ymjЯкутский медицинский журналYakut Medical Journal1813-19052312-1017ЯНЦ КМП10.25789/YMJ.2021.76.08ymj-592Research ArticleМЕТОДЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯMETHODS OF DIAGNOSIS AND TREATMENTЛечение хронической артериальной гипертензии при беременности: влияние сроков начала на состояние органов-мишенейTreatment of chronic arterial hypertension during pregnancy: the influence of the start time on the state of target organshttps://orcid.org/0000-0001-6871-7102ГасановаБ. М.GasanovaB. M.

Гасанова Бахтыкей Мусалавовна – к.м.н., докторант Медицинского института

Gasanova Bakhtykei Musalavovna – PhD in Medical Sciences, Doctoral Candidate of the Department of Obstetrics and Gynaecology with a course in Perinatology of the Medical Institute

Moscow

gsbhms69@gmail.comhttps://orcid.org/0000-0003-3883-3967ПолинаМ. Л.PolinaM. L.

Полина Мирослава Леонидовна – к.м.н., врач акушер-гинеколог

Москва

Polina Miroslava Leonidovna – PhD in Medical Sciences, Gynecologist

Moscow

polina.ml@mail.ruДугласН. И.DouglasN. I.

Дуглас Наталья Ивановна – д.м.н., зав. кафедрой Медицинского института

Douglas Natalya Ivanovna – Grand PhD in Medical Sciences, Head of the Department of Obstetrics and Gynecology, Medical Institute

Yakutsk

nduglas@yandex.ruЗахароваП. Н.ZakharovaP. N.

Захарова Прасковья Николаевна – ординатор кафедры Медицинского института

Zakharova Praskovya Nikolaevna – clinical resident of the Department of Obstetrics and Gynecology, Medical Institute

Yakutsk

ФГАОУВО «Российский университет Дружбы народов»РоссияFederal State Autonomous State Educational Institution of Higher Education «People's Friendship University of Russia»MoscowRussian FederationМедицинский центр женского здоровьяРоссияWomen's Health Medical CenterRussian FederationСеверо-Восточный федеральный ун-т им. М.К. АммосоваРоссияM.K. Ammosov North-Eastern Federal UniversityRussian Federation202104052025043438Copyright © Гасанова Б.М., Полина М.Л., Дуглас Н.И., Захарова П.Н., 20252025Гасанова Б.М., Полина М.Л., Дуглас Н.И., Захарова П.Н.Gasanova B.M., Polina M.L., Douglas N.I., Zakharova P.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ymj.elpub.ru/jour/article/view/592

Представлены результаты сравнительного анализа влияния сроков начала гипотензивной терапии на состояние органов-мишеней (миокарда левого желудочка (ЛЖ), почек) у беременных с хронической артериальной гипертензией (ХАГ) и с развитием на ее фоне преэклампсии (ПЭ).

Ранняя гипотензивная терапия позволяет реализовать протективное влияние на органы-мишени беременных с ХАГ (адаптивное ремоделирование миокарда ЛЖ, почечный эндотелий (МАУ) и пуриновый обмен (синтез мочевой кислоты)). Отсроченная гипотензивная терапия (после 15-й-20-й недели беременности) способствует доминированию дезадаптивных механизмов регуляции активности сердечно-сосудистой системы. Этих беременных отличает прогрессирование морфофункциональных изменений миокарда ЛЖ (концентрической гипертрофии и диастолической дисфункции), в наибольшей степени при развитии ПЭ. Наибольшая частота нарушений суточного ритма артериального давления (типы «нон-диппер» и «найт-пикер») и метаболических сдвигов (гиперурикемия, МАУ) выявлена у беременных с развитием ПЭ.

The results of a comparative analysis of the effect of the timing of the start of antihypertensive therapy on the state of target organs (left ventricular (LV) myocardium, kidneys) in pregnant women with chronic arterial hypertension (CAH) and with the development of preeclampsia (PE) on its background are presented.

Early antihypertensive therapy makes it possible to implement a protective effect on the target organs of pregnant women with CAH (adaptive remodeling of the LV myocardium, renal endothelium (MAU) and purine metabolism (synthesis of uric acid)). Delayed hypotensive therapy (after 15-20 weeks of pregnancy) contributes to the dominance of maladaptive mechanisms of regulating the activity of the cardiovascular system. These pregnant women are distinguished by the progression of morphofunctional changes in the LV myocardium (concentric hypertrophy and diastolic dysfunction), to the greatest extent with the development of PE. The highest frequency of disturbances in the circadian rhythm of blood pressure (non-dipper and night-picker types) and metabolic changes (hyperuricemia, MAU) was revealed in pregnant women with the development of PE.

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