Фармакотерапия беременных женщин с артериальной гипертензией с учетом патогенетических факторов в условиях пандемии инфекции SARS-CoV-2

Abstract

Objective. To analyze and present current scientific data and the results of our own research on the features of pharmacotherapy for pregnant women with arterial hypertension (AH) under present conditions. Materials and methods. A comprehensive analysis of the available up-to-date scientific sources over the past decade was carried out in the Scopus, PubMed.com, and E-library databases. Physicians (n = 100) and pregnant women with AH (n = 164) were interviewed about the use of antihypertensive agents between 2009 and 2021. Conclusions. The general principles of pharmacotherapy for AH in pregnant women include: maximum efficacy for the mother; fetal safety; therapy according to blood pressure (BP) levels, maternal and fetal risk factors; initiation of treatment with minimal doses of one drug; switching to another class of drugs and combination therapy when the first-line drugs are not effective or poorly tolerated; preference to dynamic, remote and “hard” control of hemodynamic parameters aimed at target systolic BP of 140 mm Hg and diastolic BP of 85 mm Hg. The antihypertensives of choice with proven efficacy and safety in the gestational period are a centrally acting α-adrenoceptor agonist α-methyldopa, a calcium channel blocker nifedipine, and beta-blockers. All interviewed specialists in the Central Federal District are sufficiently competent and informed about the pharmacological control of AH in pregnant women. Key words: pregnant women, arterial hypertension, SARS-CoV-2, antihypertensive agents