ARTERIAL GIPERTENZIYA: ZAMONAVIY DIAGNOSTIKA, DAVOLASH YONDASHUVLARI VA ANTIGIPERTENZIV FARMAKOTERAPIYA SAMARADORLIGI
Keywords:
arterial gipertenziya, arterial bosim, diagnostika, ABPM, uy sharoitidagi monitoring, yurak-qon tomir xavfi, antigipertenziv terapiya, ACE ingibitorlari, ARB, kalsiy kanal blokatorlari, diuretiklar, beta-blokatorlar, kombinatsion terapiya, rezistent gipertenziya, klinik farmatsiya.Abstract
Arterial gipertenziya yurak-qon tomir tizimining eng ko‘p uchraydigan surunkali kasalliklaridan biri bo‘lib, yurak ishemik kasalligi, insult, yurak yetishmovchiligi, surunkali buyrak kasalligi va boshqa nishon-a’zolar zararlanishining muhim modifikatsiyalanuvchi xavf omili hisoblanadi. Kasallikning uzoq vaqt davomida simptomsiz kechishi uning o‘z vaqtida aniqlanishini qiyinlashtirib, klinik asoratlar xavfini oshiradi. Shu sababli arterial bosimni standartlashtirilgan sharoitda o‘lchash, takroriy tekshiruvlar, uy sharoitidagi monitoring va 24 soatlik ambulator arterial bosim monitoringidan foydalanish zamonaviy diagnostik strategiyaning muhim tarkibiy qismlaridir. Mazkur maqolada arterial gipertenziyani erta aniqlash, yurak-qon tomir xavfini stratifikatsiya qilish, nishon-a’zolar zararlanishini baholash va farmakologik davolashning zamonaviy tamoyillari tahlil qilindi. Diagnostik yondashuvda ofisdagi arterial bosim ko‘rsatkichlarini takroriy baholash bilan birga uy va ambulator monitoringning klinik ahamiyati yoritildi. Davolash strategiyasida turmush tarzini modifikatsiya qilish, natriy iste’molini kamaytirish, jismoniy faollikni oshirish, tana vaznini nazorat qilish va yurak-qon tomir xavf omillarini boshqarish farmakoterapiya bilan uzviy bog‘liqligi ko‘rsatildi. Antigipertenziv preparatlar orasida angiotenzin-konvertlovchi ferment ingibitorlari, angiotenzin II retseptor blokatorlari, kalsiy kanal blokatorlari va tiazid yoki tiazidsimon diuretiklarning klinik samaradorligi tahlil qilindi. Beta-blokatorlarning esa yurak ishemik kasalligi, yurak yetishmovchiligi yoki ayrim boshqa klinik ko‘rsatmalar mavjud bo‘lganda muhim o‘rin tutishi ko‘rsatildi. Kombinatsion terapiyaning monoterapiyaga nisbatan arterial bosimni tezroq va barqarorroq nazorat qilishdagi afzalliklari, bir tabletkali kombinatsiyalarning davolanishga rioya qilishni yaxshilashdagi ehtimoliy ahamiyati yoritildi. Rezistent gipertenziyada esa davolanishga rioya qilishni tekshirish, ikkilamchi sabablarni istisno qilish va mineralokortikoid retseptor antagonistlaridan foydalanish masalalari ko‘rib chiqildi. Maqolada farmakoterapiya samaradorligini faqat arterial bosim pasayishi bilan emas, balki yurak-qon tomir hodisalari va nishon-a’zolar zararlanishining oldini olish bilan baholash zarurligi asoslandi.
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