kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2019-8-4-116-126kpccz-636Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Внутренние болезниREVIEWS. Internal medicineСовременные представления о проблеме ортостатической гипотензииModern concepts of orthostatic hypotensionhttps://orcid.org/0000-0002-8493-0058ПетроваМ. М.PetrovaM. M.

Петрова Марина Михайловна - доктор медицинских наук, профессор кафедры поликлинической терапии и семейной медицины с курсом последипломного образования.

Ул. Партизана Железняка, 1, Красноярск, 660022

Petrova Marina M. - PhD, Ршfessor at the Department of Outpatient Care and Family Medicine.

https://orcid.org/0000-0002-0795-8225ОстроумоваО. Д.OstroumovaO. D.

Остроумова Ольга Дмитриевна - профессор, доктор медицинских наук, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней Первого МГМУ им. И.М. Сеченова, заведующая лабораторией клинической фармакологией и фармакотерапией РНИМУ им. Н.И. Пирогова.

Ул. Большая Пироговская, 2, стр. 4, Москва, 119435; ул. 1-я Леонова, 16, Москва, 129226

Ostroumova Olga D. - PhD, Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, I.M. Sechenov MSMU; Head of the Laboratory of Clinical Pharmacology and Pharmacotherapy RGR CC.

Bolshaya Pirogovskaya st. 2/4, Moscow, 119435; 1 Leonova st. 16, Moscow, 129226

https://orcid.org/0000-0003-3091-7904ЧерняеваМ. С.CherniaevaM. S.

Черняева Марина Сергеевна - кандидат медицинских наук, доцент кафедры внутренних болезней и профилактической медицины.

Ул. Маршала Тимошенко 19, стр. 1а, Москва, 121359; тел.: +7 (964) 587-30-03

Cherniaeva Marina S. - PhD, Associate Professor at the Department of Internal Medicine and Preventive Medicine.

Marshal Timoshenko st. 19/1A, Moscow, 121359; phone +7 (964) 587-30-03

Pilya.ru@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Красноярский государственный медицинский университет имени профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения Российской ФедерацииРоссияKrasnoyarsk State Medical University of the Ministry of Healthcare of the Russian FederationRussian FederationФедеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Федеральное государственное бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации - Обособленное структурное подразделение Российский геронтологический научно-клинический центрРоссияI.M. Sechenov First Moscow State MedicalUniversity; Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation - Russian Gerontological Research and Clinical CenterRussian FederationФедеральное государственное бюджетное учреждение дополнительного профессионального образования «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical Academy of the Department of Presidential AffairsRussian Federation20192512201984116126Copyright © Петрова М.М., Остроумова О.Д., Черняева М.С., 20192019Петрова М.М., Остроумова О.Д., Черняева М.С.Petrova M.M., Ostroumova O.D., Cherniaeva M.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/636

На сегодняшний день имеется много литературных данных, о том, что частота встречаемости ортостатической гипотензии (ОГ) увеличивается с возрастом и при наличии сопутствующей патологии. Кроме того, ОГ ассоциируется с повышенным риском серьезных неблагоприятных цереброваскулярных и коронарных событий, может способствовать нарушению когнитивных функций и развитию деменции, а также является одним из главных факторов риска падений, особенно у пожилых пациентов. В данном обзоре обобщены современные отечественные и зарубежные литературные данные о данной проблеме, представлены обновленное определение ОГ, её современная классификация, патофизиология, особенности течения ОГ у пожилых людей, рекомендации по диагностике и лечению. Особое внимание в обзоре уделено одной из форм вторичной ОГ - лекарственно индуцированной ОГ, частота встречаемости которой увеличивается с увеличением количества принимаемых лекарственных препаратов. Подробно представлены перечень лекарственных препаратов, вызывающих ОГ и методы борьбы с полипрагмазией.

Recent literary data reports an increase in the prevalence of orthostatic hypotension (ОН) with age and with the presence of comorbidities. In addition, ОН is associated with a high risk of major adverse cardiovascular and cerebrovascular events and may contribute to cognitive impairment and the onset of dementia. Moreover, OH is one of the main risk factors for falls, especially among elderly patients. The review covers recent national and foreign studies focusing on this problem, and presents an updated definition of ОН, its modern classification, pathophysiology, peculiarities of the ОН course in the elderly, guidelines on OH diagnosis and treatment. Particular attention is given to the secondary ОН, commonly known as drug-induced ОН. Its prevalence increases with increased number of medications taken. A list of drugs that may induce ОН and treatment approaches to polypragmasia are provided.

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