Formation Of Arterial Hypertension Research Articles

Participation of Leptin and Corticosterone in the Decrease in Infarct-Limiting Efficiency of Remote Postconditioning and in the Development of Arterial Hypertension in Metabolic Syndrome in Rats

We studied the effect of induced metabolic syndrome (MetS) on the effectiveness of the infarct-limiting effect of remote ischemic postconditioning (RP) in Wistar rats. The involvement of leptin and corticosterone in the formation of arterial hypertension (AH) and in reduction of the effectiveness of RP in MetS was also studied. MetS was induced by high-carbohydrate high-fat diet with replacement of drinking water with 20% fructose solution for 90 days. MetS simulation led to obesity, AH, impaired lipid and carbohydrate metabolism, hyperleptinemia, and moderate stress. All animals were subjected to 45-min coronary occlusion and 120-min reperfusion. In the RP groups, tourniquets were applied on the hind limbs in the area of the hip joint immediately after the end of ischemia (3 cycles consisting of 5-min ischemia and 5-min reperfusion). A direct correlation was found between the severity of AH in rats with MetS and the levels of corticosterone and leptin. In rats with MetS, the effectiveness of RP decreased: a direct correlation between the infarct size and serum content of leptin was revealed in rats with MetS+RP. Corticosterone seems to be one of the factors of AH development in rats with MetS.

The role of gene-gene and gene-environmental interactions of polymorphic matrix metalloproteinases loci in the formation of the risk of stroke in men with hypertension

Analysis of the role of genetic polymorphisms of matrix metalloproteinases (MMPs), their gene-gene and gene-environment interactions in the formation of ischemic stroke in men with arterial hypertension (AI). The study included 523 men with arterial hypertension: 201 patients with ischemic stroke and 322 patients without stroke. The association of MMPs loci with stroke with hypertension was determined by logistic regression analysis in dominant, recessive, additive genetic models in PLINK v.2.050. For five SNPs co-located on chromosome 11 (314.3 kb), haplotypic analysis was performed, the relationship of haplotypes with stroke development was determined by the EM algorithm. Gene-gene and gene-environment interactions of MMPs with smoking and alcohol consumption during stroke development were evaluated by GMDR (Generalized Multifactor Dimensionality Reduction) using GMDR v.0.9 software. Polymorphic locus rs3025058 is associated with stroke in men in dominant and additive genetic models (OR=0.63-0.74, pperm=0.03). Four haplotypes of MMPs have a protective effect on the development of stroke with hypertension (OR=0.48-0.50, pperm=0.02-0.03). Four models of gene-gene interactions of polymorphic MMPs loci (OR=2.19-2.55, pperm<0.001) and three four-factor models of gene-environment interactions of MMPs with alcohol abuse (OR=2.82-3.11, pperm<0.001) are associated with a high risk of ischemic stroke in men with hypertension. rs3025058, rs1320632, rs11225395 and rs1799750 demonstrate the greatest contribution to gene-gene and gene-environment interactions in the formation of AI. Thus, the results of the study indicate that the interactions of MMPs genes with each other and with modifiable environmental factors play a significant role in the development of stroke with hypertension in men.

The study of systemic hemodynamics by the method of volumetric compression oscillometry in young people

Aim. To investigate the state of systemic hemodynamics (SHD) in young people to assess the potential impact of its disorders in the formation of arterial hypertension (AH) and to carry out preventive measures.Methods. A random sample of 91 young people from 17 to 25 years old was examined; 27 of them were men (average age 23.7±1.6 years) and 64 women (average age 20.4±1.1 years). The study involved clinical residents and students who, according to preliminary and periodic medical examinations, excluded the presence of cardiovascular diseases. The indicators of SHD were investigated by the method of volumetric compression oscillometry using a portable automated software and hardware complex for non-invasive research of central hemodynamics (Device “CAP TsG osm-“Globus”).Results. AH was detected in 4.4%; “white coat” AH in 8.79%; arterial hypotension – in 5.49%. In individuals with normal blood pressure (BP) (75 people), an increase in specific peripheral vascular resistance was most often revealed in 30.6%. An unchanged hemodynamic profile in the group with a normal BP level was recorded only in 28.0% of the examinees.Conclusion. The obtained results indicate that even among “healthy” young people aged 18- 25 years with a normal BP level, the proportion of people with impaired SHD values is 72%. People with hypertension and with altered SHD indicators should be included in the regular medical check-up observation group.

Value of psychological adaptation of labor-intensive underground workers in formation of arterial hypertension regarding age aspect

Objective. To study the prerequisites for the development of hypertension based on the manifestation of psychovegetative dysfunction and some changes in the biochemical and functional parameters of CVS in the age aspect. Psychological adaptation of a group of underground miners in conditions of intensive labor was analyzed on the basis of indicators of psycho-vegetative status taking into account the influence of professional and psychosocial factors. In connection with the established diagnosis i.e. arterial hypertension (AH) syndrome, especially in middle-aged persons, it is of interest to study the indicators of psycho-vegetative status in the age aspect and to compare them with some changes in biochemical and functional state of cardiovascular system (CVS) in this contingent of patients.&#x0D; Materials and methods. The results of the study of psycho-vegetative status of 60 underground miners with AH syndrome (age 46.8 2.0 years, experience 22.0 2.4 years) using the method of psychophysiological testing as well as analysis of some clinical, functional and laboratory parameters are presented.&#x0D; Results. The adaptive psycho-vegetative phenotypes in a group of underground workers with AH syndrome in the age aspect were identified.&#x0D; Conclusions. With an increase in the length of service among labor-intensive workers, the characteristics of psycho-vegetative status change qualitatively in the form of elevated anxiety and neuro-psychical stress with a decrease in the function of attention combined with a negative relationship of these parameters with increasing age, that is accompanied by dysfunction of CVS; studying of this aspect allows identifying the prerequisites for the development of hypertension so as to form a risk group in time.

Characteristics of calcium homeostasis in patients with different degrees of arterial hypertension

Background: Calcium is the most common cation in the human body. An abnormal distribution of intracellular and extracellular ionized Ca plays a significant role in the formation of arterial hypertension. The purpose of the study is to analyze the fractional composition of calcium in blood serum and urinary calcium excretion in patients with hypertension, as well as to identify the features of the distribution of these. Material and methods: The study included 80 patients. The population of the study consisted of 60 patients with various degrees of hypertension (38 women and 22 men) aged from 65 to 74 years old and the control group composed of 20 patients (12 men and 8 women) in the same age group without signs of hypertension. The patients with clinically expressed coronary heart disease requiring specific therapy, heart defects, impaired liver function and impaired kidney function were excluded from this study. Patients were divided into three groups, according to the World Health Organization (WHO) classification of arterial hypertension. Indicators of calcium concentration in blood and urine were determined using test kits for determining calcium with glyoxal bis-2 hydroxyanil from LACHEMA. To determine the ionized calcium, a standard technique of ion-selective electrode was used. Results and conclusion: In patients with arterial hypertension, a redistribution of the calcium pool in the blood is noted due to a decrease in the concentration of ionized calcium and an increase in the bound calcium, depending on the severity of the disease. An increase in urinary calcium excretion in patients with arterial hypertension is characteristic of moderate and severe forms of arterial hypertension, which given the age of patients, may be one of the causes of osteoporosis. The increase in the level of intracellular calcium with the progression of arterial hypertension is an example of pathophysiological reactions that occur at the body level, the result of which can be not only banal muscle constriction but also a violation of the synthesis and production of biologically active substances that regulate blood pressure.

Some relationships in the formation of arterial hypertension in patients with chronic obstructive pulmonarydiseases and influence of calcium antogonists at this process

Intracardiac and central hemodynamics, interleukins, nitric oxide levels and nitric oxide synthase, endothelin-1 were studied. We observed 63 patients with chronic obstructive pulmonary disease with hypertension who received combination therapy with pentoxifylline, of whom 32 patients (main group) included felodipine in addition to this therapy. After treatment, there was a decrease of pressure in pulmonary artery and main vessels, which was accompanied by improvement of clinical manifestations of the disease, hemodynamics, increased activity of nitric oxide synthase and reduction of endothelin-1, interleukin-1β, interleukin-6 and tumor necrosis factor. Positive clinical laboratory dynamics were more pronounced in the main observation group than in the comparison one. Keywords: chronic obstructive pulmonary disease, arterial hypertension, endothelial dysfunction, pentoxifylline and felodipine.

Marker profile of myocardial remodeling in different etiopathogenetic forms of arterial hypertension in the experiment

The aim was to determine the morphodensitometric parameters of cardiomyocytes and features of the marker profile of remodeling in the left ventricular myocardium of rats with experimental hypertension of different etiopathogenetic forms.Materials and methods. The experiment was conducted on 20 male Wistar rats and 10 SHR which were divided into two groups of 10 animals each: the 1st –control; the 2nd – rats of the SHR line (EAH); the 3rd – 10 male Wistar rats with endocrine-salt arterial hypertension. Systolic and diastolic BP levels were measured in all the rats using the system of non-invasive arterial pressure measurement BP-2000. The objects of the study were myocardial sections in which the content of immunoreactive material to remodeling markers (cardiotrophin-1, titin, collagen type I, annexin V) was determined by the immunofluorescent method, titin / collagen ratio was calculated, the average linear size of cardiomyocyte nuclei, their density, RNA concentrations in the nucleus and cytoplasm were determined by morphodensitometric method.Results. Arterial hypertension, regardless of its etiopathogenetic form, is characterized by an increase in the number of cardiomyocyte nuclei with an increase in their size, decrease in the density and decrease in their RNA concentration against increase in the cytoplasm. In rats with EAH, the content of cardiotrophin-1 was higher than the control by 27 %, and in ESAH by 80 %. Titin levels were 12% higher in EAH and 46 % in ESAH. The collagen type I content of EAH was higher than the control by 49 %, while in the group with ESAH by 68 %. EAH rats had a higher annexin V content by 58 %, while ESAH – 64 %. The ratio of the content of titin and type I collagen in control rats was 1.01, in rats with EAH decreased to 0.76, while in rats ESAH it was 1.3.Conclusions. The formation of arterial hypertension, regardless of its etiopathogenetic form, leads to the development of pathological myocardial remodeling, as indicated by increased heart mass and specific gravity, changes in the cytoarchitectonics of cardiomyocytes, the development of polymorphism of their nuclei with increasing size against increasing of its number with nuclear dysfunction. The marker profile of myocardial remodeling in rats with essential hypertension is characterized by a moderate increase in cardiotrophin-1 and titin, with a significant increase in collagen type I and annexin V, which in combination with a low ratio of titin / collagen type indicates fibrosis with increased myocardial stiffness and the development of hypertrophic-fibrous type of myocardial remodeling with moderate apoptosis. In rats with endocrine-salt arterial hypertension, the marker profile of myocardial remodeling is characterized by a significant increase in all 4 immunohistochemical markers of remodeling, moderate fibrosis and an increase in the titin / collagen ratio, which is characteristic of hypertrophic-apoptotic type of pathological remodeling.

Methods of Physiotherapy in the Medical Rehabilitation of Children with Primary Arterial Hypertension

Introduction. Arterial hypertension (AH) is a widely occurring disease of the cardiovascular system in the children’s population, which often debuts in childhood, persists into adulthood, which dictates the need for early treatment and prevention of arterial hypertension. The formation of AH is associated with maladaptation of physiological mechanisms of self-regulation, with a complex interaction of psychosocial and genetic factors. The use of non-medicinal agents to reduce blood pressure is a starting approach in the treatment of children and adolescents with hypertension and complements medication therapy. Purpose. analysis of literature sources on the effectiveness of hardware physiotherapy methods in the treatment of hypertension in children. Discussion. In the treatment of children with hypertension, the leading role belongs to hardware physiotherapy technologies. Widely used sedative, hypotensive and vegetative-corrective methods are pathogenetically justified and can be used at all stages of arterial hypertension development. Transcranial pulsed electrotherapy (transcranial electrostimulation, electroson, infitotherapy), darsonvalization, aromafitotherapy and medicinal electrophoresis of sedatives belong sedative methods aimed at enhancing inhibitory processes in the Central nervous system. Amplipulster therapy, intermittent normobaric hypoxytherapy, low-intensity magnetic therapy, medicinal electrophoresis of spasmolytic drugs, EHF therapy, laser therapy, which lead to a decrease in arterial hypertension and improve microcirculation, are hypotensive methods. Bio-controlled aerionotherapy, aimed at correcting vegetative dysfunction, is a vegetative corrective method. Conclusion. Currently, there is a wide range of scientifically-based methods of hardware physiotherapy used in the medical rehabilitation of children with arterial hypertension, allowing to improve cerebral hemodynamics, normalize neurophysiological and hemodynamic processes in the Central nervous system, provide sedative and hypotensive effects, stimulate peripheral vasodepressor mechanisms, normalize neuroendocrine processes. The use of hardware physiotherapy methods in the complex treatment of hypertension can improve the quality of life of patients, achieve stable normalization of blood pressure, and reduce the risk of early cardiovascular diseases.

Correction of systemic inflammation and endothelial dysfunction in patients with chronic obstructive pulmonary disease in combination with arterial hypertension under the influence of the therapy

One of the main pathogenetic mechanisms combining chronic obstructive pulmonary disease (COPD) and arterial hypertension (AH) is a persistence systemic inflammation leading to the formation of endothelial dysfunction (ED), which serves as an independent predictor of the adverse prognosis of most cardiovascular diseases (CVD), while the treatment of patients with COPD in combination with AH requires the inclusion of drugs that have a beneficial effect on these pathological conditions. Prolonged-release indapamide has a number of pleiotropic effects, but most studies to study its effect on the state of endothelium and the intensity of systemic inflammation were conducted in patients with AH without associated bronchial obstructive diseases. The works carried out in conditions of comorbidity with COPD and according to the data of which the influence of diuretic drugs on the markers of systemic inflammation and ET in patients would be evaluated, were not found out, in this connection the present research was initiated and carried out. The aim of the study was to evaluate the dynamics of markers of systemic inflammation and ET in the inclusion of diuretics in the complex therapy of patients with COPD in combination with BA. Materials. Patients (n = 65: 50 men and 15 women) with stage I – IV COPD suffering from arterial hypertension (AH) I – III with initially elevated levels of systemic inflammation markers and ET, in whom the antihypertensive therapy performed was not effective enough, were included in the study. Results. The results of the research on estimation of dynamics of markers of system inflammation – highly sensitive C-reactive protein (hsСRP), an intercellular adhesion molecule of type 1 (sICAM-1) and ET – endothelin-1, sP-selectin at the inclusion of diuretics in the therapy of patients with COPD with AH are presented. When analyzing the dynamics of the studied markers, a decrease in their level was noted, but statistically significant changes were obtained only in patients against the background of prolonged-release indapamide treatment. Additional pleiotropic effects of indapamide, consisting in reduction of activity of markers of systemic inflammation and ET, are also shown. Its high efficiency in achieving and maintaining the target AH levels compared to hydrochlorothiazide has been demonstrated. Conclusion. The expediency of the inclusion of prolonged-release indapamide in the complex therapy of patients with COPD in combination with AH on the first line of antihypertensive therapy has been demonstrated due to its additional pleiotropic properties, which consist in the influence on the general pathogenetic links of the formation and progression of AH in COPD and its high antihypertensive efficiency in comparison with hydrochlorothiazide.

4-9FEATURES OF HOMOCYSTEINE LEVEL AND A POTENTIAL WAY OF IT'S CORRECTION IN HYPERTENSIVE PATIENTS

Background: Arterial hypertension (AH) is one of the most wide-spread cardiovascular pathology all over the world. Initiation and progression of AH are linked to many potentially modified metabolic factors, for example-hyperhomocysteinemia. Despite the fact that diagnostics, treatment and prevention of AH is evident, key risk factors correction are still concealed at present. Aim: To study the features of serum HH in hypertensive patients and optimize treatment strategy. Methods: According to the aim of our investigation, we examined 74 high cardiovascular risk level hypertensive patients (before and after 12-weeks of atorvastatin 20 mg per day oral administration based on their standard hypotensive treatment) and 68 healthy volunteers (equivalent with group of observation in age and gender representation) with fasting homocysteine plasma level via ELISA. The statistically significance was considered at P &lt; 0,05. Results: It's set that AH is associated with fasting homocysteine plasma concentration 2,22 times more (P &lt; 0,01) opposite to healthy subjects, that was according to mild level of hyperhomocysteinemia. Besides, it was found that additive 12-weeks treatment with atorvastatin (based on specific antihypertensive approaches) leads to clinically significant reduction of homocysteine plasma level by 28,78% (P &lt; 0,05) in the hypertensive patients. Conclusions: HH is stationed as a key metabolic risk factor in way of arterial hypertension's formation and progression over the high cardiovascular risk population. At the same time, specific hypolipidemic and antiatherosclerotic treatment based on regular atorvastatin administration can be counted as an effective way of reducing elevated plasma homocysteine level and shows alternative pleiotropic effect of statins in AH patients.

Врожденный иммунитет у больных эссенциальной артериальной гипертонией и эффективность антигипертензивной фармакотерапии

The purpose of the study was to assess the parameters of innate immunity in patients with essential arterial hypertension and to establish a relationship with the effectiveness of antihypertensive pharmacotherapy. Materials and methods. The study included 48 patients with essential arterial hypertension stage II, arterial hypertension 2 degree and hypertrophy of the left ventricular myocardium, which were divided into 2 groups: the first group (25 patients) - these are patients whose blood pressure reached the target values, and the second group (23 patients) are patients whose blood pressure did not reach the target values against the background of antihypertensive therapy (perindopril - 5 mg/day and amlodipine - 5 mg/day) (group 2). Indicators of 18 healthy donors were used as a comparison group (control group). Results. In patients with essential arterial hypertension of group 1, compared with the control group, the concentration of IL-1α, IL-6, IL-8, IL-10, IL-1 receptor antagonist, IL-2, C4- and C5a-components of the complement system and factor H is significantly higher and the level of C3 is lower-component of the complement system. In patients with essential arterial hypertension of group 2, more pronounced changes in the cytokine link of the immunity and the complement system were established before the start of antihypertensive therapy. After the antihypertensive therapy in patients with essential arterial hypertension of the 1st group in the blood plasma, the concentration of TNF, IL-1α, IL-8, IL-10, IL-1 receptor antagonist significantly decreased, but not to the values of the control group, and in patients of the 2nd group, the effectiveness of antihypertensive therapy in correcting parameters innate immunity was found to be less effective. Conclusion. Revealing the participation of innate immunity indicators in the formation of arterial hypertension opens up new possibilities for the pathogenetic therapy of this disease and developing measures to prevent or level the damage to target organs.

The role of physical factors of the working environment in the formation of arterial hypertension

The influence of noise and vibration on the development of arterial hypertension in workers employed in adverse working conditions was studied. It is shown that these physical factors of the working environment make a significant contribution to the formation of an increased risk of cardiovascular complications

Mechanisms of chronic stress influence on the brain hemodynamic in persons with employment-related chronic stress

To discuss the mechanisms by which chronic psychosocial stress (CPSS) affects the parameters of cerebral blood flow. One hundred and sixty locomotive machinists (LM) and machinist assistants (MA), whose profession is rated as one of the most stressful, were enrolled in this study. The control group consisted of 100 healthy volunteers. The activity of the stressor system was assessed by the levels of stress hormones in serum (ACTH, cortisol, adrenaline). The functional state of the endothelium was assessed by secretion of nitric oxide and endothelin-1. Doppler ultrasound was used to measure the linear velocity of blood flow in the cerebral vessels, the size of the intima-media complex of the common carotid artery, and the results of the endothelium-dependent vasodilation. Blood pressure was monitored daily. The action of CPSS is accompanied by the persistent increase in the serum cortisol levels. This process contributes to the development of vasoconstriction with the initiation of endothelial dysfunction with impaired production of nitric oxide and increased secretion of endothelin-1 and the formation of arterial hypertension. With progression of these processes, there is a decrease in cerebral blood flow. The observed increase in the size of the intima-media complex of the common carotid artery correlates with the severity of arterial hypertension and endothelial dysfunction. CPSS leads to a decrease in cerebral blood flow and subsequent development of endothelial dysfunction and arterial hypertension, which are related to high levels of stress hormones circulating in the blood. These processes lead to functional failure of the vascular endothelium.

Polymorphism of genes of renin-angiotensin-aldosterone system in the development of hypertension in workers exposed to physical factors

Introduction. The problem of reducing the risk of cardiovascular disease among the working population today remains the most urgent. One risk factor for arterial hypertension (AH) is exposure to high levels of noise and vibration in the workplace. Along with occupational risk factors, hereditary predisposition makes a significant contribution to the development of AH. In the pathogenesis of AH, a special role is played by genes that determine the synthesis of angiotensinogen (AGT), angiotensin converting enzyme (ACE), angiotensin receptor type 1 (AGTR1), etc.The aim of the study was to study the polymorphism of genes of the renin-angiotensin-aldosterone system in the development of hypertension in workers exposed to physical factors (noise and vibration) in the workplace.Materials and methods. A survey of 123 men working in «Kolomna plant» (KP), 84 of them-workers who were exposed to physical factors, and 39 people who are not in contact with harmful industrial factors. Th e presence/absence of GD, the age of its beginning, blood pressure, heart rate, the total experience of work on the KP in harmful conditions were assessed on outpatient cards. Molecular genetic studies of polymorphic genes of renin-angiotensin-aldosterone system (ALU Ins/Del of ACE gene, M235T of AGT gene, a1166c of AGTR1 gene) were carried out for all examined patients.Results. The results of correlation analysis showed the presence of a significant (р&lt;0,05) relationship between AH and noise γ=0.42 p=0.0004, total vibration γ=0.57 p=0.002, heating microclimate γ=0.57 p=0.01. The correlation between the presence of polymorphic variant M235T AGT gene and GB γ=0.35 p=0.001, as well as levels of SAD γ=0.28 p=0.00054 and dad γ=0.29 p=0.00053 in the group of workers exposed to noise was revealed. A significantly higher prevalence of the SS genotype of the AGT gene was also found in the group of workers with AH compared to carriers of the TT variant χ2=6.18 p=0.013 and all carriers (SS+ST) of the C allele compared to carriers of the allele T χ2=6.0 p=0.014. An Association between increased SAD and the presence of the ACE gene allele D (Alu Ins/Del) and the AGTR1 gene allele C (A1166C) in individuals exposed to noise and vibration in the workplace was revealed.Conclusions. The obtained results indicate the multifactorial nature of hypertension, the importance of occupational factors in the formation of AH, primarily noise and vibration, and genetic factors: homozygous variant of the CC gene AGT (Met235Th r), the presence of the d allele of the ACE gene (Alu Ins/Del) and the C allele of the AGTR1 gene (A1166C).

Soybean proteins counteract heart remodeling in wistar rats fed a high sodium chloride diet

BACKGROUND. Increased salt intake is associated with a number of cardiovascular events, including increased blood pressure (BP) and the development of left ventricular hypertrophy (LVH). However, there is much evidence that a high content of sodium chloride in the diet does not always lead to an increase in BP, but almost inevitably causes cardiac remodeling, in particular, LVH. Many aspects of myocardial remodeling induced by high sodium content in the food have not been studied enough. THE AIM of the study was to trace the echocardiographic changes in Wistar rats fed the high salt ration and the high salt ration supplemented with soy proteins.MATERIAL AND METHODS. Echocardiography and BP measurements were performed on male Wistar rats, divided into three groups. The first (control; n = 8) included rats that received standard laboratory feed (20.16 % animal protein and 0.34 % NaCl); the second (n = 10) – animals that received standard feed and 8 % NaCl (high salt ration). The third group (n = 10) consisted of rats who consumed a low-protein diet containing 10 % soy protein isolate (SUPRO 760) and 8 % NaCl. The follow-up period was 2 and 4 months.THE RESULTS of the study showed that: (1) the intake of a large amount of salt with a diet does not necessarily lead to the formation of arterial hypertension; (2) despite the absence of a distinct increase in BP, under these conditions signs of cardiac remodeling, in particular, LVH, appear rather quickly; (3) supplementing a high-salt diet with soy isolates counteracts the development of LVH.CONCLUSION. High salt intake with food can cause heart remodeling, regardless of blood pressure, while soy proteins can counteract this process.

Non-drug technologies in the prevention of arterial hypertension in civil aviation dispatchers

Purpose. In recent decades, there has been an increased interest in the study of the prevention of cardiovascular diseases in civil aviation dispatchers, for whom professional stress is one of the leading risk factors in the formation of arterial hypertension in the workplace.&#x0D; Material and methods. The article presents the survey data of 120 civil aviation dispatchers, who, in order to reduce the prevention of the development of arterial hypertension, underwent a complex of combined color-light-and psycho-correctional music therapy.&#x0D; Conclusion. As a result of the study, it was proved that the combined color-light therapy technology and psycho-correctional music therapy have a pronounced vasocorrecting effect, which is confirmed by a decrease in systolic and diastolic pressure and heart rate to the level of healthy individuals in the studied contingent of air traffic controllers.

Моделювання артеріальної гіпертензії шляхом тривалого сольового навантаження. Моніторинг функціонування серцево-судинної системи та динаміки інтегральних показників життєдіяльності в щурів (частина II)

Запропоновано нову модель артеріальної гіпертензії (АГ), індуковану тривалим сольовим навантаженням. Розробка такої моделі базується на ролі натрію хлориду у функціонуванні життєво важливих органів і систем, у генезі АГ та її судинних порушень. Недостатня вивченість механізмів розвитку сольової АГ, фазності та тривалості патологічного стану за умов продовження сольового навантаження на тривалий час (до декількох місяців), особливостей дії різних лікарських засобів на тлі підвищеного споживання солі, стану серцево-судинної системи та інтегральних показників життєдіяльності зумовили мету дослідження. Мета дослідження – вивчити стан серцево-судинної системи та динаміку інтегральних показників життєдіяльності в білих щурів за формування АГ шляхом тривалого сольового навантаження. Формування нової моделі АГ забезпечувалося сольовим навантаженням щурів упродовж 81 доби за умов заміни води на 1 % розчин натрію хлориду з вільним доступом тварин до пиття. За проведення динамічних досліджень встановлено, що модель АГ характеризується суттєвим підвищенням артеріального тиску на 10–18 % у самиць і на 14–36 % у самців, про що свідчать зміни зазначеного показника в різні терміни від початку до 81 доби сольового навантаження. Значне зростання артеріального тиску спостерігалося в 54,5–66,6 % тварин упродовж 60 діб від початку сольового навантаження, водночас кількість тварин з підвищеним артеріальним тиском знижувалася до 23,6 % через 81 добу від початку сольового навантаження. Продовження сольового навантаження понад 21 добу характеризувалося розвитком брадикардії. Збільшення терміну сольового навантаження в щурів не призводило до суттєвої зміни інтегральних показників життєдіяльності різних органів і систем, патологічної зміни маси тіла тварин і коефіцієнтів маси внутрішніх органів, у тому числі тимуса. За формування АГ на 18–30 % знижувалася больова чутливість у щурів і спостерігався набряк кінцівок (суглобів і м’яких тканин стоп), що зростав з тривалістю сольового навантаження й перевищував значення в інтактних тварин понад 21 % через 81 добу від початку формування моделі АГ. Запропонована модель АГ відрізняється простотою формування, економічністю, досягненням відповідного ефекту в значної кількості щурів різної статі, можливістю відбору тварин з підвищеним артеріальним тиском на будь-якому етапі формування патологічного процесу, можливістю їхнього утримання за звичайних лабораторних умов, відсутністю загибелі тварин. Формування моделі АГ шляхом тривалого сольового навантаження не потребує спеціальної підготовки фахівців. Модель АГ за тривалого сольового навантаження пропонується для дослідження специфічної фармакологічної ефективності (гіпотензивної дії) і безпечності новосинтезованих сполук і відомих ліків за умов їхнього тривалого застосування.

P3560Prospects for the use of integrated assessment of gene-candidates polymorphisms in the management of arterial hypertension: let's start

Abstract Nowadays a large amount of data about the frequency of gene-candidates polymorphisms occurrence in patients with arterial hypertension (AH) have been accumulated. The using of single polymorphisms for diagnostic and prognostic purposes appeared to be not perspective. However multiple accumulation of gene-candidates polymorphisms in person is realized mostly in formation of AH. The purpose of the research was to compare the proportion of modified gene-candidates in a group of hypertensive patients with a similar group of non-hypertensive patients using the gene modification index (GMI) calculation for possible using in diagnostic and prevention of AH. Methods 180 patients with AH (age 54,2 [43–75], male/female 86/94) and 82 non-hypertensive patients (age 52,6 [42–71], male/female 38/44) were examined (ESC/ISH 2018). For comparative significance in the conducted research the patients under 40 years old were not included. Patients of both groups were perfomed the analysis of polymorphisms of the following candidate genes by PCR: ADD1:1378, AGT: 704, AGT: 521, AGTR1:1166, AGTR2: 1675, CYP11B2:-344, GNB3:825, NOS3:-786, NOS3:894. Then the GMI was formed where the proportion of “pathological” homozygous polymorphism of one gene was 1.5 points, the heterozygous polymorphism – 1 point, “normal” genotype – 0 points. Then points were summed up and formed the GMI as proportion of the “pathological” genotypes, expressed as a percentage. GMI is calculated by the formula: GMI = (N/13,5) × 100, where N is the sum of points of present genetic polymorphisms; N = n1 + n2 + n3 + n4 + n5 + n6 + n7 + n8 + n9; 13,5 – the maximum number of points of present genetic polymorphisms. The GMI from 0 to 20% was considered as low genetic risk, from 21 to 40% – moderate risk, from 41 to 70% – high risk, from 71 to 100% – very high risk. Results In hypertensive patients the low genetic risk was in 5% of cases, in the group of non-hypertensive patients - in 85.4% (p=0.0001); moderate genetic risk was observed in 22.2% of patients with AH and in 13.4% patients without AH (p=0.14); 52.2% of hypertensive patients and 1.2% of non-hypertensive patients had a high genetic risk (p=0.0001); a very high risk was in 20.6% of patients with AH and was absent in patients without AH (p=0.0001). The average mean of GMI in the group with AH was 64.2% [CI 95%, 30–78], in the group of non-hypertensive patients - 22% [CI 95%, 5–30], (p=0.0001). At the same time in GMI less than 25% there was no case of the presence of AH. Conclusions In the conducted research the representative data was obtained: the proportion of the modified gene-candidates significantly exceeded the proportion of the modified genes in non-hypertensive patients. It demonstratively shows the perspectivity of GMI using in the diagnostic and preventive management of patients with AH. GMI up to 25% mostly is not phenotypically realized and the probability of hypertension developing in these patients is extremely low.

The Role of Genetic Polymorphism in the Formation of Arterial Hypertension, Type 2 Diabetes and their Comorbidity.

Hereditary component plays a significant role in the formation of insulin resistance (IR) - one of the pathogenetic links of arterial hypertension (AH) and type 2 diabetes mellitus (DM2). However, the genetic predisposition to IR can not be realized and does not manifest itself clinically in the absence of appropriate factors of the environment (excessive nutrition, low physical activity, etc.). The review summarizes the results of studies which describe the contribution of genetic polymorphism to the formation and progression of AH, DM2 and their comorbidity in various populations. In many studies, it has been established that genetic polymorphism of candidate genes is influenced by the formation, course and complication of AH and DM2. According to research data, the modulating effect of polymorphism of some genetic markers of AH and DM2 on metabolism and hemodynamics has been established. The results of numerous studies have shown a higher frequency of occurrence of AH and DM2, as well as their more severe course with adverse genetic polymorphisms. At the same time, the role of genetic polymorphism in the formation of AH and DM2 differs in different populations. Contradictory data on the influence of gene polymorphisms on the formation of AH and DM2 in different populations, as well as a small number of studies on the combined effects of several polymorphisms on the formation of comorbidity, determine the continuation of research in this direction.

АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ В ПОСТМЕНОПАУЗЕ - КОРРЕЛЯЦИОННЫЕ ПАРАЛЛЕЛИ

Arterial hypertension is probably one of the most widespread diseases. According to statistics, the prevalence of AH at the age of 45–54 years among women is 58%, and at the age of 55–64 years it increases to 74.5%. Given the fact that the antihypertensive drugs are provided in the age group of 55–64 years, the order of 80% provides that the effectiveness of the use of drug therapy is only 30%. It is at this age that the postmenopause period occurs. On average, the duration of postmenopausal varies from 5 to 6 years and can last up to 65–69 years. Compared with men of the same age group, cardiovascular diseases are significantly less frequently affected. The presence of cardinal changes in the mechanism of occurrence and course of the pathology of the cardiovascular system in men and women, primarily due to the general differences and cardioprotective effects of ovarian hormones. It has been established that in the period of postmenopause a significant increase in the frequency of arterial hypertension occurs in women. Hypoestrogenism plays a significant role in the formation of arterial hypertension in this cohort of patients, and this affects the endothelium leading to its dysfunction, and its implementation is carried out through the components of the metabolic syndrome. From an analysis of the literature, it can be seen that the effect of hormone replacement therapy should be positive. Nevertheless, it should be noted that the development of arterial hypertension in postmenopause is a complex and multifaceted process.