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Первичная артериальная гипертензия (АГ) или гипертоническая болезнь (ГБ) остается одним из наиболее распространенных сердечно-сосудистых заболеваний. Длительное и стойкое повышение артериального давления (АД) приводит к поражению органов-мишеней, способствуя развитию тяжелых сердечно-сосудистых осложнений (мозгового инсульта, инфаркта миокарда, жизненно опасных нарушений ритма и сердечной недостаточности), поражений почек (почечной недостаточности) и зрения и обуславливает высокую смертность и инвалидизацию населения трудоспособного возраста. Ежегодно в мире гипертензия является причиной смерти более 10 млн. человек. В Украине зарегистрировано более 12,6 млн. человек с этой болезнью, или более 35% населения. Но, сСреди лиц с повышенным артериальным давлением (АД) знают о наличии болезни только 52% больных, из них лечатся менее трети, причем эффективно лечится не более 15% больных.
“For the second month, we see an increase in the number of coronavirus diseases. Over the past week, 24,000 new cases were recorded, the week before that there were 16,000, that is, there is a gradual increase. Our experts, together with WHO experts, predict that this year the peak incidence will be at the beginning October... In previous years, it was the end of October - the beginning of November. We are preparing for this in order to provide proper medical care," the minister said.
A separate problem is the treatment of hypertension in patients with COVID-19. The presence of a history of hypertension in patients with COVID-19 was associated with a more severe course of infection, in contrast to patients who did not have hypertension. According to modern concepts, during the COVID-19 pandemic, patients with hypertension should carefully monitor their blood pressure levels and take constantly prescribed medications. This also applies to the use of so-called blockers of the renin-angiotensin system for the treatment of patients with hypertension: angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. A number of recent studies show that these groups of drugs not only do not increase the risk of infection with the virus, but also significantly improve the course of coronavirus disease.
The use of thiopurine (azathioprine and mercaptopurine) reduces the immune response to viruses, which is associated with an increased risk of opportunistic infections. There is limited evidence that they increase the risk of respiratory infections. The risks and benefits should be considered, but most patients can continue on a stable dose. In patients in stable remission, elderly patients and in the presence of concomitant pathology, it is recommended to stop taking thiopurine. During a pandemic, it is recommended to avoid starting thiopurine or increasing the dose, which will allow patients to avoid potential side effects. If the patient is in contact with a COVID-19 person, temporary withdrawal of thiopurine for 2 weeks should be considered. If a patient tests positive for SARS-CoV-2 and/or develops COVID-19, temporary discontinuation of thiopurine may be recommended until the patient clears the infection.
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