avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2019-9-2-85-92avk-899Research ArticleЛЕКЦИИLECTURESРациональная антигипертензивная терапия пациентов с обструктивным апноэ снаRational antihypertensive therapy in patients with obstructive sleep apneaГорбуноваМ. В.GorbunovaM. V.

Department of phthisiology and pulmonology

mgorb@mail.ruБабакС. Л.BabakS. L.

Department of phthisiology and pulmonology

МалявинА. Г.MalyavinA. G.

Department of phthisiology and pulmonology

ФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияMoscow State University of Medicine and Dentistry named after A.I. EvdokimovRussian Federation201930032019928592Copyright © Горбунова М.В., Бабак С.Л., Малявин А.Г., 20192019Горбунова М.В., Бабак С.Л., Малявин А.Г.Gorbunova M.V., Babak S.L., Malyavin 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.medarhive.ru/jour/article/view/899

Взаимосвязь между обструктивным апноэ сна и артериальной гипертензией не вызывает сомнения. В многочисленных исследованиях было установлено, что обструктивное апноэ сна являлось независимым предиктором развития резистентной артериальной гипертензии, причём степень тяжести апноэ напрямую коррелировала с выраженностью резистентной артериальной гипертензии с исключением влияния таких конфаундеров, как возраст, ожирение, пол.

Целью настоящей публикации является изложение новой стратегии и современных подходов медикаментозной и немедикаментозной терапии резистентной артериальной гипертензии пациентов с обструктивным апноэ сна с возможностью их выполнения в реальной клинической практике.

Заключение. В настоящее время для практикующего специалиста терапия пациента с обструктивным апноэ сна и резистентной артериальной гипертензией представляет серьёзную клиническую проблему. Новая рациональная терапевтическая стратегия лечения таких пациентов включает комбинированную трёхкомпонентную лекарственную и немедикаментозную терапию методом постоянного положительного воздухоносного давления (СРАР-терапия). Разумная длительность СРАР-терапии должна превышать 12 недель. Предлагаемая тактика лечения пациентов с обструктивным апноэ сна и резистентной артериальной гипертензией имеет самую высокую эффективность достижения целых уровней АД и достоверно снижает риски фатальных сердечно-сосудистых событий.

Background

Background. The relationship between obstructive sleep apnea (OSA) and hypertension (AH) is well known. In numerous studies it was found that obstructive sleep apnea was an independent predictor of the development of resistant AH (RAH), and the severity of apnea was directly correlated with the severity of RAH with the exception of the such confounders as age, obesity, sex.

The purpose of this publication is to present a new strategy and modern approaches of drug and non-drug therapy of resistant hypertension in patients with OAS with the possibility of their implementation in real clinical practice.

Conclusion

Conclusion. Currently, for a practitioner, the therapy of the patient with OSA and RAH is a serious clinical problem. A new rational therapeutic strategy for the treatment of such patients includes a combination of three-component drug therapy and non-drug continuous positive air pressure therapy (CPAP therapy). A reasonable duration of CPAP therapy should exceed 12 weeks. The proposed strategy for the treatment of patients with OAS+RAH has the highest efficiency of achieving blood pressure levels and significantly reduces the risks of fatal cardiovascular events.

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