Противоопухолевые препараты и лекарственно-индуцированная артериальная гипертензия

   Артериальная гипертензия (АГ) представляет собой одну из самых часто встречаемых коморбидностей у пациентов с онкологическими заболеваниями. Помимо этого, само лечение противоопухолевыми препаратами может приводить к развитию лекарственно-индуцированной (ЛИ) АГ.

   Цель работы: систематизация и анализ данных научной литературы о противоопухолевых лекарственных средствах (ЛС), применение которых может вызвать развитие ЛИ АГ, а также об эпидемиологии, патофизиологических механизмах, факторах риска, клинической картине, диагностике и дифференциальной диагностике, лечении и профилактике АГ, ассоциированной с применением противоопухолевых ЛС.

   В результате анализа данных установлено, что ЛС, используемые для лечения онкологических заболеваний, нередко способствуют развитию ЛИ АГ. Механизмы, которые обусловливают развитие АГ, разнообразны и могут включать развитие эндотелиальной дисфункции (нарушению баланса между вазоконстрикторами и вазодилататорами), увеличение жесткости артериального русла, рарефикацию капилляров, нарушение водно-электролитного баланса, а также генетические факторы. АГ, в том числе индуцированная противоопухолевыми ЛС – важный фактор развития сердечно-сосудистых событий, включая инсульт, ишемическую болезнь сердца, сердечную недостаточности. Для снижения риска развития нежелательных реакций, и предотвращения сердечно- сосудистых событий важно знать и помнить о ЛС, которые могут вызвать ЛИ АГ. Лечение АГ, возникшей на фоне приема противоопухолевых ЛС, часто требует незамедлительной отмены ЛС, так нередко нежелательные реакции имеют жизнеугрожающий характер. В некоторых ситуациях возможно снижение дозы ЛС и (или) назначение антигипертензивных ЛС.

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