Heart rate variability and risk of cardiovascular complications in patients with arterial hypertension and non-alcoholic fatty liver disease

Therapy ◽  
2021 ◽  
Vol 2_2021 ◽  
pp. 85-93
Author(s):  
Statsenko M.E. Statsenko ◽  
Streltsova A.M. Streltsova ◽  
Tyschenko I.A. Tyschenko ◽  
Turovets M.I. Turovets ◽  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Liver Disease ◽  
Arterial Hypertension ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cardiovascular Complications ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

scholarly journals Risk factors of arterial hypertension in patients with nonalcoholic fatty liver disease.

2018 ◽  
Vol 96 (6) ◽  
pp. 537-543
Author(s):  
E. V. Sevostyanova ◽  
V. Ya. Polyakov ◽  
Yu. A. Nikolaev ◽  
I. M. Mitrofanov
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Density Lipoprotein ◽  
Modifiable Risk Factors ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Purpose of the study. To study frequency of occurrence and values ofparameters of the main risk factors for cardiovascular diseases in patients with hypertension in combination with non-alcoholic fatty liver disease. Material and methods. The analysis of 17,202 medical cards of patients (6,730 men, 10,472 women), which were examined and treated in the clinic of the Scientific Research Institute of Experimental and Clinical Medicine, Novosibirsk, was carried out. Of them - 3,087patients with arterial hypertension (AH), combined with non-alcoholic fatty liver disease (NAFLD) (main group); 13,384 patients with isolated arterial hypertension; 731 patients with NAFLD (comparison groups). According to the clinical and laboratory examination, the following risk factors were assessed: high blood pressure, obesity, elevated blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, uric acid, a low content of high-density lipoprotein cholesterol in the blood. Results. In patients with hypertension combined with NAFLD, in comparison with patients with isolated diseases, an increase in the values of the indices determining the main modifiable risk factors for cardiovascular diseases (hypertension, obesity, hyperglycemia, hypercholesterolemia, hyperuricemia) was revealed. Similar changes were detected in both men and women. Conclusion. An important role of risk factors for cardiovascular diseases, which together represent the clinical manifestations of the metabolic syndrome, has been identified in the development of comorbid pathology - AH and NAFLD. The data obtained indicate the need for differentiated, personified prevention and treatment of patients with this comorbid pathology with mandatory identification and correction of modifiable risk factors for cardiovascular diseases.

scholarly journals Features of the therapy of non-alcoholic fatty liver disease in comorbid patients

2021 ◽  
pp. 136-143
Author(s):  
M. M. Maevskaya
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Steatosis ◽  
Modern Society ◽  
Cardiovascular Complications ◽  
Efficacy And Safety ◽  
Alcoholic Fatty Liver ◽  
Positive Effect ◽  
Alcoholic Fatty Liver Disease

The problem of modern medicine and modern society is a comorbid patient with metabolic disorders. Hypothetical portrait of such a patient: over 40 years old, overweight, arterial hypertension, coronary atherosclerosis, impaired carbohydrate and lipid metabolism, liver steatosis or steato-hepatitis, often with changes in the function of the musculoskeletal system. Rational pharmacotherapy of this patient is of fundamental importance. The article analyzes, from the point of view of polypotency, efficacy and safety, the main drugs used in Russia for treatment of non-alcoholic fatty liver disease in comorbid patients. Attention is paid to vitamin E, glycyrrhizin, ursodeoxycholic acid. Domestic and foreign studies of these drugs are analyzed, and the scope of their rational use is shown: reducing the risk of cardiovascular complications, a positive effect on the lipid spectrum, reducing the activity of serum transaminases and other hepatotropic effects. Their side effects are also considered, which should be taken into account when choosing the treatment of a comorbid patient. We have analyzed the efficacy and safety of new molecules that are in clinical trials and/or have not yet been registered in our country, e.g. obeticholic acid, cenicriviroc, tropifexor, etc. The ability of some molecules to act as biological enhancers is also highlighted, which is important to consider when prescribing combination therapy. Doctors are recommended to carefully consider and take into account all the features of a comorbid patient and choose for this category of patients safe drugs of hepatotropic action with simultaneous positive effect on the cardiovascular system. Among other things, it will avoid polypragmasy.

scholarly journals PROTO-HORMONES LEVELS OF ADIPOSE TISSUE, INTERLEUKIN-6 AND INDICATORS OF DETOXIFYING FUNCTION OF THE LIVER IN PATIENTS WITH HYPERTENSION AND OBESITY COMBINED WITH NON-ALCOHOLIC FATTY LIVER DISEASE

2020 ◽  
pp. 3-6
Author(s):  
Olesia Bochar
Keyword(s):  
Adipose Tissue ◽  
Liver Disease ◽  
Arterial Hypertension ◽  
Fatty Liver ◽  
Interleukin 6 ◽  
Fatty Liver Disease ◽  
Left Ventricular ◽  
The Body ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

The research estimates the state of liver detoxifying function and analyzes the changes in the levels of leptin, adiponectin and interleukin-6 in patients with arterial hypertension in combination with obesity and non-alcoholic fatty liver disease. Aim. The aim of the study is to evaluate levels of proto-hormones adipose tissue, interleukin-6 and indicators of detoxifying function of the liver in patients with hypertension and obesity combined with non-alcoholic fatty liver disease (NAFLD). Materials and methods. The study involved patients with arterial hypertension combined with obesity and NAFLD. All patients underwent anthropometric, general clinical, laboratory (blood lipid profile) and instrumental diagnostics (electrocardiography, echocardiography, ultrasonography, 13C-metacetin breath test, ELISA (adiponectin, leptin, IL-6). The patients’ height and weight were measured, the body mass index was calculated according to standard formulas. Results. Patients with arterial hypertension combined with obesity and NAFLD at the stage of steatohepatitis showed an increase in the levels of leptin and IL-6 and a decrease in the level of adiponectin. This group also revealed a moderate decrease in liver detoxifying function, as indicated by the results of 13C- MBT due to a 46.7 % decrease in the metabolic rate and a decrease in cumulative doses of CUM40 by 40 % and CUM120 by 46.8 %, respectively. Conclusions. The elevated levels of leptin and IL-6 and lowered adiponectin levels can be used to determine the degree of activity of non-alcoholic steatohepatitis and predict the course of NAFLD in combination with hypertension and obesity. An increased level of leptin and IL-6 and a low level of adiponectin in patients with such a comorbid pathology lead to an increase in the left ventricular myocardial mass index and aggravate the course of arterial hypertension.

scholarly journals Effects of Ademetionine on Liver Fibrosis, Level of Pentraxin-3 and Metabolic Indicators in Patients with Comorbid Course of Non-alcoholic Liver Disease and Arterial Hypertension

2020 ◽  
Vol 5 (6) ◽  
pp. 95-101
Author(s):  
T. N. Alexandrova ◽  
◽  
O. Ya. Babak
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Arterial Hypertension ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Pentraxin 3 ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease is the most common liver disease in the world, showing a variety of histopathological findings ranging from simple steatosis to nonalcoholic steatohepatitis and cirrhosis. Patients with nonalcoholic fatty liver disease have the potential to develop fibrosis and cirrhosis leading to portal hypertension, liver decompensation, and even hepatocellular carcinoma. Nonalcoholic fatty liver disease can be differentiated from simple steatosis by liver biopsy and is diagnosed when all of the following three criteria are met: macrovesicular fatty change of hepatocytes, inflammatory cell infiltration, and ballooning degeneration of hepatocytes. Lipid accumulation in hepatocytes can lead to inflammation within them. Accordingly, significant fibrosis can cause cirrhosis over a period of 10-20 years, but the pathophysiology is not well understood yet. However, liver biopsy is invasive, has drawbacks such as sampling error and cost, and it is not applicable for all patients. Also, there was a greater interest in science and practical medicine in the use of non-invasive methods for diagnosing the stages of nonalcoholic fatty liver disease. Primed on clinical and scientific data, non-invasive markers of liver fibrosis have to be highly sensitive and specific in identifying the early stages of liver fibrosis. The purpose of the work was to determine the effect of S-adenosylmethionine (ademetionine) on the stage of liver fibrosis, the level of pentraxin-3, C-reactive protein and metabolic parameters in patients with comorbide course of non-alcoholic fatty liver disease and arterial hypertension. Results and discussion. On the 61st day from the start of ademetionine use, there was a tendency to a decrease in the number of patients with comorbid course of non-alcoholic fatty liver disease and arterial hypertension in the stage of liver fibrosis F1 and F2 and an increase in the F0 stage. In addition, a significant decrease in the indicators of systemic inflammation (pentraxin-3, C-reactive protein) was achieved (p <0.05). The patients with comorbid course of non-alcoholic fatty liver disease and arterial hypertension also had a statistically significant (p <0.05) positive dynamics of hepatocyte cytolysis indicators was achieved in comparison with those before treatment and with the control group (p <0.05), as well as the lipid profile (p <0.05). Conclusion. The study showed that using ademetionine in patients with comorbid course of non-alcoholic fatty liver disease and arterial hypertension promoted regression of the stage of liver fibrosis, a significant decrease in the level of pentraxin-3, C-reactive protein, and an improvement in metabolic parameters. Appointment of ademetionine is an expedient method of treating patients with comorbid course of non-alcoholic fatty liver disease and arterial hypertension as a pathogenetic medicine with a pronounced antifibrotic, anti-inflammatory and cytoprotective effect

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