MECHANISMS OF VASOPROTECTION AND CARDIOPROTECTION IN HYPOXYTHERAPY OF ARTERIAL HYPERTENSION AND CORONARY ARTERY DISEASE

Abstract

Highlights The article presents a modern understanding of the main links of the functional circulatory regulation system and its response to exogenous hypoxia, as well as describes the data available on molecular mechanisms of vasoprotection and cardioprotection involved in response to hypoxytherapy in patients with arterial hypertension and coronary artery disease.  AbstractHypoxic conditioning has taken an important place in the range of non-drug methods for stimulating the adaptive potential of a healthy person and patients with cardiovascular diseases. There are many approaches to the use of various methods of exogenous hypoxia, however, there is no consensus on the essence of sanogenetic mechanisms that provide a multi-level functional system for maintaining oxygen supply and blood circulation. Adaptive reactions of afferent, central and efferent links of the functional circulatory regulation system in hypoxia in a healthy person are described. The results of studies of physiological systemic reactions realized by respiratory and vegetative plasticity using interval (intermittent) hypoxia are presented. In patients with arterial hypertension and coronary artery disease, the facts of chemoreflective stimulation and modulation of lung ventilation, autonomic nervous system status, especially sympathetic activity of peripheral blood vessels and vagal activation of cardiac activity have been established. The main vaso- and cardioprotective properties of interval hypoxytherapy are based on the leveling of oxidative stress, inflammation, activation of angiogenesis, and a shift in the secretory activity of the endothelium towards vasodilating, antiproliferative, and antithrombotic mediators. We present the evidence for the role of shear stress and the state of glycocalyx, angiopoietin and adrenomedulline in the regulation of vascular tone, as well as cytoprotective properties of cytoplasmic and mitochondrial metabolic factors in the formation of ischemic tolerance of cardiomyocytes. The issues of the relationship between systemic (neuronal and humoral) reactions and structural and functional responses of target cells in providing adaptive/compensatory mechanisms for regulating blood circulation under the influence of exogenous hypoxia require further research and evaluation.