rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2011-7-2-219-226rpcardio-753Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯPECULIAR PROPERTIES OF ANTITHROMBOTIC THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION. IS IT POSSIBLE TO DO THE TREATMENT SAFE?ОСОБЕННОСТИ АНТИТРОМБОТИЧЕСКОЙ ТЕРАПИИ У БОЛЬНЫХ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ. МОЖНО ЛИ СДЕЛАТЬ ЛЕЧЕНИЕ БЕЗОПАСНЫМ?ЗотоваИ. В.ZotovaI. V.

к.м.н., ассистент кафедры кардиологии и общей терапии

irinazotova@bk.ruЗатейщиковД. А.ZateyshchikovD. A.

д.м.н., профессор кафедры кардиологии и общей терапии

Учебно-научный медицинский центр Управления делами Президента Российской ФедерацииРоссияTeaching and Research Medical Center , Department of Affairs of the President of Russian FederationRussian Federation20111401201672219226Copyright © Zotova I.V., Zateyshchikov D.A., 20162016Зотова И.В., Затейщиков Д.А.Zotova I.V., Zateyshchikov D.A.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/753

Arterial hypertension (HT) is a reason for raising a question about need for antithrombotic therapy. At the same time, increased blood pressure associated with an increased risk of hemorrhagic complications. Possible ways to minimize the hemorrhagic risk in different groups of hypertensive patients who need in antithrombotic therapy are discussed.

Наличие артериальной гипертензии (АГ) является веским основанием для постановки вопроса о необходимости применения антитромботических препаратов. Вместе с этим, повышение артериального давления ассоциировано с увеличением риска развития геморрагических осложнений. Обсуждают возможные способы минимизации геморрагического риска у различных групп больных АГ , которые нуждаются в приеме антитромботических препаратов.

артериальная гипертензияфибрилляция предсердийацетилсалициловая кислотаварфаринатеротромбозarterial hypertensionatrial fibrillationacetylsalicylic acidwarfarinatherothrombosisReferencesMackay J., Mensah G. The Atlas of Heart Disease and Stroke. Geneva: WHO; 2004.Mackay J., Mensah G. The Atlas of Heart Disease and Stroke. Geneva: WHO; 2004.Zanchetti A., Hansson L., Dahlo F.B. et al. HOT Study Group. Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk. J Hypertens 2002; 20:2301-7Zanchetti A., Hansson L., Dahlo F.B. et al. HOT Study Group. Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk. J Hypertens 2002; 20:2301-7Oganov R.G., editor. National clinical guidelines. 2nd ed. M.: Silitseya-Poligraf; 2009. Russian (Ога-нов Р.Г., редактор. Национальные клинические рекомендации. 2-е изд. М.: Силицея-Полиграф; 2009).Oganov R.G., editor. National clinical guidelines. 2nd ed. M.: Silitseya-Poligraf; 2009. Russian (Ога-нов Р.Г., редактор. Национальные клинические рекомендации. 2-е изд. М.: Силицея-Полиграф; 2009).Aspirin for the Prevention of Cardiovascular Disease: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2009;150:396-404Aspirin for the Prevention of Cardiovascular Disease: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2009;150:396-404Berger J.S., Roncaglioni M.C., Avanzini F. et al. Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA 2006; 295:306-13.Berger J.S., Roncaglioni M.C., Avanzini F. et al. Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA 2006; 295:306-13.Coronary Heart Disease Risk Calculator. Available on: http://www.mcw.edu/calculators/Coronary-HeartDiseaseRisk.htm.Coronary Heart Disease Risk Calculator. Available on: http://www.mcw.edu/calculators/Coronary-HeartDiseaseRisk.htm.Framingham Stroke Risk. Available on: http://www.westernstroke.org/PersonalStrokeRisk1.xls.Framingham Stroke Risk. Available on: http://www.westernstroke.org/PersonalStrokeRisk1.xls.Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2009;150(6):396-404.Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2009;150(6):396-404.National guidelines for antithrombotic therapy in patients with stable manifestations of atherothrombosis. Kardiovaskulyarnaya terapiya i profilaktika 2009; 8(6) suppl 6:1-20. Russian (Национальные рекомендации по антитромботической терапии у больных со стабильными проявлениями атеротромбоза. Кардиоваскулярная терапия и профилактика 2009; 8(6) Приложение 6:1-20).National guidelines for antithrombotic therapy in patients with stable manifestations of atherothrombosis. Kardiovaskulyarnaya terapiya i profilaktika 2009; 8(6) suppl 6:1-20. Russian (Национальные рекомендации по антитромботической терапии у больных со стабильными проявлениями атеротромбоза. Кардиоваскулярная терапия и профилактика 2009; 8(6) Приложение 6:1-20).Eikelboom J.W., Mehta S.R., Anand S.S. et al. Adverse impact of bleeding on prognosis in patients with acute coronary syndromes. Circulation 2006; 114:774–782.Eikelboom J.W., Mehta S.R., Anand S.S. et al. Adverse impact of bleeding on prognosis in patients with acute coronary syndromes. Circulation 2006; 114:774–782.Subherwal S., Bach R.G., Chen A.Y. et al. Baseline Risk of Major Bleeding in Non–ST-Segment–Elevation Myocardial Infarction. The CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) Bleeding Score. Circulation 2009; 119:1873-1882.Subherwal S., Bach R.G., Chen A.Y. et al. Baseline Risk of Major Bleeding in Non–ST-Segment–Elevation Myocardial Infarction. The CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) Bleeding Score. Circulation 2009; 119:1873-1882.Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of an-tiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71– 86.Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of an-tiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71– 86.Weil J., Colin-Jones D., Langman M. et al. Prophylactic aspirin and risk of peptic ulcer bleeding. BMJ 1995;310:827–30.Weil J., Colin-Jones D., Langman M. et al. Prophylactic aspirin and risk of peptic ulcer bleeding. BMJ 1995;310:827–30.Bhatt D.L., Scheiman J., Abraham N.S. et al. ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use: A Report of the Ameri-can College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Col Cardiol 2008; 52(18): 1502-1517.Bhatt D.L., Scheiman J., Abraham N.S. et al. ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use: A Report of the Ameri-can College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Col Cardiol 2008; 52(18): 1502-1517.Bhatt D.L., Scheiman J., Abraham N.S. et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol 2008;103(11):2890-907.Bhatt D.L., Scheiman J., Abraham N.S. et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol 2008;103(11):2890-907.Bogousslavsky J., Cachin C., Regli F. et al. Cardiac sources of embolism and cerebral infarction-clinical consequences and vascular concomitants: the lausanne stroke registry. Neurology 1991;41: 855–9.Bogousslavsky J., Cachin C., Regli F. et al. Cardiac sources of embolism and cerebral infarction-clinical consequences and vascular concomitants: the lausanne stroke registry. Neurology 1991;41: 855–9.Hart R.G., Pearce L.A., Aguilar M.I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146:857– 67.Hart R.G., Pearce L.A., Aguilar M.I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146:857– 67.Gage B.F., Waterman A.D., Shannon W. et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 2001; 285:2864—2870.Gage B.F., Waterman A.D., Shannon W. et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 2001; 285:2864—2870.van Walraven W.C., Hart R.G., Wells G.A. et al. A clinical prediction rule to identify patients with atrial fibrillation and a low risk for stroke while taking aspirin. Arch Intern Med 2003; 163:936—943.van Walraven W.C., Hart R.G., Wells G.A. et al. A clinical prediction rule to identify patients with atrial fibrillation and a low risk for stroke while taking aspirin. Arch Intern Med 2003; 163:936—943.Gorin L., Fauchier L., Nonin E. et al. Antithrombotic treatment and the risk of death and stroke in patients with atrial fibrillation and a CHADS2 score=1. Thromb Haemost 2010; 103(3):833—840.Gorin L., Fauchier L., Nonin E. et al. Antithrombotic treatment and the risk of death and stroke in patients with atrial fibrillation and a CHADS2 score=1. Thromb Haemost 2010; 103(3):833—840.Lip G., Nieuwlaat R., Pisters R. et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor based approach: The Euro Heart Survey on Atrial Fibrillation. Chest 2010; 137(2):263—272.Lip G., Nieuwlaat R., Pisters R. et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor based approach: The Euro Heart Survey on Atrial Fibrillation. Chest 2010; 137(2):263—272.Camm A.J., Kirchhof P., Lip G.Y.H. et al. Guidelines for the management of atrial fibrillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31(19): 2369—2429.Camm A.J., Kirchhof P., Lip G.Y.H. et al. Guidelines for the management of atrial fibrillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31(19): 2369—2429.Gage B.F. Clinical classification schemes for predicting hemorrhage: Results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J 2006; 151:713—719.Gage B.F. Clinical classification schemes for predicting hemorrhage: Results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J 2006; 151:713—719.Pisters R., Lane D.A., Nieuwlaat R. et al. A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest 2010;138:1093-1100.Pisters R., Lane D.A., Nieuwlaat R. et al. A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest 2010;138:1093-1100.Lip G.Y. Don't add aspirin for associated stable vascular disease in a patient with atrial fibrillation receiving anticoagulation. BMJ 2008; 336:614–615.Lip G.Y. Don't add aspirin for associated stable vascular disease in a patient with atrial fibrillation receiving anticoagulation. BMJ 2008; 336:614–615.Lane D.A., Kamphuisen P.W., Minini P. et al. Bleeding risk in atrial fibrillation patients: The Аmadeus study. Chest 2011; 10:1378-1383.Lane D.A., Kamphuisen P.W., Minini P. et al. Bleeding risk in atrial fibrillation patients: The Аmadeus study. Chest 2011; 10:1378-1383.

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