Pub Date : 2023-01-16DOI: 10.18705/1607-419x-2023-29-1-14-23
N. Borovkova, V. K. Kurashin, A. Tokareva, K. I. Krisanova, N. N. Savitskaya, N. K. Pershina, E. Makarova, A. A. Nekrasov, M. V. Doyutova, N. Zelyaeva, R. A. Mazhara
Objective. To assess the prevalence of hypertension (HTN) in the population of the Nizhny Novgorod region and its relationship with hyperuricemia (HU) and other cardiovascular risk factors. Design and methods. We examined 2501 people aged 35–74 in the population of the Nizhny Novgorod region, selected by the stratified multi-stage random sample. All respondents underwent a laboratory study of the following parameters: total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins, triglycerides (TG), fasting glucose, creatinine, uric acid, highly sensitive C-reactive protein (Hs-CRP) and fibrinogen. We also calculated body mass index (BMI), visceral obesity index with Amato formula and glomerular filtration rate with CKD-EPI formula. Binary logistic regression method was used to construct a predictive model for the risk of HTN. Statistical analysis was performed with IBM SPSS Statistics 26 software (USA). Results. HU was identified in 29,3 % of respondents with HTN. The mean uric acid level in this group was 345,1 [285,6; 410,55] µmol/l and significantly differed from the same indicator in residents without HTN — 297,5 [249,9; 351,1] µmol/L (p < 0,001). In the multiple logistic regression model, the most significant factors associated with HTN were age over 53 years (odds ratio (OR) 2,954, 95 % confidence interval (CI) 2,456-3,554 p < 0,001), abdominal obesity (OR 2,112, 95 % CI 1,663-2,730, p < 0,001) and HU (OR 1,709, 95 % CI 1,341–2,177, p < 0,001). A lesser contribution was made by such factors as the respondents’ BMI over 25 kg/m2 (OR 1,634, 95 % CI 1,262–2,117, p < 0,001), elevated TG level (OR 1,567, 95 % CI 1,289–1,906, p < 0,001), male gender (OR 1,553, 95 % CI 1,281–1,883, p < 0,001), elevated Hs-CRP (OR 1,498, 95 % CI 1,242–1,806, p < 0,001), elevated LDL (OR 1,277, 95 % CI 1,038–1,570, p = 0,020). Conclusions. The results of the study indicate the widespread prevalence of HU in residents of the Nizhny Novgorod region with HTN: almost every third (29,3 %) had this disorder. In a multiple logistic regression model, HU was found to be highly correlated with HTN (OR 1,709, 95 % CI 1,341–2,177, p < 0,001), along with traditional cardiovascular risk factors such as male gender, age, overweight and obesity, lipid metabolism disorders. The high frequency of HU, its independent correlation with HTN, and the prospects for urate-lowering therapy in the prevention of cardiovascular diseases determine the need for further research.
目标。评估下诺夫哥罗德地区人群高血压(HTN)患病率及其与高尿酸血症(HU)和其他心血管危险因素的关系。设计和方法。我们调查了下诺夫哥罗德地区人口中年龄在35-74岁之间的2501人，这些人是通过分层多阶段随机抽样选择的。所有受访者都接受了以下参数的实验室研究:总胆固醇、低密度脂蛋白(LDL)、高密度脂蛋白、甘油三酯(TG)、空腹血糖、肌酐、尿酸、高敏感c反应蛋白(Hs-CRP)和纤维蛋白原。我们还计算了体重指数(BMI)、内脏肥胖指数(Amato公式)和肾小球滤过率(CKD-EPI公式)。采用二元logistic回归方法构建HTN风险预测模型。采用美国IBM SPSS Statistics 26软件进行统计学分析。结果。在患有HTN的应答者中，有29.3%的人被确定为HU。该组平均尿酸水平为345,1 [285,6;[410,55]µmol/l，与非HTN - 297,5的居民相比差异显著[249,9];351,1]µmol/L (p < 0.01)。在多元logistic回归模型中，与HTN相关的最显著因素是年龄超过53岁(优势比(OR) 2,954, 95%可信区间(CI) 2,456-3,554 p < 0.001)、腹部肥胖(OR 2,112, 95% CI 1,663-2,730, p < 0.001)和HU (OR 1,709, 95% CI 1,341-2,177, p < 0.001)。以下因素的影响较小:被调查者的BMI超过25 kg/m2 (OR 1,634, 95% CI 1,262-2,117, p < 0.001)， TG水平升高(OR 1,567, 95% CI 1,281 - 1,906, p < 0.001)，男性(OR 1,553, 95% CI 1,281-1,883, p < 0.001)， Hs-CRP升高(OR 1,498, 95% CI 1,242-1,806, p < 0.001)， LDL升高(OR 1,277, 95% CI 1,038-1,570, p = 0,020)。结论。研究结果表明，在患有HTN的下诺夫哥罗德地区的居民中，HU普遍存在:几乎每三分之一(29.3%)患有这种疾病。在多元logistic回归模型中，发现HU与HTN高度相关(OR 1,709, 95% CI 1,341-2,177, p < 0.001)，同时与传统的心血管危险因素如男性性别、年龄、超重和肥胖、脂质代谢紊乱等高度相关。HU的高频率、与HTN的独立相关性以及降尿酸治疗在预防心血管疾病中的前景决定了进一步研究的必要性。
{"title":"The problem of hyperuricemia in the hypertensive population of the Nizhny Novgorod region","authors":"N. Borovkova, V. K. Kurashin, A. Tokareva, K. I. Krisanova, N. N. Savitskaya, N. K. Pershina, E. Makarova, A. A. Nekrasov, M. V. Doyutova, N. Zelyaeva, R. A. Mazhara","doi":"10.18705/1607-419x-2023-29-1-14-23","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-1-14-23","url":null,"abstract":"Objective. To assess the prevalence of hypertension (HTN) in the population of the Nizhny Novgorod region and its relationship with hyperuricemia (HU) and other cardiovascular risk factors. Design and methods. We examined 2501 people aged 35–74 in the population of the Nizhny Novgorod region, selected by the stratified multi-stage random sample. All respondents underwent a laboratory study of the following parameters: total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins, triglycerides (TG), fasting glucose, creatinine, uric acid, highly sensitive C-reactive protein (Hs-CRP) and fibrinogen. We also calculated body mass index (BMI), visceral obesity index with Amato formula and glomerular filtration rate with CKD-EPI formula. Binary logistic regression method was used to construct a predictive model for the risk of HTN. Statistical analysis was performed with IBM SPSS Statistics 26 software (USA). Results. HU was identified in 29,3 % of respondents with HTN. The mean uric acid level in this group was 345,1 [285,6; 410,55] µmol/l and significantly differed from the same indicator in residents without HTN — 297,5 [249,9; 351,1] µmol/L (p < 0,001). In the multiple logistic regression model, the most significant factors associated with HTN were age over 53 years (odds ratio (OR) 2,954, 95 % confidence interval (CI) 2,456-3,554 p < 0,001), abdominal obesity (OR 2,112, 95 % CI 1,663-2,730, p < 0,001) and HU (OR 1,709, 95 % CI 1,341–2,177, p < 0,001). A lesser contribution was made by such factors as the respondents’ BMI over 25 kg/m2 (OR 1,634, 95 % CI 1,262–2,117, p < 0,001), elevated TG level (OR 1,567, 95 % CI 1,289–1,906, p < 0,001), male gender (OR 1,553, 95 % CI 1,281–1,883, p < 0,001), elevated Hs-CRP (OR 1,498, 95 % CI 1,242–1,806, p < 0,001), elevated LDL (OR 1,277, 95 % CI 1,038–1,570, p = 0,020). Conclusions. The results of the study indicate the widespread prevalence of HU in residents of the Nizhny Novgorod region with HTN: almost every third (29,3 %) had this disorder. In a multiple logistic regression model, HU was found to be highly correlated with HTN (OR 1,709, 95 % CI 1,341–2,177, p < 0,001), along with traditional cardiovascular risk factors such as male gender, age, overweight and obesity, lipid metabolism disorders. The high frequency of HU, its independent correlation with HTN, and the prospects for urate-lowering therapy in the prevention of cardiovascular diseases determine the need for further research.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83966940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-13DOI: 10.18705/1607-419x-2023-29-1-100-108
S. Goroshchenko, V. Bobinov, N. A. Mamonov, E. G. Kolomin, M. Tastanbekov, K. Samochernykh, A. Petrov, L. Rozhchenko
Giant aneurysms of the vertebrobasilar basin manifesting as brain stem compression are a rare pathology with an incidence ranging from 3 to 13,5 %. Surgery of such aneurysms is often associated with unsatisfactory treatment results due to the high traumatic nature of direct surgery on aneurysms of this region, as well as the close proximity of vital brain structures. Surgical intervention is also hampered by the large volume of the aneurysm, possible presence of thrombus in the sac, frequent absence of the neck, location in the anatomically difficult region, and small volume of the posterior cranial fossa (PCF). The above factors make it difficult to clip the aneurysm and increase the risk of perioperative complications. Endovascular intervention is a method of choice in most cases allowing to switch an aneurysm off the blood flow, however in the presence of mass effect aneurysm occlusion does not always achieve a clinical effect due to the preservation of brain stem compression. The aim of this publication was to demonstrate the possibility of successful combined surgical treatment of a giant aneurysm located in the PCF and accompanied by brain stem compression.
{"title":"Successful combined treatment of a giant aneurysm of the posterior inferior cerebellar artery manifesting by brain stem compression","authors":"S. Goroshchenko, V. Bobinov, N. A. Mamonov, E. G. Kolomin, M. Tastanbekov, K. Samochernykh, A. Petrov, L. Rozhchenko","doi":"10.18705/1607-419x-2023-29-1-100-108","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-1-100-108","url":null,"abstract":"Giant aneurysms of the vertebrobasilar basin manifesting as brain stem compression are a rare pathology with an incidence ranging from 3 to 13,5 %. Surgery of such aneurysms is often associated with unsatisfactory treatment results due to the high traumatic nature of direct surgery on aneurysms of this region, as well as the close proximity of vital brain structures. Surgical intervention is also hampered by the large volume of the aneurysm, possible presence of thrombus in the sac, frequent absence of the neck, location in the anatomically difficult region, and small volume of the posterior cranial fossa (PCF). The above factors make it difficult to clip the aneurysm and increase the risk of perioperative complications. Endovascular intervention is a method of choice in most cases allowing to switch an aneurysm off the blood flow, however in the presence of mass effect aneurysm occlusion does not always achieve a clinical effect due to the preservation of brain stem compression. The aim of this publication was to demonstrate the possibility of successful combined surgical treatment of a giant aneurysm located in the PCF and accompanied by brain stem compression.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74213109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-10DOI: 10.18705/1607-419x-2023-29-1-24-37
L. I. Malinova, P. Dolotovskaya, N. Furman, S. Tolstov, V. Klochkov, T. Denisova
The objective of the study was to assess the metabolic burden within the concept of vascular ageing in hypertension (HTN) based on the results the able-bodied population study of a large industrial center. Design and methods. A continuous non-randomized cross-sectional study was performed, it included the employees of two medium-sized industrial and commercial enterprises (n = 547). All subjects underwent a formalized medical questionnaire aimed at identifying cardiovascular risk factors, symptoms and signs of cardiovascular pathology, measuring blood pressure (BP), serum levels of total cholesterol, high-density lipoproteins cholesterol, low-density lipoproteins cholesterol, triglycerides, glucose, creatinine and uric acid. Values for 10-year risk of fatal cardiovascular events, total cardiovascular risk, vascular age, and metabolic burden were calculated. Results. In the formed sample, the metabolic burden varied from 0.00 (0.00; 28.57) % in patients with low BP (without antihypertensive medication) to 42,86 (42,86; 57,14) % in patients with the 3rd degree HTN. Positive relationships were found between the magnitude of the metabolic burden, the level of systolic BP (R = 0,432; p < 0,01), diastolic BP (R = 0,360; p < 0,01), 10-year risk of fatal cardiovascular events (R = 0,777; p < 0,01) and total cardiovascular risk (R = 0,781; p < 0,01). Patients with HTN who achieved target BP differed from those with similar BP levels by higher metabolic burden values (p < 0,05). Conclusions. HTN is associated with an increase in metabolic burden, regardless of BP level achieved during treatment. Metabolic burden assessment may be useful in identifying potentially unfavorable HTN phenotypes.
{"title":"Estimation of metabolic burden within the concept of vascular ageing in hypertension (a study of the able-bodied population of a large industrial center)","authors":"L. I. Malinova, P. Dolotovskaya, N. Furman, S. Tolstov, V. Klochkov, T. Denisova","doi":"10.18705/1607-419x-2023-29-1-24-37","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-1-24-37","url":null,"abstract":"The objective of the study was to assess the metabolic burden within the concept of vascular ageing in hypertension (HTN) based on the results the able-bodied population study of a large industrial center. Design and methods. A continuous non-randomized cross-sectional study was performed, it included the employees of two medium-sized industrial and commercial enterprises (n = 547). All subjects underwent a formalized medical questionnaire aimed at identifying cardiovascular risk factors, symptoms and signs of cardiovascular pathology, measuring blood pressure (BP), serum levels of total cholesterol, high-density lipoproteins cholesterol, low-density lipoproteins cholesterol, triglycerides, glucose, creatinine and uric acid. Values for 10-year risk of fatal cardiovascular events, total cardiovascular risk, vascular age, and metabolic burden were calculated. Results. In the formed sample, the metabolic burden varied from 0.00 (0.00; 28.57) % in patients with low BP (without antihypertensive medication) to 42,86 (42,86; 57,14) % in patients with the 3rd degree HTN. Positive relationships were found between the magnitude of the metabolic burden, the level of systolic BP (R = 0,432; p < 0,01), diastolic BP (R = 0,360; p < 0,01), 10-year risk of fatal cardiovascular events (R = 0,777; p < 0,01) and total cardiovascular risk (R = 0,781; p < 0,01). Patients with HTN who achieved target BP differed from those with similar BP levels by higher metabolic burden values (p < 0,05). Conclusions. HTN is associated with an increase in metabolic burden, regardless of BP level achieved during treatment. Metabolic burden assessment may be useful in identifying potentially unfavorable HTN phenotypes.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87235904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.18705/1607-419x-2023-29-1-6-13
O. Antropova, L. A. Obraztsova
The article presents the recent data on the pathogenic links and potential targets for the treatment of salt-sensitive hypertension (HTN). Distinguishing salt-sensitive and salt-resistant phenotypes is one approach to personalized medicine. In the review, special attention is paid to the intestinal microbiota as an etiological factor in salt-sensitive HTN, which, along with the imbalance of neurohumoral systems and the subsequent dysregulatory hemodynamic response to salt load, plays a leading role in the development of salt sensitivity. The advantages and limitations of methods for quantitative assessment of sodium intake are discussed, ways of their optimization are indicated, which is necessary for a more accurate determination of the optimal threshold for salt intake.
{"title":"Salt-sensitive hypertension: modern pathogenetic mechanisms and prospects","authors":"O. Antropova, L. A. Obraztsova","doi":"10.18705/1607-419x-2023-29-1-6-13","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-1-6-13","url":null,"abstract":"The article presents the recent data on the pathogenic links and potential targets for the treatment of salt-sensitive hypertension (HTN). Distinguishing salt-sensitive and salt-resistant phenotypes is one approach to personalized medicine. In the review, special attention is paid to the intestinal microbiota as an etiological factor in salt-sensitive HTN, which, along with the imbalance of neurohumoral systems and the subsequent dysregulatory hemodynamic response to salt load, plays a leading role in the development of salt sensitivity. The advantages and limitations of methods for quantitative assessment of sodium intake are discussed, ways of their optimization are indicated, which is necessary for a more accurate determination of the optimal threshold for salt intake.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89866325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-22DOI: 10.18705/1607-419x-2022-28-6-718-727
E. G. Kolomin, L. Rozhchenko, V. Bobinov, S. Goroshchenko, A. Petrov, O. A. Frolova, K. Samochernykh
Infectious aneurysms (IA) are cerebral aneurysms that are formed due to the infectious inflammation of the arterial wall. They are a rather rare pathology and in most cases prove to be a complication of infectious (bacterial) endocarditis of the left heart chambers. Timely diagnosis of IA in the pre-hemorrhagic period is problematic due to the variability of the clinical picture of IA, frequent blurred or low-symptomatic clinical course, the possibility of IA formation in the remote period after septic embolism, even despite the background of antibiotic therapy. The presented clinical case illustrates the first successful use of a low-profile flow-diverting stent for the treatment of a young patient with a mechanical heart valve and an infectious aneurysm of the left middle cerebral artery, developed at the site of septic embolism in the acute period of septic bacterial endocarditis accompanied by ischemic stroke. This observation demonstrates the effectiveness of the chosen method of treatment, peculiarities of adequate preoperative preparation, possible postoperative complications and detailed correction of anticoagulant and antiplatelet therapy.
{"title":"First case of successful usage of a low-profile flow-diverting stent for treatment of intracranial infectious aneurysm in patient with a mechanical heart valve. Clinical case and literature review","authors":"E. G. Kolomin, L. Rozhchenko, V. Bobinov, S. Goroshchenko, A. Petrov, O. A. Frolova, K. Samochernykh","doi":"10.18705/1607-419x-2022-28-6-718-727","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-718-727","url":null,"abstract":"Infectious aneurysms (IA) are cerebral aneurysms that are formed due to the infectious inflammation of the arterial wall. They are a rather rare pathology and in most cases prove to be a complication of infectious (bacterial) endocarditis of the left heart chambers. Timely diagnosis of IA in the pre-hemorrhagic period is problematic due to the variability of the clinical picture of IA, frequent blurred or low-symptomatic clinical course, the possibility of IA formation in the remote period after septic embolism, even despite the background of antibiotic therapy. The presented clinical case illustrates the first successful use of a low-profile flow-diverting stent for the treatment of a young patient with a mechanical heart valve and an infectious aneurysm of the left middle cerebral artery, developed at the site of septic embolism in the acute period of septic bacterial endocarditis accompanied by ischemic stroke. This observation demonstrates the effectiveness of the chosen method of treatment, peculiarities of adequate preoperative preparation, possible postoperative complications and detailed correction of anticoagulant and antiplatelet therapy.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73447449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-14DOI: 10.18705/1607-419x-2022-28-6-51-57
Y. Polonskaya, E. Kashtanova, E. Stakhneva, V. Shramko, E. Sadovski, L. Shcherbakova, A. Khudyakova, Y. Ragino
Objective. To investigate the adipokine blood profile in young people with hypertension (HTN) and abdominal obesity (AO). Design and methods. In total. 530 people were included in the study, including 267 people with HTN, of which 169 had AO. In the control group (without HTN) there were 263 people comparable to the study group by gender and age. Among them there were 106 people with AO. The blood levels of adiponectin, adipsin, lipocalin-2, resistin and plasminogen activator inhibitor-1 (PAI-1) were determined in all examined patients by multiplex analysis. Statistical data processing was carried out with the use of SPSS 13.0 program. Results. The levels of adiponectin and lipocalin-2 were lower in the group of HTN patients by 1,46 (p < 0,01) and 1,14 times (p < 0,05), respectively. The level of adipsin in HTN patients was significantly higher (p < 0,01) by 19,14 % compared to the control. The levels of resistin and PAI- did not differ in the control group and the group with HTN. Adiponectin level was 1,35 times lower (p < 0,05) in the group with AO compared to those without AO, the other indicators did not differ in the AO group and controls. In the HTN group, higher levels of PAI-1 were found in the subgroup with AO. When comparing the subgroup without HTN and without AO with the subgroup with HTN and AO, a significant decrease in concentration of adiponectin and lipocalin-2 was found. For the subgroups with AO, a decrease in adiponectin levels and an increase in adipsin levels (p < 0,01) were found in HTN patients. No statistically significant difference was found for the remaining indicators. The relative chance of early onset HTN was associated with the decrease in adiponectin and lipocalin-2 levels, and with the increase in adipsin levels, regardless of gender, age and the presence of AO. Conclusions. Thus, an increased level of adipsin and a reduced level of adiponectin and lipocalin-2 can serve as potential biomarkers indicating a high probability of developing early HTN in people under 45 years of age.
{"title":"The level of adipokines in young people with hypertension and abdominal obesity","authors":"Y. Polonskaya, E. Kashtanova, E. Stakhneva, V. Shramko, E. Sadovski, L. Shcherbakova, A. Khudyakova, Y. Ragino","doi":"10.18705/1607-419x-2022-28-6-51-57","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-51-57","url":null,"abstract":"Objective. To investigate the adipokine blood profile in young people with hypertension (HTN) and abdominal obesity (AO). Design and methods. In total. 530 people were included in the study, including 267 people with HTN, of which 169 had AO. In the control group (without HTN) there were 263 people comparable to the study group by gender and age. Among them there were 106 people with AO. The blood levels of adiponectin, adipsin, lipocalin-2, resistin and plasminogen activator inhibitor-1 (PAI-1) were determined in all examined patients by multiplex analysis. Statistical data processing was carried out with the use of SPSS 13.0 program. Results. The levels of adiponectin and lipocalin-2 were lower in the group of HTN patients by 1,46 (p < 0,01) and 1,14 times (p < 0,05), respectively. The level of adipsin in HTN patients was significantly higher (p < 0,01) by 19,14 % compared to the control. The levels of resistin and PAI- did not differ in the control group and the group with HTN. Adiponectin level was 1,35 times lower (p < 0,05) in the group with AO compared to those without AO, the other indicators did not differ in the AO group and controls. In the HTN group, higher levels of PAI-1 were found in the subgroup with AO. When comparing the subgroup without HTN and without AO with the subgroup with HTN and AO, a significant decrease in concentration of adiponectin and lipocalin-2 was found. For the subgroups with AO, a decrease in adiponectin levels and an increase in adipsin levels (p < 0,01) were found in HTN patients. No statistically significant difference was found for the remaining indicators. The relative chance of early onset HTN was associated with the decrease in adiponectin and lipocalin-2 levels, and with the increase in adipsin levels, regardless of gender, age and the presence of AO. Conclusions. Thus, an increased level of adipsin and a reduced level of adiponectin and lipocalin-2 can serve as potential biomarkers indicating a high probability of developing early HTN in people under 45 years of age.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83439840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-08DOI: 10.18705/1607-419x-2022-28-6-91-99
A. Gordeev, M. Bochkarev, L. Korostovtseva, E. Zabroda, V. Amelina, S. Osipenko, Y. Sviryaev, A. Alekhin
Objective. To identify objective measures of sleep and molecular markers of sleep reactivity to stress to determine its role for insomnia prevention and management. Design and methods. The sample included 42 subjects with sleep disturbances and 23 subjects without sleep-related complaints (control group) aged 18 to 72 years. Altogether there are 19 men and 55 women. Nine participants were excluded from the study. Sleep reactivity to stress was assessed using the Ford Insomnia Response to Stress Test (FIRST) questionnaire. The Integrative Anxiety Test was used to screen for anxiety. Sleep indices were assessed by polysomnography (PSG). Blood plasma samples were collected in the morning after PSG to determine brain-derived neurotrophic factor (BDNF), and 24-hour urine was collected one week after PSG to assess metanephrine levels. Results. There were 64 % healthy subjects with low sleep reactivity to stress and low anxiety and 79 % subjects showed insomnia among persons with high sleep reactivity and anxiety. Significant differences in PSG measures were found in groups with low and high sleep reactivity: the efficiency of sleep and the percentage of the second stage of NREM sleep were higher in group with low reactivity, also sleep latency and wake time after sleep onset were lower in group with high reactivity. In addition, serum BDNF level was significantly higher in group with low reactivity, and it correlates positively with daily urinary metanephrine excretion and the absolute duration of stage N3 and negatively with sleep latency. Conclusions. Subjects with high reactivity to stress have lower sleep quality and depth that corresponds to other studies. The level of BDNF is a possible marker of sleep reactivity to stress and it can indicate the potential adaptation to stress.
{"title":"Sleep reactivity to stress and insomnia: sleep measures and molecular markers","authors":"A. Gordeev, M. Bochkarev, L. Korostovtseva, E. Zabroda, V. Amelina, S. Osipenko, Y. Sviryaev, A. Alekhin","doi":"10.18705/1607-419x-2022-28-6-91-99","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-91-99","url":null,"abstract":"Objective. To identify objective measures of sleep and molecular markers of sleep reactivity to stress to determine its role for insomnia prevention and management. Design and methods. The sample included 42 subjects with sleep disturbances and 23 subjects without sleep-related complaints (control group) aged 18 to 72 years. Altogether there are 19 men and 55 women. Nine participants were excluded from the study. Sleep reactivity to stress was assessed using the Ford Insomnia Response to Stress Test (FIRST) questionnaire. The Integrative Anxiety Test was used to screen for anxiety. Sleep indices were assessed by polysomnography (PSG). Blood plasma samples were collected in the morning after PSG to determine brain-derived neurotrophic factor (BDNF), and 24-hour urine was collected one week after PSG to assess metanephrine levels. Results. There were 64 % healthy subjects with low sleep reactivity to stress and low anxiety and 79 % subjects showed insomnia among persons with high sleep reactivity and anxiety. Significant differences in PSG measures were found in groups with low and high sleep reactivity: the efficiency of sleep and the percentage of the second stage of NREM sleep were higher in group with low reactivity, also sleep latency and wake time after sleep onset were lower in group with high reactivity. In addition, serum BDNF level was significantly higher in group with low reactivity, and it correlates positively with daily urinary metanephrine excretion and the absolute duration of stage N3 and negatively with sleep latency. Conclusions. Subjects with high reactivity to stress have lower sleep quality and depth that corresponds to other studies. The level of BDNF is a possible marker of sleep reactivity to stress and it can indicate the potential adaptation to stress.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88068624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-07DOI: 10.18705/1607-419x-2022-28-6-659-668
V. Safronenko, A. Chesnikova, N. Sementsova
Objective. The aim of the study was to evaluate the features of vascular rigidity in patients with arterial hypertension (AH) depending on the presence of chronic heart failure (CHF) and senile asthenia syndrome (SAS).Design and methods. 320 patients with AH were divided into two main groups: group 1 — patients with AH and CHF (n = 161), group 2 — patients with AH without CHF (n = 159). Depending on the presence of SAS, patients of each group were divided as follows: subgroup 1A — patients with AH, CHF and SAS (n = 84), subgroup 1B — patients with AH, CHF without SAS (n = 77), subgroup 2A — patients with AH, SAS without CHF (n = 84), subgroup 2B — patients with AH without CHF and without SAS (n = 75). To identify SAS, we used the “Age is not a barrier” questionnaire and a short battery of physical functioning tests. The parameters of vascular stiffness were determined using a device for daily monitoring of blood pressure BPLab using Vasotens technology (Peter Telegin, Nizhny Novgorod). The obtained data were processed using STATISTICA 12.0 (StatSoft Inc., USA), SPSS 21.0, MedCalc (version 9.3.5.0).Results. Analysis of the effect of SAS on vascular stiffness showed that in patients with AH, CHF and SAS, compared with patients with AH, CHF without SAS, there were statistically significantly lower values of the reflected wave propagation time (RWTT) (p = 0,001) against the background of higher values pulse wave velocity in the aorta (РWVао) (p < 0,001), arterial stiffness index (ASI) (p = 0,0001) and ambulatory arterial stiffness index (AASI) (p = 0,002), which indicates more pronounced vascular stiffness in patients with AH, CHF in the presence of SAS. In the group of patients with AH and SAS without CHF, compared with patients with AH without CHF and without SAS, higher values of РWVао (p < 0,001) and “adjusted” index of augmentation index (AIх@75) (p < 0,001) were revealed, which allows to judge the effect of SAS on the development of arterial stiffness in patients with AH without CHF. Analysis of the effect of CHF on vascular stiffness showed that in patients with AH, SAS and CHF, compared with patients with AH, SAS without CHF, statistically significantly lower values of RWTT (p < 0,001) and higher values of РWVао (p = 0,024) were noted, ASI (p < 0,001), AASI (p < 0,001), maximum rate of blood pressure rise (dP/dtmax) (p < 0,001) and AIх@75 (p < 0,001). In the group of patients with AH, CHF without SAS, compared with patients with AH without CHF and without SAS, lower values of RWTT (p < 0,001) and higher values of РWVаo (p = 0,004), ASI (p < 0,001), AASI (p < 0,001) and dP/dtmax (p < 0,001), which in turn demonstrates the contribution of CHF to the development of vascular stiffness in AH patients without SAS. CS.Conclusions. In hypertensive patients over 80 years of age, the development of both SAS and CHF was accompanied by limited compliance of the aortic walls and increased vascular stiffness in the peripheral arteries. Significantly more p
{"title":"Features of vascular rigidity in patients with arterial hypertension in combination with chronic heart failure and senile asthenia syndrome","authors":"V. Safronenko, A. Chesnikova, N. Sementsova","doi":"10.18705/1607-419x-2022-28-6-659-668","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-659-668","url":null,"abstract":"Objective. The aim of the study was to evaluate the features of vascular rigidity in patients with arterial hypertension (AH) depending on the presence of chronic heart failure (CHF) and senile asthenia syndrome (SAS).Design and methods. 320 patients with AH were divided into two main groups: group 1 — patients with AH and CHF (n = 161), group 2 — patients with AH without CHF (n = 159). Depending on the presence of SAS, patients of each group were divided as follows: subgroup 1A — patients with AH, CHF and SAS (n = 84), subgroup 1B — patients with AH, CHF without SAS (n = 77), subgroup 2A — patients with AH, SAS without CHF (n = 84), subgroup 2B — patients with AH without CHF and without SAS (n = 75). To identify SAS, we used the “Age is not a barrier” questionnaire and a short battery of physical functioning tests. The parameters of vascular stiffness were determined using a device for daily monitoring of blood pressure BPLab using Vasotens technology (Peter Telegin, Nizhny Novgorod). The obtained data were processed using STATISTICA 12.0 (StatSoft Inc., USA), SPSS 21.0, MedCalc (version 9.3.5.0).Results. Analysis of the effect of SAS on vascular stiffness showed that in patients with AH, CHF and SAS, compared with patients with AH, CHF without SAS, there were statistically significantly lower values of the reflected wave propagation time (RWTT) (p = 0,001) against the background of higher values pulse wave velocity in the aorta (РWVао) (p < 0,001), arterial stiffness index (ASI) (p = 0,0001) and ambulatory arterial stiffness index (AASI) (p = 0,002), which indicates more pronounced vascular stiffness in patients with AH, CHF in the presence of SAS. In the group of patients with AH and SAS without CHF, compared with patients with AH without CHF and without SAS, higher values of РWVао (p < 0,001) and “adjusted” index of augmentation index (AIх@75) (p < 0,001) were revealed, which allows to judge the effect of SAS on the development of arterial stiffness in patients with AH without CHF. Analysis of the effect of CHF on vascular stiffness showed that in patients with AH, SAS and CHF, compared with patients with AH, SAS without CHF, statistically significantly lower values of RWTT (p < 0,001) and higher values of РWVао (p = 0,024) were noted, ASI (p < 0,001), AASI (p < 0,001), maximum rate of blood pressure rise (dP/dtmax) (p < 0,001) and AIх@75 (p < 0,001). In the group of patients with AH, CHF without SAS, compared with patients with AH without CHF and without SAS, lower values of RWTT (p < 0,001) and higher values of РWVаo (p = 0,004), ASI (p < 0,001), AASI (p < 0,001) and dP/dtmax (p < 0,001), which in turn demonstrates the contribution of CHF to the development of vascular stiffness in AH patients without SAS. CS.Conclusions. In hypertensive patients over 80 years of age, the development of both SAS and CHF was accompanied by limited compliance of the aortic walls and increased vascular stiffness in the peripheral arteries. Significantly more p","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74282100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-19DOI: 10.18705/1607-419x-2022-28-6-689-698
N. Bagisheva, I. Viktorova, A. Mordyk, M. Moiseeva, V. Goloshubina, G. V. Filipenko, A. Aroyan, E. A. Stativka
Chronic heart failure (CHF), arterial hypertension (AH), chronic obstructive pulmonary disease (COPD) worsen the prognosis for the cure of newly diagnosed pulmonary tuberculosis (TB), including due to an increase in negative symptoms and a deterioration in the quality of life of patients in the intensive phase of TB treatment. This requires the algorithmic diagnostic actions of a doctor for the subsequent appointment of rational pharmacotherapy with a proven best outcome in the treatment of TB.Objective. To develop an algorithm for the diagnosis and pharmacotherapy of patients with hypertension, CHF and COPD in the intensive phase of chemotherapy for newly diagnosed TB in terms of the best outcome of TB cure.Design and methods. An open, prospective, randomized comparative study included 135 patients who were admitted to a tuberculosis dispensary for the treatment of newly diagnosed TB. Depending on concomitant cardiac pathology, patients were divided into 2 groups: 76 patients with TB, COPD and AH; 59 patients with TB, COPD and CHF. In patients on the background of intensive chemotherapy for newly diagnosed TB, symptoms such as shortness of breath, tachycardia, and increased blood pressure (BP) were first detected or intensified. The selection of treatment regimens was carried out with an assessment of the best tolerability and effectiveness. Duration of follow-up was 6 months with an assessment of the outcomes of TB treatment in comparison with retrospective control (a similar group according to the inclusion and exclusion criteria treated in 2018).Results. During intensive chemotherapy of newly diagnosed TB, increasing symptoms were assessed and analyzed, indicating the appearance or exacerbation of comorbid pathology: AH, CHF and COPD. Based on the results of the study, an algorithm of doctor’s actions was developed for the differential diagnosis of cardiovascular (AH and CHF) and bronchopulmonary (COPD) pathologies with recommendations for prescribing a rational combination of drugs. In patients with TB, hypertension and COPD, the best effect was obtained in reducing the average daily systolic and diastolic BP during therapy with an angiotensin II receptor antagonist and a dihydropyridine calcium antagonist with satisfactory tolerability. For patients with TB, COPD and CHF, an angiotensin-converting enzyme inhibitor (if intolerant, an angiotensin II receptor antagonist) in combination with a mineralocorticoid receptor antagonist and titration of a beta-blocker with the addition of a myocardial cytoprotector to the above therapy showed an optimal effect on the severity of CHF symptoms. These treatment regimens for 3 months led to the achievement of target indicators for BP, heart rate, exercise tolerance in the test with a 6-minute walk, and improvement in echocardiography. Continuation of treatment up to 6 months showed a significant improvement in the outcomes of TB chemotherapy, expressed in an increase in the number of people who achieved
{"title":"Algorithm for the diagnosis and pharmacotherapy of arterial hypertension, chronic heart failure in patients with newly diagnosed tuberculosis and chronic obstructive pulmonary disease in the the intensive phase of tuberculosis chemotherapy","authors":"N. Bagisheva, I. Viktorova, A. Mordyk, M. Moiseeva, V. Goloshubina, G. V. Filipenko, A. Aroyan, E. A. Stativka","doi":"10.18705/1607-419x-2022-28-6-689-698","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-689-698","url":null,"abstract":"Chronic heart failure (CHF), arterial hypertension (AH), chronic obstructive pulmonary disease (COPD) worsen the prognosis for the cure of newly diagnosed pulmonary tuberculosis (TB), including due to an increase in negative symptoms and a deterioration in the quality of life of patients in the intensive phase of TB treatment. This requires the algorithmic diagnostic actions of a doctor for the subsequent appointment of rational pharmacotherapy with a proven best outcome in the treatment of TB.Objective. To develop an algorithm for the diagnosis and pharmacotherapy of patients with hypertension, CHF and COPD in the intensive phase of chemotherapy for newly diagnosed TB in terms of the best outcome of TB cure.Design and methods. An open, prospective, randomized comparative study included 135 patients who were admitted to a tuberculosis dispensary for the treatment of newly diagnosed TB. Depending on concomitant cardiac pathology, patients were divided into 2 groups: 76 patients with TB, COPD and AH; 59 patients with TB, COPD and CHF. In patients on the background of intensive chemotherapy for newly diagnosed TB, symptoms such as shortness of breath, tachycardia, and increased blood pressure (BP) were first detected or intensified. The selection of treatment regimens was carried out with an assessment of the best tolerability and effectiveness. Duration of follow-up was 6 months with an assessment of the outcomes of TB treatment in comparison with retrospective control (a similar group according to the inclusion and exclusion criteria treated in 2018).Results. During intensive chemotherapy of newly diagnosed TB, increasing symptoms were assessed and analyzed, indicating the appearance or exacerbation of comorbid pathology: AH, CHF and COPD. Based on the results of the study, an algorithm of doctor’s actions was developed for the differential diagnosis of cardiovascular (AH and CHF) and bronchopulmonary (COPD) pathologies with recommendations for prescribing a rational combination of drugs. In patients with TB, hypertension and COPD, the best effect was obtained in reducing the average daily systolic and diastolic BP during therapy with an angiotensin II receptor antagonist and a dihydropyridine calcium antagonist with satisfactory tolerability. For patients with TB, COPD and CHF, an angiotensin-converting enzyme inhibitor (if intolerant, an angiotensin II receptor antagonist) in combination with a mineralocorticoid receptor antagonist and titration of a beta-blocker with the addition of a myocardial cytoprotector to the above therapy showed an optimal effect on the severity of CHF symptoms. These treatment regimens for 3 months led to the achievement of target indicators for BP, heart rate, exercise tolerance in the test with a 6-minute walk, and improvement in echocardiography. Continuation of treatment up to 6 months showed a significant improvement in the outcomes of TB chemotherapy, expressed in an increase in the number of people who achieved ","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75819585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-19DOI: 10.18705/1607-419x-2023-29-1-58-67
T. A. Mulerova, N. Morozova, E. Bazdyrev, T. F. Gaziev, E. Indukaeva, D. Tsygankova, O. V. Nakhratova
Objective. To determine the prognostic role of the polymorphism of candidate genes for hypertension (HTN) in the effectiveness of antihypertensive therapy in the population of Mountain Shoria, taking into account the ethnic factor. Design and methods. The material for the study was the population of indigenous (Shors) and nonindigenous inhabitants of Mountain Shoria. In the first stage of the study (2013–2017), 901 indigenous people and 508 non-indigenous people were included in the continuous method. A group of patients with HTN was identified — 367 (40,7 %) shors and 230 (45,3 %) representatives of non-indigenous ethnic group. The second stage of the study involved 525 patients with HTN (317 shors, 208 non-indigenous representatives). According to the recommendations of National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010), antihypertensive therapy was prescribed by a cardiologist. A re-examination of patients with HTN included in the prospective stage of the study was carried out after a month, 3 months and 6 months by a paramedic of the local feldsher-obstetric center and after 12 months by a cardiologist. Gene polymorphism ACE (I/D, rs 4340), AGT (c. 803T > C, rs699), AGTR 1 (А1166С, rs5186), ADRB 1 (с. 145A > G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c. 677C > T, Ala222Val, rs1801133) and NOS 3 (VNTR, 4b/4a) were tested using polymerase chain reaction. Results. In the Shors cohort, the minor allele D of the ACE gene and the favorable allele A of the AGTR 1 gene were associated with a significant decrease in blood pressure (BP) with the 2-component therapy for HTN using blockers of the renin-angiotensin-aldosterone system (RAAS) with a diuretic (odds ratio (OR) = 5,01 and OR = 6,28). The carriage of the mutant allele D of the ACE gene in subjects with the 3-component therapy (RAAS blocker, calcium channel blocker (CCB), diuretic) also determined the achievement of the target BP level (OR = 3,11). In the cohort of non-indigenous nationality, allele A of the AGTR 1 gene was associated with positive dynamics of BP with the use of another combination therapy with a RAAS blocker and CCB (OR = 5,38). Conclusions. Taking into account the ethnicity, genetic characteristics of the patient when choosing drugs is a key point in the effectiveness of therapy in HTN patients. The possibility of using pharmacogenetics in the practice of a cardiologist opens up promising areas and has a great future.
{"title":"Genetic approaches in the choice of therapy for hypertension in the population of Mountain Shoria","authors":"T. A. Mulerova, N. Morozova, E. Bazdyrev, T. F. Gaziev, E. Indukaeva, D. Tsygankova, O. V. Nakhratova","doi":"10.18705/1607-419x-2023-29-1-58-67","DOIUrl":"https://doi.org/10.18705/1607-419x-2023-29-1-58-67","url":null,"abstract":"Objective. To determine the prognostic role of the polymorphism of candidate genes for hypertension (HTN) in the effectiveness of antihypertensive therapy in the population of Mountain Shoria, taking into account the ethnic factor. Design and methods. The material for the study was the population of indigenous (Shors) and nonindigenous inhabitants of Mountain Shoria. In the first stage of the study (2013–2017), 901 indigenous people and 508 non-indigenous people were included in the continuous method. A group of patients with HTN was identified — 367 (40,7 %) shors and 230 (45,3 %) representatives of non-indigenous ethnic group. The second stage of the study involved 525 patients with HTN (317 shors, 208 non-indigenous representatives). According to the recommendations of National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010), antihypertensive therapy was prescribed by a cardiologist. A re-examination of patients with HTN included in the prospective stage of the study was carried out after a month, 3 months and 6 months by a paramedic of the local feldsher-obstetric center and after 12 months by a cardiologist. Gene polymorphism ACE (I/D, rs 4340), AGT (c. 803T > C, rs699), AGTR 1 (А1166С, rs5186), ADRB 1 (с. 145A > G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c. 677C > T, Ala222Val, rs1801133) and NOS 3 (VNTR, 4b/4a) were tested using polymerase chain reaction. Results. In the Shors cohort, the minor allele D of the ACE gene and the favorable allele A of the AGTR 1 gene were associated with a significant decrease in blood pressure (BP) with the 2-component therapy for HTN using blockers of the renin-angiotensin-aldosterone system (RAAS) with a diuretic (odds ratio (OR) = 5,01 and OR = 6,28). The carriage of the mutant allele D of the ACE gene in subjects with the 3-component therapy (RAAS blocker, calcium channel blocker (CCB), diuretic) also determined the achievement of the target BP level (OR = 3,11). In the cohort of non-indigenous nationality, allele A of the AGTR 1 gene was associated with positive dynamics of BP with the use of another combination therapy with a RAAS blocker and CCB (OR = 5,38). Conclusions. Taking into account the ethnicity, genetic characteristics of the patient when choosing drugs is a key point in the effectiveness of therapy in HTN patients. The possibility of using pharmacogenetics in the practice of a cardiologist opens up promising areas and has a great future.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80861757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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