Significant prognostic markers of arterial hypertension formation and progression

Abstract

One of the priorities in the fight against the incidence, morbidity and mortality from complications of hypertension (AH) is the development of new methods of diagnosis and prognosis of hypertension. The purpose is selection of prognostic markers of hypertension formation and progression, using multivariate discriminate analysis. Materials and methods. In conducting the discriminate analysis data of 238 patients with various stages of AH (group 1 - 74 patients with I stage: group 2 - 74 patients with II stage; the third group - 72 patients with III stage) were analyzed. Using ANOVA, we analyzed the effect of hypertension stage (independent variable) on 37 indicators (dependent variables), the list of which is composed of the following characteristics: anthropometry (height, weight, body mass index, waist circumference, hip circumference, waist/hip ratio), hemodynamics (systolic, diastolic pressure, heart rate), heart failure stage, concomitant cardiovascular diseases presence, clinical and laboratory parameters of carbohydrate metabolism (glucose, insulin, HbAc1, HOMA, Caro, Duncan), lipid profile (total cholesterol, triglycerides, LDL, HDL, apolipoprotein B), adipokines (interleukin-6, tumor necrosis factor-α, adiponectin, plasminogen activator inhibitor-1). All indicators were coded and distributed to 37-dimensional vector, which allows for the absence, presence, direction and magnitude of each indicator. The mathematical treatment of the results was performed using Microsoft Excel 2007 and SPSS Statistics 17.0. Results. The most significant prognostic factors for cardiometabolic risk affecting arterial hypertension, and based on which a mathematical model predicting the formation and progression of hypertension is - the stage of heart failure, the degree of obesity, ischemic heart disease presence, the insulin resistance index Caro, the levels of HDL cholesterol, apolipoprotein B, interleukin-6, tumor necrosis factor-α, adiponectin. The value of the canonical discriminant function coefficients represent the total contribution rate to the total risk of the formation and progression of hypertension in the course of certain sets of prognostic markers of cardiometabolic risk. Conclusions. Definition of valid prognostic markers of cardiometabolic risk in patients with hypertension will valid predict the course of hypertension, total individual cardiometabolic risk based on mathematical calculation of individual prognostic markers for the patient.