Tom 18, Nr 4 (2021)
Artykuł przeglądowy
Opublikowany online: 2022-01-14
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Od klasyki do nowoczesności. Teoria kontinuum sercowo-naczyniowego a rozwój farmakoterapii
Choroby Serca i Naczyń 2021;18(4):200-218.
Streszczenie
Choroby układu krążenia są najczęstszą przyczyną zgonow w Polsce. Związek przyczynowo-skutkowy między czynnikami predysponującymi do wystąpienia chorob układu krążenia i w konsekwencji do schyłkowej niewydolności serca (kontinuum sercowo-naczyniowe) w 1991 roku zaproponowali Dzau i Braunwald, a następnie był rozwijany przez innych badaczy, między innymi Claudio Borghi. Klasyczne kontinuum sercowo-naczyniowe bierze swoj początek w czynnikach ryzyka, takich jak: hipercholesterolemia, nadciśnienie tętnicze czy cukrzyca. Nowsze kontinuum sercowo-naczyniowe zawiera kardiologiczne powikłania naturalnych procesow starzenia się organizmu, jak sztywnienie aorty. Podstawą skutecznego zapobiegania występowaniu chorob układu krążenia jest nowoczesna farmakoterapia oparta na zasadach medycyny opartej na dowodach naukowych. Wspołczesne leczenie wszystkich stanow klinicznych prowadzących do etapow schyłkowych dwoch teorii kontinuum sercowo-naczyniowego wymaga intensywnej i wieloskładnikowej terapii. Terapię taką oferują preparaty złożone (SPC), oddziałujące na kilka mechanizmow patofizjologicznych. Stosowanie SPC w terapii nadciśnienia tętniczego (np. preparatow złożonych walsartanu z diuretykiem, walsartanu z antagonistą wapnia czy walsartanu z antagonista wapnia i diuretykiem rownocześnie), korzystanie z nowych lekow w terapii niewydolności serca (walsartan/sakubitril) czy w końcu optymalizacja leczenia hipercholesterolemii (preparaty złożone rosuwastatyna/ezetimib w połączeniu z zastrzykiem inklisiranu raz na poł roku) umożliwia skuteczną prewencję sercowo-naczyniową i przerwanie złowrogiego kontinuum sercowo-naczyniowego.
Słowa kluczowe: kontinuum sercowo-naczyniowenadciśnienie tętniczehipercholesterolemianiewydolność serc
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