обмена и, в итоге, влияние на частоту переломов, связанных с остеопорозом. В настоящее время приведено недостаточно доказательств позитивного влияния этих препаратов на костную ткань, полученных в рандомизированных контролируемых исследованиях. Это не позволяет рекомендовать обсуждаемые группы кардиологических препаратов для профилактики остеопороза и переломов, а также регистрировать у них новые показания. Однако знания о дополнительном влиянии на костный метаболизм препаратов, назначаемых при заболеваниях сердечно-сосудистой системы, позволят врачам подобрать оптимальную схему лечения артериальной гипертонии и нарушений липидного обмена, учитывая состояние костной ткани, и одновременно проводить профилактику остеопороза у лиц с начальными признаками снижения костной массы или имеющих факторы риска остеопороза.

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