Первичный гиперпаратиреоз и сердечно-сосудистые заболевания

Уже длительное время сердечно-сосудистые заболевания (ССЗ) занимают первое место в структуре общей смертности и заболеваемости. Было показано, что нарушения кальций-фосфорного обмена, в частности первичный гиперпаратиреоз (ПГПТ), могут вносить дополнительный вклад в их развитие и прогрессирование. Несмотря на прослеживаемую связь между ПГПТ и ССЗ, многие аспекты этой проблемы остаются недостаточно изученными. Состояние сердечно-сосудистой системы имеет решающее значение при оценке смертности пациентов, тем не менее в настоящее время отсутствуют четкие предикторы развития ССЗ при ПГПТ. Сердечно-сосудистая патология не входит в перечень абсолютных показаний к хирургическому лечению заболевания околощитовидных желез. Однако, принимая во внимание частоту артериальной гипертензии и других ССЗ, в обновленные отечественные рекомендации по ПГПТ включена консультация врача-кардиолога в целях диагностики сердечно-сосудистой патологии и подготовки к хирургическому лечению всем пациентам. Цель данной статьи — рассмотреть результаты актуальных исследований, посвященных влиянию ПГПТ на сердечно-сосудистую систему, проанализировать патогенетические механизмы и  обсудить стратегию диагностики и лечения данной группы пациентов. Комплексная оценка кардиоваскулярных изменений с учетом патогенетических механизмов их развития направлена прежде всего на повышение качества и продолжительности жизни населения.

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