Медіатори запалення та антропометричні параметри в прогресуванні АГ з коморбідною патологією

Abstract

The development of obesity in patients with arterial hypertension and their mortality remains high in all countries, despite advances in early diagnosis, the introduction of high-tech treatments and prevention of arterial hypertension. Obesity and diabetes significantly impair the prognosis, contribute to the progression of vascular changes, and accelerate the development of arterial hypertension. Thus, determining the impact of these diseases on a certain level of pathogenesis of inflammation is of great importance. The purpose of the study was to conduct an analysis of some clinical and inflammatory factors values in the progression of damage to target organs in arterial hypertension with diabetes and obesity. Material and methods. There were 48 patients with second stage arterial hypertension, 1-2 grade, and of high and very high cardiovascular risk score (22 men and 26 women) under observation. The average age of patients was 57.6 ± 4.7 years. The patients were divided into groups: the first group consisted of 23 patients with arterial hypertension with diabetes and obesity, which had no progression of the disease, the 2nd group included 25 patients with hypertension in combination with diabetes and obesity with progression of lesions of target organs. Results and discussion. The survey showed that the BMI ≤ 39.0 kg / m2 was relatively non-specific, as it was determined in almost all (97.7%) patients without progression of the disease and significantly exceeded the proportion of patients with progression of hypertension (77.6%, p ≤ 0.001). Normative and slightly exceeding the normative figures of the ratio of waist and thigh circumference were characteristic of patients without progression of the disease and were found in 65.2% of them. At the same time the proportion of such patients was 1.6 times lower and was 40, 8% (p ≤ 0.01) in the second group. The presence of inflammatory component in the body of patients with hypertension contributes to the progression of the disease. Regarding the level of anti-inflammatory cytokine IL-10, its significance did not reveal any significant differences in the groups (≥ 0.05). Significant increase in the content of chemerin (≥ 241 pg / ml) was 3.1 fold more (p ≤ 0.001) in the group with progression of the disease. The normative value of the indicator (≤ 200 pg / ml) was characteristic for the group without progression of hypertension. It was diagnosed by 2.7 times (р ≤ 0,001) more often in this group than in patients with progression of the disease. Conclusions. The direct reliable association with the progression of hypertension was determined by the weight of the patients’ body, the value of BMI, the ratio of the waist / thigh circumference, the thickness of the epicardial fat and the inverse correlation with the height of the patients. The presence of inflammatory component in the body of patients with hypertension, which is associated with obesity, contributes to the progression of the disease. The research leads to the continuation of studying the feasibility and the possibility of applying these criteria at all levels of treatment and prevention with the aim of stratifying the effectiveness of therapeutic tactics.