The influence of family history, aggravate by essential hypertension and metabolic disorders, on some cardiovascular risk factors in patients with essential hypertension

Abstract

Objective — to clarify the effects of family history (FH), aggravate by essential hypertension (EH) and metabolic disorders (MD) (excessive body mass, obesity, diabetes mellitus) on some cardiovascular risk factors (arterial blood pressure (ABP), characteristics of visceral obesity (VO), a state of lipid, carbohydrate and purine exchange) in patients (pts) with EH.Materials and methods. The retrospective study has been performed with the data of clinical examination of 114 pts (46 (40.3 %) females and 68 (59.6 %) males) aged to 23 — 74 years old (average age is 60.7 ± 1.84 years old) with EH of I — III stage. FH with EH and MD was revealed in 82 (71.9 %) of cases. The following data were extracted from the case histories: levels of systolic and diastolic blood pressure (SBP and DBP) measured by S. N. Korotkov’s method, body mass index (BMI) total fat mass (TFM) and fat mass index (FMI), serum levels of glucose and uric acid (UA), measured by glucosooxidase and phosphovolframic methods, respectively. Blood lipid spectrum included levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) assessed by enzyme method with autoanalyser. Very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C) and non-HDL cholesterol (non-HDL-C), lipid ratios such as LDL-C/HDL-C, TC/HDL-C, non-HDL-C/TC, TG/HDL-C and ln (TG/HDL-C) were calculated by known formulas. Triglyceride-glucose index (TGGI) was calculated by known formula and used to reveal muscular insulin resistance (IR).Results. It has been established that FH, aggravated with EH and MD from mother’s or in both of parents’ side, was associated with higher SBP elevation in proband compared with heredity without such history. In men with FH, aggravated from both of parents’ side, the MD presence in mothers in the grater degrees was associated with DBP elevation in proband. The FH, aggravated by MD from both of parents’ side, in women in more extant vs men contributed to the elevation of TFM and FMI. In this case a considerable elevation of FMI in proband was associated with a presence of MD in mother. In pts with EH and FH included MD compared with an absence of such history was found to be associated with hypercholesterolemia (HC) and dysfunction of reverse cholesterol transport evidenced by elevation of such lipid ratios as TC/HDL-C and LDL-C/HDL-C due to a growth of serum TC, LDL-C and non-HDL-C levels in persons with MD in FH. In female probands compared with male with FH of EH and MD there was an association of more significant HC with serum UA levels elevation. The genetic factor determined a significance of HC in female probands was a FH of MD in both parents. Among the pts with EH included in the investigation there was also an association of FH with MD in mother and HC combined with serum UA elevation in proband.Conclusions. The history family aggravated with essential hypertension and metabolic disorders, was associated with such cardiovascular risk factors as increased blood pressure, elevated total fat mass and fat mass index in combination with hypercholesterolemia, reverse cholesterol transport dysfunction and increased serum uric acid levels in probands with essential hypertension and insulin resistance.