Arterial hypertension among young people (18–27 years ) with connective tissue dysplasia: prevalence of behavioral factors cardio vascular risk

Objective. To assess the occurrence of various vascular aging phenotypes among young people, depending on the level of blood pressure (BP) and in relation to risk factors (RF) and the presence of connective tissue dysplasia (CTD).Design and methods. In total, 250 young people (88 boys and 162 girls) aged from 18 to 25 years old were examined at the University Health Center. All the subjects were divided into tercile groups based on cardio-ankle vascular index (CAVI), determined by the VaSera-1500 (Fucuda Denshia, Japan). According to the latest expert recommendations the third tercile group corresponds to early vascular aging or EVA syndrome. The first tercile group corresponds to favorable vascular aging. We have analyzed the representation of various vascular phenotypes in individuals with elevated and normal BP, as well as the main RF and external signs of CTD in each of CAVI-tercile group. Data processing was performed using the software package “Statistica 10.0” (StatSoft Inc., USA).Results. Among young people with office hypertension and high normal BP, the EVA phenotype and phenotypes of normal and favorable vascular aging are equally distributed. In persons with office normal and elevated BP, vascular stiffness correlates with weight, body mass index and waist circumference (with the increase in arterial rigidity these indicators decrease). CTD is registered among subjects with severe vascular remodeling both in boys and girls.Conclusions. Our data indicate the feasibility of angiology screening for identification of vascular aging phenotypes as a part of preventive measures among young people, regardless of the level of initial office BP. This strategy strategy will contribute to a more differentiated identification of risk groups and more individualized preventive interventions based on vascular aging phenotypes.

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Phenotypes of early and favorable vascular aging in young people depending on the risk factors and presence of connective tissue dysplasia

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2020-2524 ◽

2020 ◽

Vol 19 (6) ◽

pp. 2524

Author(s):

M. E. Evseveva ◽

M. V. Eremin ◽

M. V. Rostovtseva ◽

O. V. Sergeeva ◽

E. N. Fursova ◽

...

Keyword(s):

Risk Factors ◽

Young People ◽

Connective Tissue ◽

Body Mass ◽

Software Package ◽

Young Person ◽

Vascular Aging ◽

Extreme Groups ◽

Tunnel Syndrome ◽

Connective Tissue Dysplasia

Aim. To study the main risk factors and signs of connective tissue dysplasia (CTD) in young people according to quartile analysis of cardioankle vascular index (CAVI).Material and methods. The study involved 243 young people (men, 81; women, 162) aged 18-25 years. All subjects were divided into quartile groups depending on CAVI on both sides, or CAVI-R and CAVI-L, determined using the VaSera-1500 system (Fucuda Denshia,Japan). According to the latest guidelines, the 4th quartile of this distribution among persons of the same sex and age corresponds to early vascular aging (EVA) syndrome. The 1st quartile corresponds to favorable vascular aging. We analyzed the main RFs and CTD signs in each of the 4 CAVI quartiles. Data processing was carried out using the Statistica 10.0 software package (StatSoft Inc,USA).Results. The minimum and maximum CAVI in the sample were 3,2 and 7,9. The overwhelming majority of studied risk factors in both sexes were not associated with the stiffness. Only body mass and body mass index increasedwith a decrease in vascular stiffness and vice versa. The average number of external stigmas of dysembryogenesis in young people increased from the 1st to the 4th CAVI quartile, with significant differences in the extreme groups. Such CTD signs as a carpal tunnel syndrome and thumb sign also significantly differed between the 1st and 4th quartiles.Conclusion. The presented results can be used for prevention among young people to form more individualized programs taking into account a comprehensive assessment of vascular aging phenotype and the level of external stigmatization of each young person.

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Exercise tolerance and physical activity in children with most common cardiovascular diseases

The Journal of V. N. Karazin Kharkiv National University, Series "Medicine" ◽

10.26565/2313-6693-2020-39-10 ◽

2020 ◽

Keyword(s):

Physical Activity ◽

Nervous System ◽

Connective Tissue ◽

Arterial Hypertension ◽

Cardiovascular System ◽

The Body ◽

Functional Capabilities ◽

Adaptive Capabilities ◽

Doppler Study ◽

Connective Tissue Dysplasia

The cardiovascular system is actively involved in the adaptive reactions of the body. The deterioration of adaptive processes decreases the functional capabilities of the heart. Arterial hypertension is often known as the main cause of fatal cardiovascular events in adults. The aim of our study was to determine the adaptive capabilities of the cardiovascular system of adolescents with non-inflammatory cardiomyopathies depending on physical activity’s level. There were examined 92 patients with arterial hypertension and connective tissue dysplasia, the mean age was 15,4 ± 1,33 years. In order to study tolerance to the minimum physical activity and its influence on the state of the cardiovascular system in children, the Ruffier test was conducted. The vegetative reactions of central nervous system were performed by the orthostatic test. The functional state of the myocardium was assessed according to the results of the ultrasonic Doppler study of the heart. As a result of the study, it was found that in connective tissue dysplasia and arterial hypertension adaptation mechanisms were affected, accompanied by a weakening of cardiac functional capabilities. This happens against the background of a decrease in the functioning of the left ventricle. These changes are accompanied by hyperactivation of the autonomic nervous system in patients in the studied groups. The physical activity and physical development of children affect the adaptive capabilities of a growing organism. This is due to the fact that the children in group with AH and CTD were less physically active than children without myocardial pathology. Adolescents who showed the reduced results of Ruffier's test and had regular sports sections need change of a mode of training and further inspection.

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DIAGNOSTIC CRITERIA FOR UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA IN PATIENTS WITH ARTERIAL HYPERTENSION

Здобутки клінічної і експериментальної медицини ◽

10.11603/1811-2471.2020.v.i2.11303 ◽

2020 ◽

pp. 49-54

Author(s):

Ye. H. Zaremba ◽

N. O. Rak ◽

O. V. Zaremba ◽

O. V. Zaremba-Fedchyshyn ◽

M. M. Virna ◽

...

Keyword(s):

Connective Tissue ◽

Arterial Hypertension ◽

Control Group ◽

Severe Dysplasia ◽

Moderate Severity ◽

Group Iii ◽

Group I ◽

Connective Tissue Dysplasia ◽

Group Ii

The aim – to improve the diagnosis efficiency of patients with arterial hypertension (AH) combined with undifferentiated connective tissue dysplasia (UCTD) based on the study of clinical course, the severity of UCTD external and internal symptoms with determining the levels of IL-1, IL-6, TNF-a, free and general blood oxyproline. Material and Methods. The study implied examination of 90 patients (52 women and 38 men) with AH of stage 2 from first to third degrees with manifestations of UCTD, who were on inpatient treatment in the Cardiology Department of the Lviv City Communal Clinical Emergency Hospital. The mean age of patients was (61.14±2.58) years. Patients were divided into 3 groups depending on the stage and degree of hypertension. Group I (n=16) included patients with hypertension of the first degree, group II (n=35) – with AH of the second degree, group III (n=39) – with AH of the third degree. The control group consisted of 20 patients with hypertension without manifestations of CTD. Patients underwent clinical (checkup, palpation, percussion, auscultation), laboratory (determination of IL-1, IL-6, TNF-a, free and general oxyprolin blood levels) and instrumental studies (ECG, echocardiography, DBPM, ultrasound examination of internal organs and vessels of the lower extremities, ultrasound duplex examination of the carotid and vertebral arteries, radiological examination of the osteoarticular system), consultations of an ophthalmologist, neurologist, traumatologist and dentist. Results. As a result of the study, in the group I of patients (n=16) UCTD of slight degree of severity was revealed in 13 (81 %), of medium degree – in 3 (19 %) persons. In the group II of patients (n=35), UCTD of moderate severity was found in 30 (86 %), severe – in 5 patients (14 %). In the group III of patients (n=39), UCTD of moderate severity was found in 32 patients (82 %), severe – in 7 (18 %). In the study of the level of TNF-a, an increase compared to the control group was detected, particularly, in the group I of patients its level exceeded in 37.4 times, in the group II – in 39.6 times, in the group III – in 46.2 times (p<0.001). IL-1b increased by 2.6-fold (р<0.05) in the group I of patients compared to the control group, 3.1-fold (р<0.01) – in the group II, and by 3.7-fold, that was the foremost (р<0.001), in patients of the group III. In turn, IL-6 in the group I of patients exceeded the indicators of the control group by 4.3 times (p<0.001), in the group II – 4.8 times (p<0.001), in the group III – 5.7 times (р<0.001). The study of the level of free oxyproline revealed its increase in comparison with the control group, namely in the group I of patients exceeded in 6.12 times, in the group II – in 6.81 times, in the group III – by 7.56 times (р<0.01). The study of the general of bound oxyproline revealed its increase in comparison with the control group, namely in the group I of patients exceeded by 6.98 times, in the group II – by 7.79 times, in the group III – by 9.42 times (p<0.01), which indicates an increase in fibrillogenesis and more pronounced destructive and inflammatory processes in connective tissue. Conclusions. Patients with AH of the stage 2 from first to third degrees with manifestations of UCTD have increased levels of IL-1, IL-6 and TNF-a, which are not only sensitive markers of inflammation, but also play an important role in the pathogenesis and progression of vascular lesions, occurrence and destabilization of atherosclerotic plaques and thrombotic vessels occlusion. The determination of blood oxyprolin in patients with hypertension combined with UCTD confirms the presence of CTD, namely the decay of collagen is more pronounced in patients with severe dysplasia.

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UNIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA AS A POTENTIAL PREDICTOR OF ARTERIAL HYPERTENSION DEVELOPMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

The Journal of V. N. Karazin Kharkiv National University, Series "Medicine" ◽

10.26565/2313-6693-2018-36-04 ◽

2018 ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Connective Tissue ◽

Arterial Hypertension ◽

Regression Model ◽

Clinical Signs ◽

Duration Of Diabetes ◽

Connective Tissue Dysplasia ◽

Dm Type 2

The article presents the results of studies of markers of connective tissue dysplasia and the content of the main fibroblast growth factor in blood plasma in patients with type 2 diabetes. The presence of significant correlations between the studied parameters with the occurrence and progression of hypertension in patients with type 2 diabetes is established. A regression model for predicting the development of arterial hypertension is proposed in patients with diabetes mellitus. The development of hypertension in patients with DM type 2 in combination with UCTD occurs earlier, is almost independent of the duration of diabetes, more pronounced hypertension is observed in patients with visceral and skeletal symptoms of UCTD. This is evidence of the role of UCTD in the pathogenesis of hypertension in patients with type 2 diabetes. Essential role in the emergence and progression of hypertension in patients with DM type 2 is played by metabolic disorders of the connective tissue that manifests as clinical signs of UCTD. FGF2, which content is increased in patients with visceral and/or skeletal symptoms of UCTD, is involved in its pathogenesis. The regression model of the prediction of hypertension in patients with DM type 2 with an assessment of the presence of UCTD signs and the duration of diabetes has a high prognosticity, specificity and sensitivity, which makes it possible to apply this method in clinical practice to determine patients with high risk of development of hypertension.

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4036The knowledge as the determinant of the adherence to antihypertensive treatment

European Heart Journal ◽

10.1093/eurheartj/ehz745.0091 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

N Swiatoniowska ◽

E Bartosiak ◽

A Szymanska-Chabowska ◽

G Mazur ◽

B Jankowska-Polanska

Keyword(s):

Risk Factors ◽

Arterial Hypertension ◽

Antihypertensive Treatment ◽

Vascular Diseases ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Adherence To Treatment ◽

Pressure Therapy ◽

Therapeutic Recommendations ◽

Cardio Vascular

Abstract Introduction The education of the patients with cardio-vascular diseases aims to modify the present risk factors and to increase the aware participation in the therapy. Arterial hypertension is one of the most common modifiable risk factors of cardio-vascular diseases. However, the knowledge of the self-care and adherence to therapeutic recommendations are highly disappointing. Understanding people's levels of knowledge on cardiovascular risk factors and its relation to level of adherence in antihypertensive treatment might contribute effectively to medical staff efforts to prevent, treat and control the disease. The aim of the study was analysis of the knowledge of the cardio-vascular risk factors and the adherence to therapeutic recommendations. Material and methods 101 patients (mean age 57.5±13.2) with arterial hypertension (stage I and II according to ESC) were enrolled into the study. The following questionnaires were used: Morisky's Self-Reported Measure of Medication Adherence (MMAS-8-Item), Hill-Bone Compliance to High Blood Pressure Therapy Scale (Hill-Bone Scale) and The Cardiovascular Disease Risk Factors Knowledge Level Scale (CARRF). Results 41% of the patients had worse knowledge of the cardio-vascular risk factors. In comparative analysis there were the significant differences in adherence to treatment with regards to the knowledge according to CRRRF questionnaire. The patients with better knowledge had the best adherence, which diminished along with worsening the knowledge (19.0±3.5 vs 18.3±3.7 vs 16.6±4.1). The increase of the knowledge by one point in scale CARRF-KL was accompanied by the increase of the adherence by 0.14 point (mean). The relations between knowledge and adherence was observed in terms of the treatment (8.3±2.0 vs 10.1±5.0 vs 8.9±3.5; p=0.003) and the global results of Hill-Bone questionnaire (19.5±4.4 vs 22.7±7.3). The relation between the knowledge and the adherence in terms of salt intake or control check-ups was not proved. In multiple regression analysis the knowledge was significant independent determinant, which influenced the adherence in terms of the treatment MMAS (b= 0.253; p=0.0004) Conclusions Adherence to therapeutic recommendations is related to the knowledge of the cardio-vascular risk factors, i.e. the better knowledge, the better adherence. The knowledge is the independent predictor of adherence to treatment in patients with arterial hypertension. The identification of knowledge deficits as a factor contributing to lack of adherence and poor hypertension control remains a key challenge for clinicians caring for patients with hypertension.

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RESTORATION OF THE KNEE JOINT OF A YOUNG PERSON BY MEANS OF PHYSICAL THERAPY ON THE WAY TO A HEALTHY LIFESTYLE

10.37386/2687-0576-2021-3-286-289 ◽

2021 ◽

pp. 286-289

Author(s):

A. A. Pantyushina ◽

◽

E. V. Ushakova ◽

E. A. Zyuzina ◽

◽

...

Keyword(s):

Young People ◽

Connective Tissue ◽

Knee Joint ◽

Healthy Lifestyle ◽

Young Person ◽

Wear And Tear ◽

Scientific Technical ◽

Connective Tissue Dysplasia ◽

Post Traumatic ◽

System Today

Quite recently, speaking about diseases of the knee joint, the discussion, as a rule, was about older people, more often, over 60 years old. Problems such as arthritis, arthrosis, acute arthrosis and other diseases arising from wear and tear of the joint during life came to mind. Nowadays, everything has changed since adolescence. Young people at the beginning of the XXI century, in connection with the development of scientific, technical and computer progress, increases physical inactivity, which leads to various diseases of the musculoskeletal system. Today, a very large number of young people suffer from knee diseases, the genesis of which is mainly post-traumatic or mediated by the growth of pathologies of the knee joint tissues. Injuries can occur due to accidents, but some of them can be triggered by the presence in patients of such chronic processes as connective tissue dysplasia. This disease significantly increases the risks of weakening the ligamentous apparatus of the joint. As a result, the likelihood of injury increases. The article presents the author’s complex of physiotherapy exercises for the restoration of the knee joint (A. A. Pantyushina) after injuries and related operations.

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