Clinical, functional and molecular characteristics of vibration disease in combination with arterial hypertension

Abstract

Introduction. The negative dynamics of the increase in the prevalence of cardiovascular pathology among industrial workers observed in recent decades within the framework of the tasks of the scientific specialty "occupational health" determines the importance of studying not only professional, but also comorbid pathology in workers, diseases accompanying the professional route, assessing the role of production factors in the development of somatic diseases, including diseases of the circulatory system, in in particular, arterial hypertension. The study aims to research the possibilities of early diagnosis of vascular disorders in vibration disease in combination with arterial hypertension based on the assessment of endothelial and hemostasiological parameters. Materials and methods. The study involved 253 patients of the Center for Occupational Pathology of the Novosibirsk State Medical Institution "City Clinical Hospital No. 2", including 144 people working in contact with local vibration for more than 15 years, among them 75 people with vibration disease, 69 people with a combination of vibration disease and hypertension; 72 people with hypertension those who work outside the influence of local vibration and 37 people who work outside of contact with local vibration and have no history of hypertension. The researchers conducted a comparative assessment of the indicators of systemic, vascular-platelet, plasma-coagulation hemostasis, the state of markers of endothelial-cellular hemostasis. Authors determined the aggregation activity of platelets, also studied adhesion molecules, the functional state of the endothelium. We considered the differences statistically significant at p≤0.05. Results. During the study the researchers found that endothelial dysfunction in vibration disease in combination with arterial hypertension is closely related to the expression of signaling molecules, an increase in endothelin-1 levels in combination with increased production of vascular endothelial growth factor and transforming growth factor. Endothelial markers can be associated with the frequency of unfavorable polymorphic gene variants. In systemic hemostasis, there are: an increase in the level of thrombospondin and thrombomodulin, platelet growth factor in conditions of decreased plasminogen activity, an increase in the concentration of α2-macroglobulin and fibrin breakdown products. We also identified earlier endothelial-hemostasiological markers of vascular disorders. Limitations. The study was conducted on the basis of Novosibirsk State Medical University and on the basis of the City Clinical Hospital No. 2. The limitations of the study may be the unidirectionality of the study performed and the small sample of patients participating in the research. Conclusion. As a result of studying the clinical, functional and molecular characteristics of vibration disease occurring in combination with arterial hypertension, scientists have obtained new knowledge. It is possible to use such knowledge to improve the diagnosis and treatment of patients, scientific justification of health risks, development of prevention and rehabilitation programs. Ethics. All patients have previously signed an informed consent form to participate in the study. The Ethics Committee of the Novosibirsk State Medical University and the State Medical Institution of the City Clinical Hospital No. 2 has approved the research program, the content of the informed consent, materials of the article.