Фармакотерапевтичні особливості ведення пацієнтів із вторинними артеріальними гіпертензіями ендокринного генезу

Abstract

Secondary arterial hypertension is the arterial hypertension, the etiology of which can be established. Secondary arterial hypertension becomes the cause of elevated blood pressure in 5–10% of patients with hypertension. More than 50 diseases and clinical conditions contributing to the development of secondary arterial hypertension have been identified. In most cases, such arterial hypertension is characterized by high blood pressure, an unfavorable prognosis of the disease, and a high frequency of cardiovascular complications. However, in some forms of it, timely diagnosis and adequate treatment allow to achieve normalization of blood pressure and prevent the development of complications. In cases of the secondary arterial hypertension, in addition to antihypertensive therapy, drug treatment or surgical treatment of the underlying disease that caused hypertension is required. Knowledge of modern diagnostics and principles of treatment of these conditions has to improve the quality of care for patients suffering from hypertension. The purpose of the study was to consider the main clinical, pathogenic, diagnostic and pharmacotherapeutic aspects of the secondary arterial hypertension of endocrine genesis. Secondary endocrine arterial hypertensions develop in diabetes mellitus, hyperaldosteronism primary (Kon's syndrome) and pseudoprimary (idiopathic hyperplasia of the adrenal cortex), Itsenko-Cushing syndrome, pheochromocytoma, pheochromoblastoma, paraganglioma, acromegaly, hypothyroidism, hyperthyroidism, hyperparathyroidism, etc. Each of these diseases has a special etiopathogenesis of arterial hypertension, which makes it necessary to carry out special screening and diagnostic tests in order to prescribe reasonable therapy. In the management of patients with secondary endocrine arterial hypertension, there cannot be universal approaches to the appointment of antihypertensive drugs, instead, an individualized approach contributes to effective control of the disease and prevention of possible complications. Conclusion. So, taking into account the high and progressive incidence of arterial hypertension worldwide, the high frequency of life-threatening complications, a large number of risk factors, constant updating of knowledge on the clinical, pathogenic, diagnostic and pharmacotherapeutic aspects of the management of such patients becomes extremely relevant. A significantly large part of secondary arterial hypertension in the structure of this pathology requires special attention of practicing doctors regarding differential diagnosis, especially in the cohort of young patients. Information about features of the pathogenic therapy of the secondary arterial hypertension of endocrine origin is necessary for a wide range of doctors of various specialties for the maximum effective management of such patients