Российские критерии приемлемости назначения менопаузальной гормональной терапии пациенткам с сердечно-сосудистыми и метаболическими заболеваниями
https://doi.org/10.18087/cardio.2025.11.n3056
Аннотация
Климактерические симптомы могут нарушать ход жизни женщин на пике карьеры и семейной жизни. В настоящее время самым эффективным методом лечения этих проявлений является менопаузальная гормональная терапия (МГТ). Наличие сердечно-сосудистых и метаболических заболеваний не исключает возможность назначения МГТ с целью купирования климактерических симптомов и улучшения качества жизни. Однако нередко препятствием для использования этого вида гормональной терапии являются опасения врачей, которые боятся принести пациенткам больше вреда, чем пользы. Осторожность особенно важна, когда речь идет о женщинах, страдающих сопутствующими заболеваниями. Более того, следует признать, что качественных исследований относительно безопасности МГТ при основных хронических неинфекционных заболеваниях и часто встречаемых коморбидных состояниях недостаточно. В представленном согласительном документе проведен анализ всех доступных в настоящее время данных, полученных в ходе клинических исследований различного дизайна, и создан свод критериев приемлемости назначения МГТ женщинам с сопутствующими сердечно-сосудистыми и метаболическими заболеваниями. Опираясь на представленный документ, врачи различных специальностей, консультирующие женщин в климактерии, получат доступный алгоритм, позволяющий избегать потенциально опасных ситуаций и обоснованно назначать МГТ в клинической практике.
Ключевые слова
Об авторах
Е. В. ШляхтоАкадемик РАН, доктор медицинских наук, профессор, директор
И. И. Дедов
Президент Центра, Академик, доктор медицинских наук, профессор
В. Н. Серов
д.м.н., профессор, президент РОАГ, главный научный сотрудник отдела научно-образовательных программ
Г. Т. Сухих
д.м.н., профессор, первый вице-президент РОАГ, директор
Г. П. Арутюнов
Доктор медицинских наук, профессор, член-корреспондент РАН, директор Института клинической медицины, заведующий кафедрой пропедевтики внутренних болезней №1 Института клинической медицины ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России
И. А. Сучков
д.м.н., профессор, кафедра сердечно-сосудистой, рентгенэндоваскулярной хирургии и лучевой диагностики Рязанского государственного медицинского университета им. акад. И.П.Павлова
О. М. Драпкина
д.м.н., профессор, академик РАН, , директор ФГБУ «НМИЦ ТПМ» Минздрава России
О. Н. Ткачева
Россия
член-корреспондент РАН, д-р мед. наук, профессор, директор Российского геронтологического научно-клинического центра, ФГАОУ ВО РНИМУ им. Н.И. Пирогова (Пироговский университет) Минздрава России
Я. А. Орлова
Россия
д.м.н., профессор, заведующий отделом возраст-ассоциированных заболеваний Университетской клиники Медицинского научно-образовательного института (МНОИ) ФГБОУ ВО «МГУ имени М.В. Ломоносова», Москва, Российская Федерация
И. И. Баранов
д.м.н., профессор, заведующий организационно-методическим отделом службы научно-организационного обеспечения
Е. Н. Андреева
Россия
д.м.н., профессор, заместитель директора-директор Института репродуктивной медицины, заведующая отделением эндокринной гинекологии ГНЦ РФ ФГБУ «НМИЦ эндокринологии им. академика И.И. Дедова» Минздрава России. Профессор кафедры акушерства, гинекологии и репродуктивной медицины ФГБОУ ВО «Российский Университет Медицины» Минздрава России
С. В. Юренева
Россия
д.м.н., профессор, зам. директора по научной работе Института онкогинекологии и маммологии, профессор кафедры акушерства и гинекологии Института профессионального образования, заведующая Научно-консультативного диагностического отделения амбулаторной онкологической помощи ФГБУ «НМИЦАГ иП
М. И. Ярмолинская
Россия
профессор РАН, д.м.н., профессор, заведующий отделом гинекологии и эндокринологии, руководитель центра «Диагностики и лечения эндометриоза» ФГБНУ «НИИ АГиР им. Д.О. Отта»; профессор кафедры акушерства и гинекологии, ФГБОУ ВО «Северо-Западный государственный медицинский университет
А. А. Сметник
к. м. н., заведующая отделением гинекологической эндокринологии
С. В. Виллевальде
Россия
д.м.н., профессор, начальник службы анализа и перспективного планирования Управления по реализации федеральных проектов, заведующая кафедрой кардиологии факультета послевузовского и дополнительного образования Института медицинского образования
Н. А. Козиолова
д.м.н., профессор, заведующая кафедрой внутренних болезней и кардиологии ФГБОУ ВО «ПГМУ имени академика Е.А. Вагнера» Минздрава России
И. В. Сергиенко
Россия
д.м.н., профессор, г.н.с. лаборатории фенотипов атеросклероза ФГБУ НМИЦ КАРДИОЛОГИИ ИМ АК ЕИ ЧАЗОВА МИНЗДРАВА РОССИИ. Москва, Российская Федерация
И. С. Явелов
д.м.н., руководитель отдела фундаментальных и клинических проблем тромбоза при неинфекционных заболеваниях ФГБУ «НМИЦ терапии и профилактической медицины», Москва, Российская Федерация
О. Б. Иртюга
Россия
д.м.н., доцент, профессор кафедры кардиологии факультета послевузовского и дополнительного образования ИМО ФГБУ «НМИЦ им. В. А. Алмазова» МЗ РФ
О. Р. Григорян
Россия
Профессор, доктор медицинских наук, доцент, главный научный сотрудник ГНЦ РФ ФГБУ «НМИЦ эндокринологии им. академика И.И. Дедова» Минздрава России
Е. Н. Дудинская
Россия
д.м.н., доцент, заведующий лабораторией возрастных метаболических и эндокринных нарушений ОСП Российский геронтологический научно-клинический центр ФГАОУ ВО РНИМУ им. Н. И. Пирогова (Пироговский университет) Минздрава России
И. А. Золотухин
Россия
профессор РАН, профессор, д.м.н., кафедра факультетской хирургии Института хирургии ФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н.И. Пирогова (Пироговский Университет)
Е. А. Илюхин
к.м.н., руководитель направления «Флебология» сети клиник «Реаклиник»
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Шляхто Е.В., Дедов И.И., Серов В.Н., Сухих Г.Т., Арутюнов Г.П., Сучков И.А., Драпкина О.М., Ткачева О.Н., Орлова Я.А., Баранов И.И., Андреева Е.Н., Юренева С.В., Ярмолинская М.И., Сметник А.А., Виллевальде С.В., Козиолова Н.А., Сергиенко И.В., Явелов И.С., Иртюга О.Б., Григорян О.Р., Дудинская Е.Н., Золотухин И.А., Илюхин Е.А. Российские критерии приемлемости назначения менопаузальной гормональной терапии пациенткам с сердечно-сосудистыми и метаболическими заболеваниями. Кардиология. 2025;65(11):24-47. https://doi.org/10.18087/cardio.2025.11.n3056
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Shlyakhto E.V., Dedov I.I., Serov V.N., Sukhikh G.T., Arutyunov G.P., Suchkov I.A., Drapkina O.M., Tkacheva O.N., Orlova I.A., Baranov I.I., Andreeva E.N., Yureneva S.V., Yarmolinskaya M.I., Smetnik A.A., Villevalde S.V., Koziolova N.A., Sergienko I.V., Yavelov I.S., Irtyuga O.B., Grigoryan O.R., Dudinskaya E.N., Zolotukhin I.A., Ilyukhin E.A. Russian Eligibility Criteria for Prescribing Menopausal Hormone Therapy to Patients With Cardiovascular and Metabolic Diseases. Consensus Document of RSC, RSOG, RAE, EUAT, RAP, RSMSI, RAGG. Kardiologiia. 2025;65(11):24-47. (In Russ.) https://doi.org/10.18087/cardio.2025.11.n3056










