Arterial Hypertension
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2021 ◽  
Author(s):  
Pilar Galicia ◽  
Juan Jose Gutierrez Cuevas ◽  
Fang Fang Chen Chen ◽  
Laura Santos Larregola ◽  
Alberto Manzanares Briega ◽  
...  

Purpose: to describe the clinical characteristics of patients with confirmed SARS-CoV-2 infection in primary care and to analyze the predictive role of different risk factors on prognosis, especially living conditions. Methods: Retrospective longitudinal observational retrospective study by reviewing medical records from a primary care center since March 1 to April 30, 2020. Case definition of confirmed SARS-CoV-2 infection, sociodemographic data, clinical characteristics, comorbidity and living conditions were collected. The statistical analysis consisted in description of the sample, comparison of prognosis groups and analysis of prognostic factors. Results. A sample of 70 patients with confirmed SARS-CoV-2 infection was obtained, with comorbidity mainly related to arterial hypertension, overweight/obesity, hypercholesterolemia, diabetes and chronic pulmonary pathology. Pneumonia was present in 66%. Exitus occurred in 14% of the sample. Factors associated with mortality were advanced age (84 vs 55; p<0.0001), arterial hypertension (78% vs 41%; p=0.040), asthma-COPD (56% vs 13%; p=0.008) and atrial fibrillation (56% vs 5%; p=0.001). Conclusions. The study reflects the clinical practice of a primary care center. This kind of studies are essential to strengthen and reorganize the Health System and to try to anticipate the medium- to long-term consequences of COVID-19 on global health.


Author(s):  
Михаил Олегович Паршин ◽  
Антон Александрович Титов ◽  
Татьяна Игоревна Субботина ◽  
Борис Дмитриевич Жидких ◽  
Елена Ефимовна Атлас

Сердечно-сосудистые заболевания в пожилом возрасте представляют актуальную проблему многих стран и на протяжении ряда последних десятилетий выступают ведущей причиной преждевременной смерти, нанося значительный экономический ущерб обществу и здравоохранению. Сердечно-сосудистые заболевания и, в частности, хроническая сердечная недостаточность в сочетании с артериальной гипертензией у пожилых встречаются часто, и такая тенденция сохранится и в ближайшие годы. Рассматриваемая патология у пожилых протекает нередко атипично и поэтому выявление ее требует комплексного функционального и инструментального обследования пациентов. Цель исследования - анализ и совершенствование функционального и инструментального обследования пожилых пациентов с сердечно-сосудистой патологией. Диагностическое обследование 86 пациентов 60-74 лет включало функциональное изучение интерлейкинового статуса и эхокардиографию при наличии хронической сердечной недостаточности и артериальной гипертензии. Диагноз хронической сердечной недостаточности устанавливался с учетом критериев NYHA и в соответствии с Рекомендациями Европейского общества кардиологов по диагностике и лечению острой и хронической сердечной недостаточности. Артериальная гипертензия верифицировалась в соответствии с «Национальными рекомендациями по диагностике, профилактике и лечению артериальной гипертензии». Контрольную группу составили 42 пациента пожилого возраста с отсутствием вышеназванных сердечно-сосудистых заболеваний. В ходе исследования установлено, что развитие сочетанной сердечно-сосудистой патологии сопровождается статистически значимым изменением ряда параметров инструментального (эхокардиографического) обследования. Одновременно при развитии сердечно-сосудистой патологии наблюдались изменения в системном интерлейкиновом профиле пациентов пожилого возраста. Они сопровождались преимущественно увеличением содержания в сыворотке крови провоспалительных интерлейкинов и особенно IL-8 до 48,6±2,5 пг/мл против 6,1±1,3 нг/мл в контрольной группе и IL-1β до 78,6±1,9 нг/мл против 13,5±1,0 пг/мл. Вместе с тем наблюдалось у пожилых пациентов с сердечно-сосудистой патологией снижение противовоспалительных интерлейкинов IL-4 и IL-10. Полученные результаты свидетельствуют о важности комплексного обследования пациентов с сердечно-сосудистой патологией Cardiovascular diseases in old age are an urgent problem in many countries and over the past few decades have been the leading cause of premature death, causing significant economic damage to society and public health. Cardiovascular diseases and, in particular, chronic heart failure in combination with arterial hypertension in the elderly are common and this trend will continue in the coming years. The pathology under consideration in the elderly is often isolated, and therefore its detection requires a comprehensive functional and instrumental examination of patients. The aim of the study was to analyze and improve the functional and instrumental examination of elderly patients with cardiovascular pathology. Diagnostic examination of 86 patients aged 60-74 years included functional study of interleukin status and echocardiography in the presence of chronic heart failure and arterial hypertension. The diagnosis of chronic heart failure was established taking into account the NYHA criteria and in accordance with the Recommendations of the European Society of Cardiology for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Arterial hypertension was verified in accordance with the"National guidelines for the diagnosis, prevention and treatment of arterial hypertension". The control group consisted of 42 elderly patients with the absence of the above-mentioned cardiovascular diseases. The study found that the development of combined cardiovascular pathology is accompanied by a statistically significant change in a number of parameters of the instrumental (echocardiographic) examination. At the same time, changes in the systemic interleukin profile of elderly patients were observed with the development of cardiovascular pathology. They were accompanied mainly by an increase in the serum content of proinflammatory interleukins and especially IL-8 to 48.6±2.5 pg / ml versus 6.1±1.3 ng/ml in the control group and IL-1β to 78.6±1.9 ng/ml versus 13.5±1.0 pg / ml. At the same time, a decrease in anti-inflammatory interleukins IL-4 and IL-10 was observed in elderly patients with cardiovascular pathology. The results obtained indicate the importance of a comprehensive examination of patients with cardiovascular pathology


2021 ◽  
Vol 12 ◽  
Author(s):  
Yong-Jie Chen ◽  
Yi Li ◽  
Xian Guo ◽  
Bo Huo ◽  
Yue Chen ◽  
...  

Abnormal proliferation of pulmonary artery smooth muscle cells (PASMCs) is a critical pathological feature in the pathogenesis of pulmonary arterial hypertension (PAH), but the regulatory mechanisms remain largely unknown. Herein, we demonstrated that interferon regulatory factor 9 (IRF9) accelerated PASMCs proliferation by regulating Prohibitin 1 (PHB1) expression and the AKT-GSK3β signaling pathway. Compared with control groups, the rats treated with chronic hypoxia (CH), monocrotaline (MCT) or sugen5416 combined with chronic hypoxia (SuHx), and mice challenged with CH had significantly thickened pulmonary arterioles and hyperproliferative PASMCs. More importantly, the protein level of IRF9 was found to be elevated in the thickened medial wall of the pulmonary arterioles in all of these PAH models. Notably, overexpression of IRF9 significantly promoted the proliferation of rat and human PASMCs, as evidenced by increased cell counts, EdU-positive cells and upregulated biomarkers of cell proliferation. In contrast, knockdown of IRF9 suppressed the proliferation of rat and human PASMCs. Mechanistically, IRF9 directly restrained PHB1 expression and interacted with AKT to inhibit the phosphorylation of AKT at thr308 site, which finally led to mitochondrial dysfunction and PASMC proliferation. Unsurprisingly, MK2206, a specific inhibitor of AKT, partially reversed the PASMC proliferation inhibited by IRF9 knockdown. Thus, our results suggested that elevation of IRF9 facilitates PASMC proliferation by regulating PHB1 expression and AKT signaling pathway to affect mitochondrial function during the development of PAH, which indicated that targeting IRF9 may serve as a novel strategy to delay the pathological progression of PAH.


2021 ◽  
Vol 99 (5-6) ◽  
pp. 342-346
Author(s):  
V. I. Podzolkov ◽  
T. V. Koroleva ◽  
A. E. Bragina ◽  
A. I. Tarzimanova ◽  
M. G. Kudryavtseva ◽  
...  

The development of microcirculatory disorders is considered to be one of the earliest changes in the cardiovascular system with a combination of arterial hypertension (AH) and obesity. The rheological properties of blood play a significant role in the system of microcirculation. An important place in changing the rheological characteristics of blood is largely assigned to erythrocytes. Aggregation of erythrocytes is closely related to the magnitude of the surface-bound charge of their membranes or zeta potential of erythrocyte membranes. Purpose. To study the state of compound zeta potential of erythrocyte membranes in patients with hypertension and obesity. Material and methods. The study included 112 patients with AH and Index of Mass Corporal more than 30 kg/m2 (main group); the control group consisted of 25 people without AH and obesity. All patients of the main group received standard antihypertensive, lipid-lowering and hypoglycemic therapy to achieve the target levels of the indices under correction. Results. The level of compound zeta potential of erythrocyte membranes in patients with AH and obesity was significantly lower than in the control group and amounted to 1.57 ± 0.06 × 107 and 1.67 ± 0.03 × 107, respectively (p < 0.05). At the same time, in patients of the main group with an increase in AH, lower indices were noted. In patients with AH and obesity, a significant inverse correlation was found between the compound zeta potential of erythrocyte membranes and the degree of hypertension, which indicates a negative effect of hypertension on the rheological properties of blood at the microvasculature level. A correlation analysis was carried out to evaluate the association between Index of Mass Corporal and zeta potential of erythrocyte membranes in obese hypertensive patients. A negative direct correlation was revealed (r = 0.7, p < 0.05). Conclusion: a decrease in the total charge of erythrocytes can be considered as an early sign of microrheological disorders in patients with a controlled course of arterial hypertension and obesity.


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