scholarly journals PECULIAR FEATURES OF STRUCTURAL AND FUNCTIONAL INDICES OF CARDIOVASCULAR SYSTEM IN YOUNG MEN WITH ARTERIAL HYPERTENSION ASSOCIATED WITH METABOLIC SYNDROME

2017 ◽  
Vol 34 (6) ◽  
pp. 17-21
Author(s):  
R T Rizvanova ◽  
N I Maksimov

Aim. To carry out dynamic assessment of the structural and functional indices of cardiovascular system in young men with arterial hypertension (AH) associated with excess body mass (Ebm) against the background of therapy. Materials and methods. Examination of 86 young men aged 18-27 years, including the group of comparison with practically healthy persons ( n = 24) and the group of observation ( n = 62) was performed. The group of observation joined patients with AH without EBM and AH+EBM. The study was conducted initially and 6 months later. Patients with AH+EBM ( n = 25) were divided into 2 subgroups: group 1 (12 persons) without therapy and group 2 (13 persons) against the background of antihypertensive therapy. Results. Six months later, in group 1 there was observed a growth of “office” systolic arterial pressure (SAP) by 3,8 % (145,0 ± 2,88 and 150,54 ± 2,99 Hg mm), p = 0,001, but in the group with antihypertensive therapy, SAP decreased by 12,7 % (145,75 ± 2,80 and 129,33 ± 1,5 Hg mm), p = 0,01 and DAP - by 12,1 % (86,5 ± 1,95 and 77,16 ± 2,41 Hg mm), p = 0,02. Pulse wave propagation velocity (PWPV) along the vessels of muscular and elastic types among patients without therapy was found to grow in dynamics by 12,2 and 16,2 %, respectively. Against the background of therapy, there was a tendency to a reliable reduction in PWPV indices. Conclusions. Antihypertensive therapy in patients with AH+EBM, while decreasing AP, leads to reduction of LVMM, LVMMI, PWPV and IMCV. The early diagnosed lesion of target organs among young men with AH+EBM and timely antihypertensive therapy can improve structural and functional characteristics of cardiovascular complications.

2013 ◽  
Vol 94 (3) ◽  
pp. 289-293
Author(s):  
N V Soldatenko ◽  
L N Yeliseyeva ◽  
O I Zhdamarova

Aim. To assess the left ventricular wall myocardium structural and functional indices change over time in patients receiving hypotensive treatment for arterial hypertension associated with subclinical hypothyroidism. Methods. Sixty eight patients with arterial hypertension and subclinical hyperthyroidism were distributed to two groups. Patients of the group 1 (37 patients) received amlodipine (5-10 mg/day) and indapamide (1.5 mg/day), patients of the group 2 (31 patients) received lisinopril (5-10 mg/day) and indapamide (1.5 mg/day). Carotid artery ultrasonography and echocardiography were performed using «Philips» HD-11 XE (USA) scanner on the baseline and after 18 months of treatment. Results. Initial parameters of the left ventricular wall myocardium in all patients were comparable. Significant increase in early diastolic left ventricular filling velocity by 5.2%, decrease of late diastolic filling velocity by 11.4%, increase of peak velocities ratio on the mitral valve by 19.7% were revealed in patients of group 1 after 18 months of treatment compared to baseline. Increase in early diastolic left ventricular filling velocity by 7.0%, increase of peak velocities ratio on the mitral valve by 13.9% were registered in patients of group 2. No signs of concentric left ventricle remodeling were revealed. The share of patients with eccentric hypertrophy was not altered (18.9 and 12.9%, respectively). Conclusion. Treatment with amlodipine + indapamine and lisinopril + indapamine during 18 months improves left ventricle diastolic function.


2011 ◽  
Vol 17 (5) ◽  
pp. 460-466 ◽  
Author(s):  
B. L. Multanovsky ◽  
S. A. Lenig

Objective. To compare parameters of 24-hour blood pressure (BP) monitoring in young men with normal, high normal BP and arterial hypertension 1 degree. Design and methods. 102 men (group 1 — 32 subjects with optimal and normal BP, group 2 — 34 subjects with high normal BP, group 3 — 36 men with 1 degree hypertension) underwent 24-hour BP monitoring, and parameters of BP loading and BP changes during the day night were assessed. Results. To a considerable extent subjects with high normal BP demonstrated hypertension at 24-hour BP monitoring, and are characterized by higher «loading pressure» and higher morning BP elevation compared to those with normal and optimal BP; in the group with higher BP the number of patients with normal night profile of BP decreases. Conclusions. Our data confirm that 24-hour BP monitoring should be performed in all patients with high normal BP, and the latest should be considered a group of a higher cardiovascular risk. The disorders of daily BP profile become more profound as arterial hypertension develops.


2018 ◽  
Vol 22 (5) ◽  
pp. 51-57 ◽  
Author(s):  
M. E. Statsenko ◽  
M. V. Derevyanchenko

THE AIM:to evaluate the role of laboratory obesity markers in the progression of chronic kidney disease (CKD) and the development of cardiovascular complications in patients with arterial hypertension (AH) and obesity.PATIENTS AND METHODS. 120 patients with AH stage II-III aged  from 45 to 70 years with unachieved target blood pressure values  (BP) were divided into four comparable in sex, age, frequency of  smoking occurrence, hypertension duration, the level of office  systolic AD (SBP) and diastolic blood pressure (DBP) groups  depending on the body mass index (BMI). We performed physical  examination, evaluated the renal function, laboratory markers of  obesity, analyzed the combined risk of CKD progression and the  development of cardiovascular complications.RESULTS.There was a significant increase in the level of proteinuria (PU) and albuminuria (AU) among the patients in groups 3 and 4  compared with group 1 (301.3 [138.1, 691.0] and 305.7 [139.4,  646.9] vs 101.3 [47.9, 116.9] mg/g; 91.0 [65.9, 273.5] and 119.2  [91.0, 291.2 vs 42.2 [41.3; 51.1] mg/g, respectively), as well as a  statistically significant decrease in the glomerular filtration rate  (GFR) in patients of groups 3 and 4 compared with patients in group 1 (63,53,73 and 61,22,71 vs 72 [ 64; 98] mL / min / 1.73 m2).  Serum leptin concentration increased from group 1 to group 4 (significant differences were found between groups 2,3,4 in  comparison with group 1 and between group 4 in comparison with group 2), while the concentration of adiponectin decreased from  group 1 to group 4 (the differences were significant between groups  2,3,4 in comparison with group 1). A statistically significant inverse  correlation between GFR and leptin concentration (r = -0.42), a direct correlation between the concentration of adiponectin and GFR (r = 0.36), the inverse relationship between the concentration of adiponectin and PU (r = -0.33), AU (r = -0.24) were found.CONCLUSION.The study showed a statistically significant  progressive deterioration in the renal function, as well as an increase in the combined risk of progression of CKD and the development of  cardiovascular complications in AH patients with an increase in  obesity with comparable values of office SAP and office DAP among  the studied groups. The revealed reliable correlation interrelations  between the parameters of renal function and obesity markers  testify to the important pathogenetic role of leptin and adiponectin in the development and progression of CKD in patients with AH and obesity.


2019 ◽  
Vol 6 (3) ◽  
pp. 132-136
Author(s):  
O. Bilovol ◽  
V. Nemtsova ◽  
I. Ilchenko ◽  
V. Zlatkina

Abstract. INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES Bilovol O.M., Nemtsova V.D., Ilchenko I.A., Zlatkina V.V. Purpose: to investigate the effect of hormonal changes on endothelial dysfunction (ED) in patients with a comorbid course of hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SHT). Methods: 183 patients with  H stage II were divided into 3 groups: Group 1 (n=50) - with isolated H (comparison group); Group 2 (n=63) - with a combined course of H and T2DM; Group 3 (n=70) - with comorbidity of H, T2DM and SHT. Blood pressure levels, carbohydrate, lipid and thyroid metabolism, plasma insulin concentration, insulin resistance (IR) the HOMA-IR index, vascular endothelial growth factor (VEGF-A) plasma levels were investigated. Results: Dyslipidemia was more pronounced in group 2 than in group 1. The addition of SHT was accompanied by a tendency to increase all the atherogenic lipids. IR was observed in all patients groups and was significantly higher than in control group (p<0.05). Significant increase of VEGF-A levels in all patients groups in comparison with the control (p<0.05) was found. In group 2 VEGF-A was lower than in group 1, which is probably due to the protective effect of metformin. Analysis  of the influence of thyroid dysfunction degree on ED revealed significant increase of VEGF-A levels in TSH>6.0 μMU/ml subgroup (352.55±17.64 pg/ml vs 461.74±20.13 pg/ml (p<0.05)). Conclusion: Hormonal disorders contribute to aggravation of endothelial dysfunction in patients with hypertension and comorbid endocrinopathies - type 2 diabetes mellitus and subclinical hypothyroidism. Even minor decrease in thyroid function lead to the progression of endothelial dysfunction. Key words: hypertension, type 2 diabetes mellitus, subclinical hypothyroidism, endothelial dysfunction   Резюме. ВПЛИВ ГОРМОНАЛЬНИХ ПОРУШЕНЬ НА ЕНДОТЕЛІАЛЬНУ ДИСФУНКЦІЮ УПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ ТА КОМОРБІДНИМИ ЕНДОКРИНОПАТІЯМИ Біловол О.М., Немцова В.Д., Ільченко І.А., Златкіна В.В. Мета: дослідити вплив гормональних змін на ендотеліальну дисфункцію (ЕД) у пацієнтів з коморбідним перебігом артеріальної гіпертензії (АГ), цукрового діабету 2 типу (ЦД2Т) тасубклінічного гіпотиреозу (СГТ). Матеріали та методи: 183 пацієнта з АГ II стадії були розділені на 3 групи: 1-а група (n=50) - з ізольованою АГ (група порівняння); Група 2 (n=63) - з поєднаним перебігом АГ та ЦД2Т; Група 3 (n 70) – з комбінованим перебігом АГ, ЦД2Т і СГТ. Вивчали рівні артеріального тиску, показники вуглеводного, ліпідного і тиреоїдного обміну, концентрацію інсуліну в плазмі, індекс інсулінорезистентності (ІР) - HOMA-IR, рівні васкулоендотеліального фактора росту (VEGF-A) в плазмі. Результати. Ступінь дисліпідемії у 2-й групі була більш вираженою, ніж в 1-й. Приєднання СГТ супроводжувалося тенденцією до збільшення всіх атерогенних фракцій ліпідів. ІР спостерігалася у всіх групах пацієнтів і була достовірно більше, ніж у контрольній групі (р<0,05). Виявлено достовірне підвищення рівнів VEGF-A у всіх групах пацієнтів в порівнянні з контролем (р<0,05). В 2-й групі рівні VEGF-A були нижче, ніж в 1-й групі, що, ймовірно, пов'язано з протективним ефектом метформіну. Аналіз впливу ступеня гіпофункції щитовидної залози на ЕД виявив значне збільшення рівнів VEGF-A в підгрупі TSH> 6,0 мкМ / мл (352,55 ± 17,64 пг / мл і 461,74 ± 20,13 пг / мл відповідно, р <0,05). Висновки. Гормональні порушення сприяють погіршенню ендотеліальної дисфункції у пацієнтів з артеріальною гіпертензією та супутніми ендокринопатіями - цукровим діабетом 2 типу та субклінічним гіпотиреозом. Навіть незначне зниження функції щитовидної залози призводить до прогресування ендотеліальної дисфункції. Ключові слова:  гіпертензія, цукровий діабет 2 тип, субклінічний гіпотиреоз, ендотеліальна дисфункція    Резюме. ВЛИЯНИЕ ГОРМОНАЛЬНЫХ НАРУШЕНИЙ НА ЭНДОТЕЛИАЛЬНУЮ ДИСФУНКЦИЮ У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И КОМОРБИДНЫМИ ЭНДОКРИНОПАТИЯМИ Беловол О.М., Немцова В.Д., Ильченко И.А., Златкина В.В. Цель: исследовать влияние гормональных изменений на эндотелиальную дисфункцию (ЭД) у пациентов с коморбидным течением артериальной гипертензии (АГ), сахарного диабета 2 типа (СД2Т) и субклинического гипотиреоза (СГТ). Материалы и методы: 183 пациента с АГ IIстадии были разделены на 3 группы: 1-я группа (n = 50) - с изолированной АГ (группа сравнения); Группа 2 (n = 63) - с сочетанным течением АГ и СД2Т; Группа 3 (n = 70) - комбинированное течение АГ, СД2Т и СГТ. Изучали уровни артериального давления,  показатели  углеводного, липидного и тиреоидного обмена, концентрацию инсулина в плазме, индекс инсулинорезистентности (ИР)- HOMA-IR, уровни васкулоэндотелиального фактора роста(VEGF-A) в плазме. Результаты. Степень дислипидемии во 2-й группе была более выраженной, чем в 1-й.  Присоединение СГТ сопровождалось тенденцией к увеличению всех атерогенных фракций липидов. ИР наблюдалась во всех группах пациентов и была достоверно больше, чем в контрольной группе (р<0,05). Выявлено достоверное повышение уровней VEGF-A во всех группах пациентов по сравнению с контролем (р <0,05). Во 2-й группе уровни VEGF-A были ниже, чем в 1-й группе, что, вероятно, связано с протективным эффектом метформина. Анализ влияния степени дисфункции щитовидной железы на ЭД выявил значительное увеличение уровней VEGF-A в подгруппе TSH> 6,0 мкМ/мл (352,55 ± 17,64 пг / мл и 461,74 ± 20,13 пг / мл соответственно, р<0,05). Заключение. Гормональные нарушения способствуют ухудшению эндотелиальной дисфункции у пациентов с артериальной гипертензией и сопутствующими эндокринопатиями - сахарным диабетом 2 типа и субклиническим гипотиреозом. Даже незначительное снижение функции щитовидной железы приводит к прогрессированию эндотелиальной дисфункции. Ключевые слова: гипертензия, сахарный диабет 2 тип, субклинический гипотиреоз, эндотелиальная дисфункция     


2019 ◽  
Vol 23 (2) ◽  
pp. 277-282
Author(s):  
V. D. Nemtsova ◽  
I. A. Ilchenko ◽  
V. V. Zlatkina

Due to the growing number of patients with age-related diseases, the aim of the study was to investigate in the changes of aging rate (AR) in patients with comorbid course of arterial hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SH) and to study the features of these changes depending on hormonal imbalance. 118 patients (63 women and 55 men, average age — 53.6±4.3 years) were divided into 3 groups: group 1 (n=37) with isolated H; group 2 (n=42) — with H and T2DM; group 3 (n=39) — with H, T2DM and SH. The investigation program included: measurement of anthropometric parameters (blood pressure, height, body weight (BW), body mass index (BMI)), carbohydrate and thyroid metabolism using standard methods, biological age (BA) by V.P. Voitenko et al. Statistical processing was performed using the Statistica for Windows 8.0 software package. When evaluating AR, physiological aging was found in 8 patients (21.6%) of group 1, in 4 (9.5%) patients of group 2 and 3 (7.7%) of patients in group 3. In the overwhelming majority of the examined patients, premature aging (PA) was noted, however, the acceleration of PA between patients of groups 2 and 3 was not differ significantly (p>0.05). The increase in AR in group 2 patients was accompanied by an increase in BA by 7.2 years, in 3 group patients — by 7.3 years compared with their chronological age. A correlation analysis revealed a positive relationship between BMI and coefficient of aging rate (CAR) (r=0.679; p<0.05); BMI and BA (r=0.562; p<0.05) and CAR and the TSH level (r=0.050; p=0.388) in the 3rd group. Thus, the presence of hypertension and comorbid endocrinopathies — T2DM and SH significantly increases the AR and when assessing the effect of endocrine disorders, the presence of T2DM is more important than SH.


2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Abimbola Abobarin-Adeagbo ◽  
Andreas Wienke ◽  
Matthias Girndt ◽  
Rainer U. Pliquett

Abstract Background Aim of this study is to investigate a possible association of hypoglycemic episodes and arterial hypertension. We hypothesize that hospitalized insulin-treated diabetes patients with hypertensive crisis have more hypoglycemic episodes than their counterparts without hypertensive crisis on admission. Methods In a prospective, observational cohort study, 65 insulin-treated diabetes patients (type 1, type 2, type 3c) were included in Group 1, when a hypertensive crisis was present, as control patients in Group 2 without hypertensive crisis or hypoglycemia, in Group 3, when a symptomatic hypoglycemia was present on admission. All patients were subjected to open-label continuous glucose monitoring, 24-h blood-pressure- and Holter electrocardiogram recordings, and to laboratory tests including plasma catecholamines. Results 53 patients, thereof 19 Group-1, 19 Group-2, 15 Group-3 patients, completed this study. Group-1 patients had the highest maximum systolic blood pressure, a higher daily cumulative insulin dose at admission, a higher body-mass index, and a higher plasma norepinephrine than control patients of Group 2. Group-3 patients had more documented hypoglycemic episodes (0.8 ± 0.5 per 24 h) than Group-2 patients (0.2 ± 0.3 per 24 h), however, they were not different to the ones in Group-1 patients (0.4 ± 0.4 per 24 h). Plasma norepinephrine and mean arterial blood pressure were higher Group-1 and Group-3 patients than in control patients of Group 2. At discharge, the daily cumulative insulin dose was reduced in Group-1 (− 18.4 ± 24.9 units) and in Group-3 patients (− 18.6 ± 22.7 units), but remained unchanged in Group-2 control patients (− 2.9 ± 15.6 units). Conclusions An association between hypoglycemic events and uncontrolled hypertension was found in this study.


2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Cheuk-Kwan Sun ◽  
Yen-Yi Zhen ◽  
Hung-I Lu ◽  
Pei-Hsun Sung ◽  
Li-Teh Chang ◽  
...  

We tested the hypothesis that Lipofectamine siRNA delivery to deplete transient receptor potential cation channel (TRPC) 1 protein expression can suppress hypoxia-induced pulmonary arterial hypertension (PAH) in mice. Adult male C57BL/6 mice were equally divided into group 1 (normal controls), group 2 (hypoxia), and group 3 (hypoxia + siRNA TRPC1). By day 28, right ventricular systolic pressure (RVSP), number of muscularized arteries, right ventricle (RV), and lung weights were increased in group 2 than in group 1 and reduced in group 3 compared with group 2. Pulmonary crowded score showed similar pattern, whereas number of alveolar sacs exhibited an opposite pattern compared to that of RVSP in all groups. Protein expressions of TRPCs, HIF-1α, Ku-70, apoptosis, and fibrosis and pulmonary mRNA expressions of inflammatory markers were similar pattern, whereas protein expressions of antifibrosis and VEGF were opposite to the pattern of RVSP. Cellular markers of pulmonary DNA damage, repair, and smooth muscle proliferation exhibited a pattern similar to that of RVSP. The mRNA expressions of proapoptotic and hypertrophy biomarkers displayed a similar pattern, whereas sarcomere length showed an opposite pattern compared to that of RVSP in all groups. Lipofectamine siRNA delivery effectively reduced TRPC1 expression, thereby attenuating PAH-associated RV and pulmonary arteriolar remodeling.


2021 ◽  
Vol 12 (1) ◽  
pp. 21-30
Author(s):  
Natalya V. Gonchar ◽  
Аnzhela А. Аvakyan ◽  
Svetlana N. Chuprova ◽  
Nikolay V. Slizovskiy

The results of investigation of features of morphofunctional state of cardiovascular system in adolescents with manifestations of metabolic syndrome depending on presence of hyperuricemia are presented. In the cardiorheumatology department of the hospital, 34 adolescent patients were observed. Criteria for inclusion in the study: the presence of increased blood pressure levels, increased body mass index values. Depending on serum uric acid levels, patients were divided into two groups: group 1 patients without hyperuricemia (n = 18) and group 2 patients with hyperuricemia (n = 16). Functional diagnostic methods were used: standard 12-channel electrocardiography, transtoral echocardiography, daily Holter monitoring. The main attention was paid to the study of the parameters of the left ventricle. Students t-test was used to determine the significance of the differences, the results at p 0.05 were considered reliable. It was established that adolescents with hyperuricemia were more often diagnosed with primary and secondary arterial hypertension, less often with labile arterial hypertension and autonomic dysfunction syndrome by hypertensive type, and adolescents without hyperuricemia were equally often diagnosed with primary arterial hypertension and labile arterial hypertension, autonomic dysfunction syndrome by hypertensive type. Signs of left ventricular remodeling according to echocardiography were more often noted in boys without hyperuricemia (62.5% of cases) than in girls without hyperuricemia (10%; p 0.01) and in boys with hyperuricemia (26.7%; p 0,05). The findings indicated more significant changes in the morphofunctional state of the cardiovascular system in adolescents with hypertensive conditions and manifestations of metabolic syndrome without hyperuricemia, which requires further study.


2013 ◽  
Vol 4 (4) ◽  
pp. 36-39
Author(s):  
D. S Kaskayeva ◽  
M. M Petrova ◽  
V. V Kostina ◽  
A. A Evsyukov ◽  
E. A Tepper

The article in comparative aspect presents results of rating of psychological profile of 142 patients (all are men, average age 46,5±0,35 years) with arterial hypertension of stage I–III with high risk of cardiovascular complications having been studied after 6 months of dynamic observation against the background of conducted antihypertensive therapy with inhibitors of angiotensin converting enzyme (ACE).


2019 ◽  
Vol 27 (2) ◽  
pp. 172-180 ◽  
Author(s):  
Daria V. Seliverstova

Aim. Identification of risk factors (RF) for myocardial infarction (MI) among women with preserved menstrual function. Material and Methods. 121 Female patients under 55 years of age, who were hospitalized with MI in the cardiology departments of Ryazan in the period 2010-2016, were studied. All patients were divided into 2 groups. The first group included women with a regular menstrual cycle without menopausal symptoms (n=60, mean age 48.0±6.1 years). The second group consisted of postmenopausal women (n=61, mean age 49.8±4.3 years). Of a cohort of studied  women a group of women was isolated (n=18 from group 1 and n=15 from group 2) who, during hospitalization with MI in 2015-2016, filled in questionnaires on nutrition and physical activity. Results. In women of group 1 such risk factors as burdened heredity for cardiovascular diseases (58.3%, p=0.02) and smoking (46.7%, p=0.03) were more common than in women of group 2. Only women of group 1 took oral contraceptives before the onset of MI (15%, p=0.005). The most common RFs were: arterial hypertension (˃80% of patients in both groups; overweight and obesity (78.3% of women from group 1 and 83.6% from group 2); type 2 diabetes mellitus  (23.3% in group 1 and 24.6% in group 2). According to the results of the questionnaire on food habits, insufficient use of fruit and vegetables was detected among all patients of both groups. In analysis of the results of the International Physical Activity Questionnaire (IPAQ), 72.2% of patients in group 1 experienced insufficient physical activity, and 53.3% of patients in group 2 showed pronounced hypodynamia. Biochemical analysis of blood revealed increased average levels of total cholesterol, low-density lipoproteins and triglycerides, with high-density lipoproteins within the normal range in both groups. Conclusion. The most common risk factors for myocardial infarction in women with preserved menstrual function in comparison with postmenopausal women were: positive heredity for cardiovascular diseases, smoking and taking oral contraceptives. Besides, a wide spread of arterial hypertension, dyslipidemia and diabetes mellitus, overweight and obesity, low physical activity and lack of fruit and vegetables in the diet of women in both groups should be noted.


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