Essential Arterial Hypertension Research Articles

Electrophysiological properties of the atrial myocardium and cardiac conduction system in patients with atrial fibrillation and different comorbidity

BACKGROUND: Atrial fibrillation is a rhythm disorder that has a complex and not yet fully understood etiology and pathogenesis. Catheter ablation is the most effective method for rhythm control in atrial fibrillation patients. The effectiveness of catheter ablation differs in patients with various concomitant pathologies of the cardiovascular system. AIM: To study electrophysiological properties of atrial myocardium and cardiac conduction system during catheter ablation for atrial fibrillation in patients with different cardiovascular comorbidities. MATERIALS AND METHODS: Intraprocedural data obtained during primary catheter ablations in 151 selected patients with atrial fibrillation were retrospectively analyzed. The patients were divided into 3 groups based on the presence or absence of cardiovascular comorbid pathology: group 1 — patients with idiopathic atrial fibrillation, group 2 — patients with a combination of atrial fibrillation and isolated essential arterial hypertension, group 3 — patients with a combination of atrial fibrillation and ischemic heart disease. RESULTS: The ventricular rate in the patients with atrial fibrillation was significantly higher than the heart rate in the patients with sinus rhythm (102.6 ± 20.8 beats/min and 64.9 ± 11.9 beats/min, respectively; p 0.001). The rhythm frequency differed significantly in Group 1, Group 2 and Group 3 in sinus rhythm (61.2 ± 10.9 beats/min, 60.1 ± 8.8 beats/min and 57.2 ± 10.3 beats/min, respectively; р 0.001), and in atrial fibrillation (107 ± 15.8 beats/min, 89.9 ± 14.3 beats/min and 102 ± 12.5 beats/min, respectively; р 0.001). In the patients of all groups both in sinus rhythm and in atrial fibrillation, the heart rate increased after pulmonary vein isolation compared with the rate before ablation (p 0.001). In all groups, after isolation of the pulmonary veins, a statistically significant decrease in the frequency of atrial fibrillatory activity was noted compared to the baseline: by 72 imp/min (р 0.001) in group 1, by 49 imp/min (р 0.001) in group 2, and by 49 imp/min (р = 0.003) in patients of group 3. The frequency of fibrillatory activity after pulmonary vein isolation was comparable in the study groups (р = 0.45), both before and after surgery. In the patients without coronary artery disease, there was a significant decrease in the amplitude of atrial electrograms after ablation compared to preoperative values (р = 0.042 in group 1; p 0.001 in group 2). The effective refractory period of the atrial myocardium did not differ between the groups (235 ± 30.3 ms, 220.6 ± 25.6 ms and 231.2 ± 39.4 ms, respectively; р = 0.359). CONCLUSIONS: In the patients with atrial fibrillation, the presence of concomitant pathology of the cardiovascular system affects the electrophysiological properties of the myocardium and conduction system of the heart and their changes after pulmonary vein isolation. Additional research is needed to develop a personalized approach to the treatment of atrial fibrillation in patients with concomitant pathology of the cardiovascular system.

The role of L-arginine in the pathogenesis of essential arterial hypertension

The role of arginine in the development of primary arterial hypertension continues to be clarified up to the present moment. During natural metabolic processes in cells, methylated forms of arginine are produced – symmetric (SDMA) and asymmetric (ADMA) dimethylarginine. ADMA is a nitric oxide synthase inhibitor and is now considered a well-established marker for endothelial dysfunction. SDMA is not a nitric oxide synthase inhibitor, but may indirectly reduce nitric oxide production through competitive interaction with cellular L-arginine.Currently, arginine preparations are practically not used for the treatment of primary arterial hypertension. This was the rationale for the given scientific review. The article summarizes the information available in the literature (2018–2022) on the pathogenetic mechanisms of  the  relationship between arginine and  the  development of impaired vascular tone. We used PubMed and RSCI databases for our review. Using keywords, 1784 publications were found over the past 5 years. The final selection criteria were time frame and matching keywords. The review provides data on the increased ADMA concentrations in experimental hypertensive animals and individuals with essential hypertension. The role of arginine metabolites in the genesis of endothelial dysfunction and arterial hypertension and the prospects for the therapeutic use of this compound are discussed.

Relationship between sleep quality and blood pressure level in nurses performing shift work

Abstract Objective The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical departments and to establish possible relationships between level of blood pressure (BP) and quality of sleep. Methods A total of 20 nurses of the therapeutic departments and 20 nurses of the surgical departments were enrolled in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). BP was measured according to the standard protocol using the Korotkoff method; a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m. and 10:30 a.m. The average value for the 2 indicators was calculated. The diagnosis of essential arterial hypertension (AH) was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension (2018). Results The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality; this was true in respondents of both the surgical and therapeutic profiles. However, it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments. Moreover, poor sleep quality was associated with AH, which was diagnosed in 65% of the nurses of the therapeutic departments and 45% of the nurses of the surgical departments, that is, in almost all of the subjects. Herewith, in the nurses of the therapeutic departments, the level of systolic BP exceeded that of the nurses of the surgical departments. Conclusions Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work. Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.

Реєстр PULSE-COR: взаємозв’язок між еластичністю лівого шлуночка та жорсткістю артерій у пацієнтів з есенціальною артеріальною гіпертензією

For a long time, the problem of the formation of diastolic dysfunction (DD) of the left ventricle (LV) in patients with arterial hypertension (AH) remained insufficiently studied. It was demonstrated that the formation of LV DD is largely related to the increase in stiffness of this heart chamber. We decided to evaluate the extent to which increased LV stiffness, determined noninvasively by echocardiography, is associated with LV diastolic dysfunction and determine the relationship of this method with arterial stiffness indicators for which validated methods have been developed.Materials and methods. A one-center registry called PULSE-COR was established in 2011 and is still in operation. There were 779 AH participants in our sample. A distinct cohort of patients (n=283) with essential AH and no substantial comorbidities were found from the final analysis, which comprised 320 patients who had undergone all requisite diagnostic procedures. Our tool of choice for measuring carotid-femoral pulse wave velocity (cfPWV) was the SphygmoCor device (AtCor, Australia). We also used the VaSera 1500 device (Fukuda Denshi, Japan) to measure cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI). Vascular ultrasound and intima-media thickness measurement (IMT) were included in the ultrasound diagnosis. The ASE 2016 recommendations were followed for the evaluation of diastolic LV function, and the standardized ASE protocol was followed for echocardiography. A standardized formula was used to assess the ventriculo-arterial coupling (VAC) which also included LV end-systolic elastance (Ees) and arterial elastance (Ea) evaluation. We conducted Spearman correlation analysis to identify relationships.Results and discussion. Our cohort were patients with AH, 51 % males; the mean age was 53.6±2.0 years. Mean office blood pressure (BP) was 159.8±4.5 mm Hg for systolic (SBP), 97.9±2.6 mm Hg for diastolic (DBP), 62.0±3.5 mm Hg for pulse blood (PBP) BP, and 76.6±2.2 bits per minute was the mean heart rate (HR). Both the left and right CAVI (R=0.698; p=0.012 and R=0.683; p=0.014) showed a strong correlation with VAC. Both E/A and E/e showed a substantial correlation with ABI (R=0.716; p=0.006 and R=0.764; p=0.002, respectively). cfPWV was linked with nearly the same parameters (R=0.248; p=0.001 for correlation with IMT, R=0.382; p=0.01 for correlation with low-density lipoproteins). Ea was substantially associated with IMT (R=0.491; p=0.24), total cholesterol (R=0.499; p=0.07), and low-density lipoproteins (R=0.687; p=0.001). Ees was substantially correlated with end diastolic volume (R=0.644; p=0.001), blood lymphocytes (R=–0.678; p=0.001), E/A (R=0.159; p=0.007), and E/e’ (R=–0.130; p=0.029).Conclusions. We have found a substantial correlation between validated arterial stiffness measurements and non-invasive LV stiffness evaluation parameters (VAC). VAC also was associated with LV diastolic function parameters

Thrombelastography and Conventional Coagulation Markers in Chronic Obstructive Pulmonary Disease: A Prospective Paired-Measurements Study Comparing Exacerbation and Stable Phases.

Chronic Obstructive Pulmonary Disease (COPD) exacerbation is known for its substantial impact on morbidity and mortality among affected patients, creating a significant healthcare burden worldwide. Coagulation abnormalities have emerged as potential contributors to exacerbation pathogenesis, raising concerns about increased thrombotic events during exacerbation. The aim of this study was to explore the differences in thrombelastography (TEG) parameters and coagulation markers in COPD patients during admission with exacerbation and at a follow-up after discharge. This was a multi-center cohort study. COPD patients were enrolled within 72 h of hospitalization. The baseline assessments were Kaolin-TEG and blood samples. Statistical analysis involved using descriptive statistics; the main analysis was a paired t-test comparing coagulation parameters between exacerbation and follow-up. One hundred patients participated, 66% of whom were female, with a median age of 78.5 years and comorbidities including atrial fibrillation (18%) and essential arterial hypertension (45%), and sixty-five individuals completed a follow-up after discharge. No significant variations were observed in Kaolin-TEG or conventional coagulation markers between exacerbation and follow-up. The Activated Partial Thromboplastin Clotting Time (APTT) results were near-significant, with p = 0.08. In conclusion, TEG parameters displayed no significant alterations between exacerbation and follow-up.

Pharmacogenetic predictors associated with reduced risk of secondary to enalapril cough

Currently, the wide prevalence of the development of secondary to ACEIs cough (3.8 to 48 % based on different findings) is one of the core causes of the dramatic impairment of the patients’ quality of life, followed by drug discontinuation. The study had the purpose of revealing the pharmacogenetic predictors associated with the reduced risk of the dry cough AEs secondary to ACEIs, in particular enalapril. The study involved 217 patients with the diagnosis of "essential arterial hypertension", who took enalapril. The patients were assigned to 2 groups: Group 1 (study group): 104 patients without secondary to enalapril adverse drug reactions; and Group 2 (control group): 113 patients with secondary to enalapril cough. All the patients underwent pharmacogenetic testing. The analysis of the distribution of frequencies of the polymorphisms rs4149056 of gene SLCO1B1, rs4459610 of gene ACE, rs1799722 of gene BDKRB2, and rs62151109 of gene CLASP1 has revealed no differences between the group without adverse drug reactions and that with secondary to enalapril dry cough. The study has revealed a statistically significant association between the absence of adverse drug reactions and the presence of the genotype AG of gene SLCO1B1 rs2306283, genotype GG of gene ABO rs8176746 and rs495828.

Cognitive function status in polymorbid patients with arterial hypertension, atrial fibrillation and chronic kidney disease

Background. Cognitive impairment is a public health problem. Polymorbid patients with arterial hypertension (AH), atrial fibrillation (AF), and chronic kidney disease (CKD) are at high risk of developing cognitive impairment, resulting in impaired quality of life, difficulty in medication adherence, and increased risk of mortality.Objective. To evaluate the cognitive status of polymorbid patients aged 60 years and older with essential AH and FP depending on the presence and stage of CKD.Materials and methods. 165 patients aged 60 years and older with essential AH and AF (80 [48.5 %] men, 85 [51.5 %] women, mean age was 82 [76; 85] years) were included and divided into three groups depending on the presence and stage of CKD: 55 (33.3 %) patients with AH and AF without CKD, 55 (33.3 %) patients with AH, AF, and CKD C 3a, and 55 (33.3 %) patients with AH, AF, and CKD C 3b. All patients included in the present study were examined for cognitive functions using a series of neuropsychological tests.Results. In the study of cognitive functions (Mini-mental State Examination, MMSE, Alzheimer Disease Assessment Scale-Cognitive (ADAS-cog), Digit Symbol Substitution Test (DSST), literature Association Test), it was found that the severity of cognitive impairment increased with increasing stage of CKD.Conclusions. The obtained results of the study indicate an unfavorable effect of CKD on cognitive functions in elderly and elderly patients with AH and FP. Thus, there is a need for regular monitoring and examination of patients with concomitant CKD for cognitive impairment.

Intraoperative atrial rhythm changes during atrial fibrillation catheter ablation in patients with arterial hypertension and coronary artery disease

Atrial fibrillation is a rhythm disorder with an extensive etiology and not fully understood pathogenesis. Catheter ablation is an effective way to control the rhythm of atrial fibrillation. The results of catheter ablation differ in patients with various comorbidities of the cardiovascular system. Intraoperative changes in the atrial rhythm can be a criterion for the long-term effectiveness of the operation or determine the need for additional effects.Aim: To assess intraoperative changes in atrial rhythm during catheter ablation of atrial fibrillation in patients with concomitant pathology of the cardiovascular system.Methodology and research methods. The results of catheter ablation of 451 patients with paroxysmal and persistent atrial fibrillation were analyzed retrospectively for the period from 2016 to 2017. After clinical and anamnestic data analysis, 151 patients with primary isolation of the pulmonary veins were selected. Depending on the concomitant pathology of the cardiovascular system, patients were divided into 3 groups: group 1 – with idiopathic atrial fibrillation, group 2 – atrial fibrillation in combination with isolated essential arterial hypertension and group 3 – atrial fibrillation in combination with ischemic heart disease.Results. In patients with idiopathic atrial fibrillation, relief of atrial fibrillation with sinus rhythm preservation until the end of surgery was more often observed than in patients with ischemic heart disease (22% vs. 10,6%, р = 0,021). In patients with ischemic heart disease, typical atrial flutter was much more common and there was a need to perform radiofrequency ablation of the cavothricuspid isthmus in addition to isolation of the pulmonary veins (47,9% vs. 18,8% 1 Group 1, р = 0,005, and 24,7% in Group 2, р = 0,01).Conclusions. The concomitant pathology of the cardiovascular system in patients affects the dynamics of the atrial rhythm during catheter treatment of atrial fibrillation and may take into account the definition of intraoperative tactics.

[Social, demographic and morbimortality characteristics of the cases treated for COVID-19 at the Ignacio Chávez National Institute of Cardiology. A descriptive cross-sectional study].

The COVID-19 pandemic brought with it a large number of adverse consequences for public health with serious socioeconomic repercussions. In this study we characterize the social, demographic, morbidity and mortality conditions of individuals treated for COVID-19 in one of the SARS-CoV-2 reference hospitals in Mexico City. A descriptive cross-sectional study was carried out in 259 patients discharged from the Instituto Nacional de Cardiología Ignacio Chávez, between April 11, 2020 and March 14, 2021. A multivariate logistic regression model was used to identify the association between sociodemographic and clinical variables. An optimization was performed using maximum likelihood calculations to choose the best model compatible with the data. The maximum likelihood model was evaluated using ROC curves, goodnessof-fit estimators, and multicollinearity analysis. Statistically significant patterns of comorbidities were inferred by evaluating a hypergeometric test over the frequencies of co-occurrence of pairs of conditions. A network analysis was implemented to determine connectivity patterns based on degree centrality, between comorbidities and outcome variables. The main social disadvantages of the studied population are related to the lack of social security (96.5%) and the lag in housing conditions (81%). Variables associated with the probability of survival were being younger (p < 0.0001), having more durable material goods (p = 0.0034) and avoiding: pneumonia (p = 0.0072), septic shock (p < 0.0001) and acute respiratory failure (p < 0.0001); (AUROC: 91.5%). The comorbidity network for survival cases has a high degree of connectivity between conditions such as cardiac arrhythmias and essential arterial hypertension (Degree Centrality = 90 and 78, respectively). Given that among the factors associated with survival to COVID-19 there are clinical, sociodemographic and social determinants of health variables, in addition to age; It is imperative to consider the various factors that may affect or modify the health status of a population, especially when addressing emerging epidemic phenomena such as the current COVID-19 pandemic.

ФИКСИРОВАННАЯ КОМБИНАЦИЯ ИРБЕСАРТАН/ГИДРОХЛОРТИАЗИД В ЛЕЧЕНИИ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ

Almost a third of the population of the Republic of Belarus suffers from elevated blood pressure which results in a high risk of cardiovascular disease developing. Despite the availability of numerous antihypertensive drugs, more than 40% of patients receiving antihypertensive therapy do not achieve target blood pressure levels and continue to be at an increased risk of cardiovascular events. A fixed combination drug irbesartan/hydrochlorothiazide, which includes two active ingredients in one dosage form of a tablet, is an anti-hypertensive combination balanced on the basis of clinical and pharmacological properties, which is approved by the Ministry of Health of the Republic of Belarus for use in patients when indicated in case of essential arterial hypertension. This fixed-dose combination is intended for adult patients whose blood pressure is not adequately controlled by irbesartan or hydrochlorothiazide monotherapy. The clinical efficacy and safety of this combination was demonstrated in randomized clinical trials, including patients with a combination of hypertension and type 2 diabetes, metabolic syndrome, and obesity. The use of the fixed-dose combination of irbesartan/hydrochlorothiazide leads to a more rapid decrease in blood pressure compared to irbesartan monotherapy, allows the majority of patients with severe hypertension to achieve the target blood pressure, and increases drug compliance. Thus, the irbesartan/hydrochlorothiazide combinationis a valuable addition to clinicians’ armamentarium for the treatment of hypertension.

Application of cardiorespiratory training with biofeedback in a patient with comorbidity

Biofeedback is increasingly used in practice due to diversity, the possibility of visualization of corrective functions, and the availability of objective indicators for assessing the dynamics of the training process. Biofeedback training helps to teach patients to skills that alleviate their condition, support active functioning, thereby increasing the quality of life. One of the simple methods of biofeedback is cardiorespiratory training, during which the patient learns the skill of diaphragmatic relaxation breathing, which is effective in rehabilitation for various pathologies, especially in pediatric practice. This type of biofeedback is based on the control of breathing and heart rate variability (HRV). HRV reflects the body’s ability to quickly recover from exposure to mental and physical stress factors. HRV is a unique marker of a person’s cardiovascular and psychophysiological health. This clinical example demonstrates a case of respiratory correction in a patient with comorbidities (multiple sclerosis, essential arterial hypertension, and panic disorder). The training was chosen as the most optimal for improving the patient’s quality of life, in respect that the leading complaint was panic attacks. One of the main goals of rehabilitation for this child is to teach the skills of diaphragmatic relaxation breathing, which allowed the patient learning to cope with future panic attacks, reduce anxiety and thereby improve his well-being. The article describes in detail the course of the training, recommended exercises for daily use, and presents the positive trend in the recorded indicators and the patient’s condition by the end of the course. Cardiorespiratory training is an effective and understandable method of rehabilitation that can be actively used in practice for an objective assessment of the classes performed and for psycho-emotional correction in children and adolescents with various pathologies.

Изменения циркадианных ритмов уровней цитокинов в крови пациентов с эссенциальной гипертензией в постковидном периоде

In spite of a vast number of trials devoted to quantitative characteristics of the cytokine profile in patients with various diseases, no exact reference intervals are presented. It is just as important that there is a limited number of trials analyzing circadian rhythms of cytokine synthesis in patients with arterial hypertension. The purpose of the work was to analyze the characteristics of circadian rhythms of cytokines (IL18, IL18 BP, LIF, sLIFr, M-CSF, MCSFR) in patients with Grade II essential arterial hypertension, and to detect pathogenetically significant characteristics developed following Covid-19. Blood samples were taken at 7.00–8.00, 12.00–13.00, 19.00–20.00.00, 00.00–1.00 to determine the levels of IL18, IL18 BP, LIF, sLIFr, M-CSF, MCSFR in 18 patients (56 (95% CI (54–69) years) with essential arterial hypertension (EAH) within three days prior to and following Covid-19. For this, the immunoenzyme method was used. The obtained data demonstrated altered circadian expression of cytokines in the peripheral blood of patients with essential hypertension depending on whether they have EAH or not, and their additional distortion following Covid-19, which is stable in the majority of cases. It is preserved for six months as low IL18 BP (р &lt; 0.001), and twofold increase of sLIFr and MCSF (р &lt; 0,001) at 18.00. A significant association is determined between the circadian rhythms of sLIFr and altered systolic BP resulting in the abnormal rhythm with BP rise at night (night peaker) in patients with EAH following COVID-19. The obtained fundamental data offer prospects for new research of immunopathogenesis following COVID-19 in patients with hypertension taking into account circadian rhythms of cytokines in the blood.

Arterial hypertension exacerbation frequencies, depression and anxiety in the condition of war in Ukraine: some statistics and survey results

Objective – to assess the level of anxiety and depression in the population before and during the war, the frequency of essential arterial hypertension (EAH) exacerbations and to establish changes in the life quality.Material and methods. 100 patients with EAH II stage participated in the study. All participants underwent a complex of clinical and laboratory examinations and determined the frequency of EAH exacerbations, crisis course, the Charlson comorbidity index, anxiety level (persistent personal and dynamic reactive according to the Spielberger method), the Cumulative Illness Rating Scale (CIRS), life quality SF-36 compared to the pre-war period. 191 respondents filled out a Google questionnaire form that included tests for depression and anxiety, SF-36. Results. The war significantly affected the life quality of Ukrainians with EAH: both the physical and mental health of patients according to the SF-36 test (by 19.65% and 23.01%), as well as social activity (by 19.71%) worsened. The frequency of EAH exacerbations and crisis course against the background of military aggression increased 2.25 times (x2=14.25 p&lt;0.001 and (x2=4.42; p=0.035), as well as the reactive and personal anxiety levels – by 13.37% (p=0.002) and 19.80% (p=0.042), respectively; 29% of respondents show symptoms of moderate, severe and very severe depression (PHQ-9); 37% had generalized anxiety disorder (GAD-7).Conclusion. The war in Ukraine affected the well-being of the general population: the frequency of persons with moderate and significant deterioration of health (according to SF-36) increased by 18%, as well as the number of those with symptoms of moderate and severe depression and anxiety disorders; the frequency of the EAH crisis course increased by 10%.

Epidemiology and diagnosis of primary aldosteronism. What have we learned from the SPAIN-ALDO registry?

To summarize the available data on the prevalence, clinical repercussion, and diagnosis of primary aldosteronism (PA) and to discuss the SPAIN-ALDO registry's findings, which is the largest PA patient registry in Spain. A comprehensive review of the literature focused on the prevalence, clinical presentation and diagnosis of PA was performed. PA is the most common cause of secondary arterial hypertension. In addition, PA patients have a higher cardio-metabolic risk than patients with essential arterial hypertension matched by age, sex, and blood pressure levels. However, despite its high prevalence and associated metabolic and cardiovascular complications, PA remains largely under-recognized, with less than 2% of people in at-risk populations ever tested. The diagnostic investigation is a multistep process, including screening, confirmatory testing, and subtype differentiation of unilateral from bilateral PA forms. Data from the SPAIN-ALDO registry have shed light on the cardiometabolic impact of PA and about the limitations in the PA diagnosis of these patients in Spain. The most common cause of secondary hypertension is PA. One of the most challenging aspects of the diagnosis is the differentiation between unilateral and bilateral PA because adrenal venous sampling is a difficult procedure that should be performed in experienced centers. Data from the SPAIN-ALDO registry have provided important information on the nationwide management of this pathology.

Study of indicators of arterial stiffness in young people depending on ‘classical’ and ‘modern’ risk factors

Objective. To identify ‘classical’ and ‘modern’ risk factors (RFs) in young people aged 18–25 years in a student environment and evaluate their impact on arterial wall stiffness using non-invasive examination methods.Materials and methods. 171 students of a humanitarian university aged 18–25 years old were examined, of which 52.1 % were girls and 47.9 % were boys. An anonymous survey was conducted to identify the main risk factors. The method of volumetric sphygmography and highly sensitive compression oscillometry was used to assess the state of the vascular wall.Results. Against the background of ‘classic’ risk factors (low physical activity – 61.9 %, essential arterial hypertension [AH] – 29.8 %, aggravated heredity for hypertension – 18.3 %, overweight – 14.0 %, obesity – 8.5 %, cigarette smoking – 3.0 %), ‘modern’ RFs were identified: a combination of hookah and cigarette smoking – 31.0 %, use of electronic cigarettes – 17.0 %, use of energy drinks – 25.3 %. In students with the presence of ‘modern’ PR, the values of pulse wave velocity (PWV) were obtained – 8.4 ± 2.7 m/s, relative to the PWV of students without PR 5.1 ± 0.6 m/s (p = 0.002). It was found that the relative risk of an increase in PWV with the combined use of hookah and cigarettes increases by 52.1 times (95 % CI: 11.2–242.1 at χ2 = 37.987; p = 0.001), with the use of energy drinks by 27.4 times (95 % CI: 6.8–111.0 at χ2 = 29.328; p = 0.001), when using electronic cigarettes by 2.6 times (95 % CI: 1.3–5.2 at χ2 = 6.496; p = 0.011).Conclusions. Students aged 18–25 years showed a high adherence to modern risk factors (a combination of hookah and cigarette smoking, energy drinks, use of electronic cigarettes) that lead to a violation of the elastic properties of the vascular wall, which indicates endothelial dysfunction.

Resistance training reduces platelet activation in hypertensive women: the role of purinergic signaling.

Essential arterial hypertension is a risk factor for stroke, myocardial infarction, heart failure, and arterial aneurysm, which are related to the activation of platelets. Purinergic signaling has a central role in platelet aggregation. Although ATP and ADP can act as a proaggregant agent, adenosine inhibits platelet aggregation and reduces vascular injury. Physical exercise exhibits antiaggregant properties and can modulate purinergic system. The aim of this study was to evaluate the effect of 6 months of resistance training on purinergic system components in platelets and on platelet activation, hemodynamic and anthropometric parameters in hypertensive woman. A total of 31 hypertensive and 28 normotensive middle-aged sedentary women were submitted to 6 months of resistance training. Purinergic enzymes activities were assessed in platelets; ATP and Tromboxane B2 (TXB2) levels were measured in serum. Blood pressure (BP), BMI, and body fat were also measured. All variables were statistically analyzed, considering P value less than 0.05. Six months of resistance training was able to significantly reduce BP, ATP, and TXB2 levels as well as NTPDase, ecto-5'nucleotidase, and ADA activities in hypertensive group. After 6 months of resistance training, purinergic system components and TXB2 of hypertensive group were similar to normotensive group in platelets, demonstrating that resistance training was able to modulate platelet activation. A positive correlation was found between BP, enzyme activities, and levels of ATP and TXB2. Our findings demonstrated the relationship between purinergic signaling and platelet activation in hypertension and suggests that resistance training serve as tool to reduce platelet aggregation in hypertensive woman by modulating purinergic system.

CORRELATION OF ECHOCARDIOGRAPHIC INDICATORS AND CLINICAL-LABORATORY PARAMETERS TAKING INTO ACCOUNT THE AGT GENE (RS4762) IN PATIENTS WITH ARTERIAL HYPERTENSION

The аim of the research – to assess the relationship between echocardiographic indices and clinical- laboratory parameters, taking into account genetic markers AGT (rs4762) in patients with essential arterial hypertension (EAH).&#x0D;  &#x0D; Material and methods. The case-control study involved 100 patients with EAH stage II, 1-3 degrees of blood pressure (BP) increase, high and very high cardiovascular risk. Among the patients there were 21 % men, 79 % women. The middle age of the patients was 59.86±6.22y.o. The control group consisted of 60 practically healthy individuals, relevant in age (49.13±6.28y.o.) and gender distribution (63 % – women, 37 % – men). To study polymorphism of AGT (rs4762) and GNB3 (rs5443) genes a qualitative polymerase chain reaction (PCR) was performed in real time. The lipidogram indices were investigated in the blood plasma using diagnostic kits «Accent 200» firm (Poland). All patients were tested for levels of fasting glucose, ionized calcium, parathyroid hormone (PTH), 25-hydroxyvitamin D. The patients were performed echocardiography to determine the left ventricle hypertrophy. Results. The structural parameters of the myocardium, which determine the size of the LVH and the type of its geometric model, in patients with essential arterial hypertension (EAH) are influenced by the following indicators with a moderate strength of connection: concentric hypertrophy (CH LV) develops at a low level of high-density lipoprotein cholesterol (LPHD) (r= –0.59; р=0.008), ionized blood Ca2+ (r= –0.50; р=0.03) and increased PTH content (r=0.40; р=0.05) and high EchoCG indicators: increase in the size of the left atrium (LA), posterior wall thickness (PWT), interventricular septum in diastole (IVSd), left ventricle mass (LVM), left ventricular mass index (LVMI) and the relative left ventricular wall thickness (RWT) (r=0.47-0.65; p≤0.04-0.002). Conclusions. Structural and functional changes of the myocardium are correlated with a number of clinical, anthropometric, metabolic indicators and depend on polymorphic variants of the AGT gene (rs4762).

Gender peculiarities of blood pressure changes in patients with arterial hypertension and different biorhythms

Background. It is known that the risk of cardiovascular diseases, especially in conditions of increased rhythm of life, psycho-emotional stress, social cataclysms, is associated with various biorhythms, therefore, the study of the influence of various factors on the course of hypertension, taking into account the patient's chronotype, remains relevant. Aim of the study was to analyze the level of blood pressure in patients with arterial hypertension with different chronotypes of the female and male genders. Materials &amp; Methods. The study included 42 patients with diagnosed essential arterial hypertension who were receiving inpatient treatment. The inclusion criterion was patients with arterial hypertension of the 2nd degree. Measurements of Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) (mmHg) were performed using the Korotkoff method. To study the chronotype, we used the validated questionnaire "Composite Scale of Morningness" and scales from official available sources. Results &amp; Conclusions. Arterial hypertension was diagnosed in 33.33% of patients with the evening chronotype, 7.17% with the morning chronotype, and 59.53% with the intermediate chronotype. Taking into account gender, female patients with evening and morning chronotypes and male patients with an intermediate chronotype predominated. Patients with evening chronotype compared to patients with intermediate and morning chronotypes had significantly higher Body Mass Index (BMI) (by 62.69% and 40.33%), disease duration (by 42.68% and 6.23%) and SBP (by 8.21% and 12.21%), respectively. At the same time, BMI in patients with arterial hypertension with an evening chronotype was as close as possible to obesity. The obtained results can be used in the practical work of nurses for the prevention of arterial hypertension by adjusting the duration of sleep and wakefulness and the diet. Keywords: chronotype, gender, age, body mass index, relationships.

Working conditions and the prevalence of chronic non-communicable diseases among workers in the production of polyacrylonitrile fibers

Introduction. Ensuring safe working conditions and preventing health problems in the workplace is a priority measure for maintaining health and extending the working life of the working population.&#x0D; Materials and methods. The working conditions and chronic non-infectious morbidity (primary, accumulated) of workers in the production of polyacrylonitrile (PAN) fibers were studied according to the data of in-depth medical examinations (2017–2021).&#x0D; Results. Workers of modern production of PAN fibers in the course of their work were shown to be exposed to the combined effects of a complex of chemicals of 1–4 hazard classes, industrial noise, severity and labour intensity, which form an occupational health risk, assessed by hygienic criteria in categories from small (class 3.1) to high (class 3.3). The first ranking places in the nosological structure of accumulated chronic non-infectious morbidity of workers were occupied by dorsalgia (24.23%), essential (primary) arterial hypertension (14.67%), obesity (9.9%) and presbyopia (8.87%). Positive associations of weak age strength with arterial hypertension, obesity, and presbyopia were revealed (Rxy=0.280, Rxy=0.121, Rxy=0.133, respectively). Work experience had a weak positive relationship with the prevalence of presbyopia (Rxy=0.239). A causal relationship was established between a moderate degree of diseases of the musculoskeletal system and connective tissue (dorsalgia, the severity of the labour process (RR=1.893; EF=47.183%; CI=1.192–3.007), a relationship between a small degree of diseases of the eye and its adnexa with exposure acrylonitrile and methyl acrylate (RR=1.46; EF=31.522%; CI=1.970–1.082), which made it possible to attribute these pathologies to work-related diseases.&#x0D; Limitations determined by the study of the subject of research in the production of polyacrylonitrile fibers of one enterprise.&#x0D; Conclusion. Despite the modernization that has taken place in the chemical industry, working conditions in the modern production of PAN fibers continue to be harmful, presenting an occupational risk for the development of chronic non-communicable diseases in workers, which determines the relevance of developing evidence-based measures for their prevention.

DO GENES AFFECT METABOLIC AND HORMONAL PARAMETERS IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION?

Objective: The aim of the study was to analyze metabolic and hormonal parameters changes in patients with essential arterial hypertension (EAH) depending on the vitamin D receptor gene (VDR, rs2228570) polymorphism. Design and method: The study involved 100 patients suffering from EAH with target-organ damaging, moderate, high or very high cardiovascular risk. Among them were 79.0% (79) women and 21.0% (21) men, an average age was 59.87±8.02 yo. The control group involved 60 practically healthy persons, matched by age and gender distribution. All enrolled/screened patients signed the Informed Consent to participate in the research. The VDR gene (rs2228570) polymorphism was studied by a real-time polymerase chain reaction (RT-PCR) method. The intact parathyroid hormone (intact PTH) and vitamin 25 (OH) D levels in blood serum were determined by chemiluminescence immunoassay (MAGLUMI). Results: The decreased level of vitamin 25 (OH) D (&lt;30 ng/ml) was found more often in the A-allele carriers of the VDR gene (rs2228570), than in GG-genotype carriers: in the control group - by 36.84% (x2 = 10.32; p = 0.001), in study group - by 42.42% (x2 = 39.27; p&lt;0.001). Hypocalcemia according to the level of ionized blood calcium (Ca2+ &lt;1.12 mmol/l) was registered only in G-allele carriers, both among practically healthy and hypertensive patients. In the control group, GG-genotype carriers had a lower ionized Ca2+ blood level with a compensatory higher concentration of the intact PTH in comparison with A-allele carriers - by 3.42%, 25.19% and 16.03% (p&lt;0.05), respectively. Secondary hyperparathyroidism due to a compensatory increasing of the intact PTH (&gt;65 pg/ml) was found more often in the G-allele carriers of the VDR gene (rs2228570) than in AA-genotype carriers: in control group - by 55.55% (x2 = 11.11; p&lt;0.001), and in the group of patients with EAH - by 62.5% (x2 = 12.5; p&lt;0.001). Conclusions: The GG-genotype of the VDR gene (rs2228570) increases the risk of hypocalcemia by more than 6 times [OR = 6.25; 95% CI: 1.05-37.37; p = 0.046], with the lowest probability in carriers of the A-allele [OR = 0.16; 95% CI: 0.03-0.96].