Особенности развития кардиоваскулярной патологии у женщин в климактерическом периоде

Высокая социальная значимость повышения заболеваемости и смертности женщин при дисфункции половых гормонов послужила основой для разработки рекомендаций по профилактике и лечению ССЗ у этой категории пациентов (Evidence-based guidelines for cardiovascular disease prevention in women). На основе актуальных данных литературы обобщены механизмы развития и клинического течения кардиометаболических нарушений, возникающих в климактерическом периоде. По данным последних лет наступление менопаузы у женщин сопровождается развитием целого комплекса гормональных, метаболических и структурно-функциональных изменений, способствующих формированию и быстрому прогрессированию кардиоваскулярной патологии. Проблема взаимоотношений структурных изменений миокарда с его функциональными характеристиками до сих пор остается предметом дискуссии, так же как и вопрос о влиянии на структуру и функцию миокарда генетических факторов, дисбаланса ренин-ангиотензин-альдостероновой и иммунной систем в зависимости от типа менопаузы, наличия и тяжести постменопаузальной гипертензии, ее длительности и некоторых других факторов. Ухудшение качества жизни у пациенток с климактерическими расстройствами обуславливает целый ряд не только медицинских, но и социально-экономических проблем. Важной задачей является создание специализированного мультидисциплинарного подхода по проблемам климактерия, что позволит обеспечить индивидуальный подбор пациентке комплексного лечения с учетом особенностей патогенетических механизмов дисгормональной кардиомиопатии.

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