verezdoВестник репродуктивного здоровьяBulletin of Reproductive Health2075-65692310-421XEndocrinology Research Centre (Moscow)10.14341/brh12709verezdo-12709Research ArticleНАУЧНЫЙ ОБЗОРREVIEWРоссийские критерии приемлемости назначения менопаузальной гормональной терапии пациенткам с сердечно-сосудистыми и метаболическими заболеваниями. Согласительный документ РКО, РОАГ, РАЭ, ЕАТ, РАФRussian eligibility criteria prescribing menopausal hormonal hormones therapy for patients with cardiovascular and metabolic diseases. Consensus document of the Russian Cardiological Society, Russian Society of Obstetricians and Gynecologists, Russian Association of Endocrinologists, Eurasian Association of Therapists, Association of Phlebologists of Russiahttps://orcid.org/0000-0003-2929-0980ШляхтоЕ. В.ShlyakhtoE. V.

Шляхто Евгений Владимирович, д.м.н., профессор

Санкт-Петербург

Evgeny V. Shlyakhto, MD, PhD, Professor

St. Petersburg

info@scardio.ruhttps://orcid.org/0000-0002-7712-1260СухихГ. Т.SukhikhG. T.

Сухих Геннадий Тихонович, д.м.н., профессор 

Москва

Gennady T. Sukhikh, MD, PhD, Professor

Moscow

secretariat@oparina4.ruhttps://orcid.org/0000-0003-2976-7128СеровВ. Н.SerovV. N.

Серов Владимир Николаевич, д.м.н., профессор

Москва

Vladimir N. Serov, MD, PhD, Professor

Moscow

v_serov@oparina4.ruhttps://orcid.org/0000-0002-8175-7886ДедовИ. И.DedovI. I.

Дедов Иван Иванович, д.м.н., профессор

Москва

Ivan I. Dedov, MD, PhD, Professor

Moscow

info@rae-org.ruhttps://orcid.org/0000-0002-6645-2515АрутюновГ. П.ArutyunovG. P.

Арутюнов Григорий Павлович, д.м.н., профессор 

Москва

Grigory P. Arutyunov, MD, PhD, Professor

Moscow

arut@ossn.ruhttps://orcid.org/0000-0002-1292-5452СучковИ. А.SuchkovI. A.

Сучков Игорь Александрович, д.м.н., профессор

Рязань

Igor A. Suchkov, MD, PhD, Professor

Ryazan

suchkov_med@mail.ruhttps://orcid.org/0000-0002-8160-5612ОрловаЯ. А.OrlovaY. A.

Орлова Яна Артуровна, д.м.н. 

Москва

Yana A. Orlova, MD, PhD

Moscow

5163002@bk.ruhttps://orcid.org/0000-0001-8425-0020АндрееваЕ. Н.AndreevaE. N.

Андреева Елена Николаевна, д.м.н., профессор

Москва

Elena N. Andreeva, MD, PhD, Professor

Moscow

endogin@mail.ruhttps://orcid.org/0000-0003-2864-066XЮреневаС. В.YurenevaS. V.

Юренева Светлана Владимировна, д.м.н., профессор

Москва

Svetlana V. Yureneva, MD, PhD, Professor

Moscow

syureneva@gmail.comhttps://orcid.org/0000-0003-2816-1183ЯвеловИ. С.YavelovI. S.

Явелов Игорь Семенович, д.м.н., профессор

Москва

Igor S. Yavelov, MD, PhD, Professor

Moscow

yavelov@yahoo.comhttps://orcid.org/0000-0002-6551-4147ЯрмолинскаяМ. И.YarmolinskayaM. I.

Ярмолинская Мария Игоревна, д.м.н., профессор

Санкт-Петербург

Maria I. Yarmolinskaya, MD, PhD, Professor

St. Petersburg

m.yarmolinskaya@gmail.comhttps://orcid.org/0000-0001-7652-2962ВиллевалдеС. В.VillevaldeS. V.

Виллевальде Светлана Вадимовна, д.м.н. 

Санкт-Петербург

Svetlana V. Villevalde, MD, PhD, Professor

St. Petersburg

villevaldes@mail.ruhttps://orcid.org/0000-0003-4979-7420ГригорянО. Р.GrigoryanO. R.

Григорян Ольга Рафаэльевна, д.м.н., профессор

Москва

Оlga R. Grigoryan, MD, PhD, Professor

Moscow

iceberg1995@mail.ruhttps://orcid.org/0000-0001-7891-6850ДудинскаяЕ. Н.DudinskayaE. N.

Дудинская Екатерина Наильевна, д.м.н.

Москва

Ekaterina N. Dudinskaya, MD, PhD

Moscow

katharina.gin@gmail.comhttps://orcid.org/0000-0002-8288-8239ИлюхинЕ. А.IlyukhinE. A.

Илюхин Евгений Аркадьевич, к.м.н.

Санкт-Петербург

Evgeniy A. Ilyukhin, MD, PhD

St. Petersburg

iluhin-e@yandex.ruhttps://orcid.org/0000-0001-7003-5186КозиоловаН. А.KoziolovaN. A.

Козиолова Наталья Андреевна, д.м.н., профессор

Пермь

Natalya A. Koziolova, MD, PhD, Professor

Perm

nakoziolova@mail.ruhttps://orcid.org/0000-0003-1534-3965СергиенкоИ. В.SergienkoI. V.

Сергиенко Игорь Владимирович, д.м.н., профессор

Москва

Igor V. Sergienko MD, PhD, Professor

Moscow

igorcardio@mail.ruhttps://orcid.org/0000-0002-0627-3902СметникА. А.SmetnikA. A.

Сметник Антонина Александровна, к.м.н.

Москва

Antonina A. Smetnik, MD, PhD

Moscow

asmetnik@gmail.comhttps://orcid.org/0000-0001-5309-0087ТапильскаяН. И.TapilskayaN. I.

Тапильская Наталья Игоревна, д.м.н., профессор

Санкт-Петербург

Natalya I. Tapilskaya, MD, PhD, Professor

St. Petersburg

tapnatalia@yandex.ruНациональный медицинский исследовательский центр им. В.А. АлмазоваРоссияNational Medical Research Center named after V.A. AlmazovRussian FederationНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. КулаковаРоссияNational Medical Research Center for obstetrics, gynecology and perinatology named after academician V.I. KulakovRussian FederationНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CenterRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияRussian National Research Medical University named after N.I. PirogovRussian FederationРязанский государственный медицинский университет им. акад. И.П. ПавловаРоссияRyazan State Medical University I.P. PavlovaRussian FederationМедицинский научно-образовательный центр МГУ им. М.В. ЛомоносоваРоссияMedical Research and Educational Center of Moscow State University named after M.V. LomonosovRussian FederationНациональный медицинский исследовательский центр терапии и профилактической медициныРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian FederationНаучно-исследовательский институт акушерства и гинекологии и репродуктологии им. Д.О. ОттаРоссияResearch Institute of Obstetrics, Gynecology and Reproductology named after D.O. OttaRussian FederationРоссийский геронтологический научно-клинический центр Российского национального исследовательского медицинского университета им. Н.И. ПироговаРоссияRussian Gerontological Research and Clinical Center of the Russian National Research Medical University named after N.I. PirogovRussian FederationООО «Медальп»РоссияMedalp LLCRussian FederationПермский государственный медицинский университет им. акад. Е.А. ВагнераРоссияPerm State Medical University named after. acad. E.A. WagnerRussian FederationНациональный медицинский исследовательский центр кардиологии им. акад. Е.И. ЧазоваРоссияNational Medical Research Center of Cardiology E.I. ChazovRussian Federation202418062024321132Copyright © Шляхто Е.В., Сухих Г.Т., Серов В.Н., Дедов И.И., Арутюнов Г.П., Сучков И.А., Орлова Я.А., Андреева Е.Н., Юренева С.В., Явелов И.С., Ярмолинская М.И., Виллевалде С.В., Григорян О.Р., Дудинская Е.Н., Илюхин Е.А., Козиолова Н.А., Сергиенко И.В., Сметник А.А., Тапильская Н.И., 20242024Шляхто Е.В., Сухих Г.Т., Серов В.Н., Дедов И.И., Арутюнов Г.П., Сучков И.А., Орлова Я.А., Андреева Е.Н., Юренева С.В., Явелов И.С., Ярмолинская М.И., Виллевалде С.В., Григорян О.Р., Дудинская Е.Н., Илюхин Е.А., Козиолова Н.А., Сергиенко И.В., Сметник А.А., Тапильская Н.И.Shlyakhto E.V., Sukhikh G.T., Serov V.N., Dedov I.I., Arutyunov G.P., Suchkov I.A., Orlova Y.A., Andreeva E.N., Yureneva S.V., Yavelov I.S., Yarmolinskaya M.I., Villevalde S.V., Grigoryan O.R., Dudinskaya E.N., Ilyukhin E.A., Koziolova N.A., Sergienko I.V., Smetnik A.A., Tapilskaya N.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vrz-endojournals.ru/jour/article/view/12709

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 само по себе 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, боящихся 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 реальной практике.

Menopausal symptoms can disrupt the life course of women at the peak of their career and family life. Currently, the most effective treatment for these manifestations is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases in itself does not exclude the possibility of prescribing MHT to relieve menopausal symptoms and improve quality of life. However, often an obstacle to the use of this type of hormonal therapy is the fear of doctors who are afraid of doing more harm to patients than good. Caution is especially important when it comes to women with underlying health conditions. Moreover, it should be recognized that there is a lack of high-quality research regarding the safety of MHT for major chronic non-infectious diseases and common comorbid conditions. The presented consensus document analyzed all currently available data obtained from clinical trials of various designs and created a set of criteria for the acceptability of prescribing MHT to women with concomitant cardiovascular and metabolic diseases. Based on the presented document, doctors of various specialties who advise women in menopause will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and reasonably prescribe MHT in real practice.

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