aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАНateroskleroz-609Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESСахарный диабет и коронарный атеросклерозDiabetes mellitus and coronary atherosclerosisВолковВ. И.VolkovV. I.

Владимир Иванович Волков, д-р мед. наук, проф., зав. отделом

ГУ «Институт терапии им. Л. Т. Малой АМН Украины»

отдел атеросклероза и ишемической болезни сердца

61039

просп. Постышева, 2а

Харьков

State Institution "L. T. Malaya Institute of Therapy

61039

avenue. Postysheva, 2a

Kharkiv

СерикС. А.SerikS. A.

Сергей Андреевич Серик, канд. мед. наук, старший научный сотрудник

ГУ «Институт терапии им. Л. Т. Малой АМН Украины»

отдел атеросклероза и ишемической болезни сердца

61039

просп. Постышева, 2а

Харьков

State Institution "L. T. Malaya Institute of Therapy

61039

avenue. Postysheva, 2a

Kharkiv

serik123@ukr.netАМН УкраиныAcademy of Medical Sciences of Ukraine20113003202272522Copyright © Волков В.И., Серик С.А., 20222022Волков В.И., Серик С.А.Volkov V.I., Serik S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/609

   Больные сахарным диабетом имеют повышенный риск развития коронарного атеросклероза и ишемической болезни сердца (ИБС), которая является самой частой причиной смерти при диабете. Наиболее значимый вклад в возрастание риска ИБС у больных диабетом вносит дислипидемия. Многокомпонентный патогенез ускоренного коронарного атеросклероза при диабете остается окончательно не выясненным. В настоящее время отсутствуют убедительные данные о пользе интенсивного контроля гликемии для предотвращения макрососудистых осложнений диабета. Первичной мишенью лечения дислипидемии при диабете является холестерин липопротеинов низкой плотности, и препаратами для его снижения считаются статины. У больных диабетом и сопутствующей артериальной гипертензией главной детерминантой сердечно-сосудистых эффектов антигипертензивных препаратов является достигнутый при лечении уровень артериального давления. Фармакотерапия должна включать или ингибитор ангиопревращающего фермента, или антагонист рецептора ангиотензина II.

   Diabetic patients have the excess risk of developing atherosclerotic coronary artery disease (CAD), which is the most common cause of death in diabetes. The major contributor to the increased CAD risk in patients with type 2 diabetes is dyslipidemia. The multicomponent pathogenesis of accelerated coronary atherosclerosis in diabetes remains incompletely understood. At present there is not convincing evidence of intensive glucose control benefit for prevention cardiovascular complications of diabetes. Low-density lipoprotein cholesterol is recognized as the primary target of the treatment of dyslipidemia in diabetic patients and statins are the drugs of choice for lowering low-density lipoprotein cholesterol. In patients with diabetes and hypertension the main determinant of the cardiovascular benefits of antihypertensive drugs is the blood pressure level achieved under treatment, but nevertheless pharmacologic therapy should include either an angiotensin-converting enzyme inhibitors or an angiotensin II receptor antagonist.

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The authors declare that there are no conflicts of interest present.