cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1676Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONТолщина комплекса интима-медиа общей сонной артерии у больных артериальной гипертонией с наличием и отсутствием метаболического синдромаIntima- media thickness of соmmоn carotid artery in patients with arterial hypertension and present or absent metabolic syndromeШариповаГ. Х.SharipovaG. Kh.gulandom05@mail.ruСаидоваМ. А.SaidovaM. A.gulandom05@mail.ruМычкаВ. Б.MychkaV. B.gulandom05@mail.ruБалахоноваТ. В.BalakhonovaT. V.gulandom05@mail.ruВоробьеваО. Н.VorobyevaO. N.gulandom05@mail.ruЧазоваИ. Е.ChazovaI. E.gulandom05@mail.ruИнститут клинической кардиологии им.А.А.Мясникова ФГУ РКНПК, г. МоскваA.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex. Moscow200820122008774550Copyright © Шарипова Г.Х., Саидова М.А., Мычка В.Б., Балахонова Т.В., Воробьева О.Н., Чазова И.Е., 20082008Шарипова Г.Х., Саидова М.А., Мычка В.Б., Балахонова Т.В., Воробьева О.Н., Чазова И.Е.Sharipova G.K., Saidova M.A., Mychka V.B., Balakhonova T.V., Vorobyeva O.N., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1676Цель

Цель. Изучить особенности изменения толщины интима-медиа сонной артерии (ТИМ ОСА) у больных артериальной гипертонией (АГ) при наличии и отсутствии метаболического синдрома (МС).

Материал и методы

Материал и методы. В исследование включены 303 больных АГ I-III степени (ст.) с или без МС в возрасте 25-70 лет (средний возраст 52+18), ПО мужчин и 193 женщины. Все больные были разделены на 2 группы в зависимости от наличия или отсутствия МС (АГ+МС и АГ-МС). В группах больные были разделены на 3 подгруппы по ст. тяжести АГ - I, II, III ст.). Больным проводилось исследование липидного спектра, суточное мониторирование артериального давления, ультразвуковое исследование сонных артерий.

Результаты

Результаты. ТИМ у больных АГ I и II ст. ± МС достоверно не различалась, при АГ III ст. отмечались достоверные различия у больных АГ+МС - средние показатели ТИМ ОСА 0,99+0,15 мм, по сравнению с больными АГ-МС - 0,79+0,11м (р<0,05). Обнаружена взаимосвязь между длительностью АГ и средней ТИМ (г=0,41, р<0,001), между ТИМ и общим холестерином в группе больных АГ III ст. + МС (r=0,42, p <0,01) и с холестерином липопротеидов низкой плотности (г=0,34, р<0,01), окружностью талии (г=0,31, р<0,05) и глюкозой крови (г=0,29, р<0,01).

Заключение

Заключение. На величину комплекса ТИМ у больных АГ оказало влияние тяжелая ст. АГ (III ст.), наличие МС, возраст, длительность АГ, уровни САД и ПАД.

Aim

Aim: To study changes in intima-media thickness of common carotid artery (CCA IMT) in patients with arterial hypertension (AH) and present or absent metabolic syndrome (MS).

Material and methods

Material and methods: The study included 303 patients with Stage I-III AH and MS, aged 25-70 years (mean age 52 ± 18 years); 110 men and 193 women. All patients were divided into 2 groups (AH+MS and АН-MS) by MS presence or absence, respectively. The groups were comparable by sex and age distribution. Pach group was also divided into three subgroups by AH stage (I-III). Pipid profile assessment, 24-hour blood pressure monitoring (BPM) and carotid artery ultrasound were performed in all patients.

Results

Results: CCA IMT was similar in participants with Stage I-II AH with or without MS. In Stage III AH, it was significantly higher among those with AH and MS, comparing to MS-free hypertensive individuals: 0,99+0,15 vs. 0,79+0,11 mm, respectively (p<0.05). AH duration correlated with mean CCA IMT (r=0,41, p<0.001), and IMT correlated with total cholesterol level in Stage III AH patients (r=0,42, p<0.01), low-density lipoprotein cholesterol (r=0,34, p<0,01), waist circumference (r=0,31, p<0.05), and blood glucose levels (r=0.29, p<0,01).

Conclusion

Conclusion. In AH patients, CCA IMT was associated with Stage III AH, MS, age, AH duration, systolic and pulse BP levels.

артериальная гипертонияметаболический синдромтолщина интима-медиа сонной артерииArterial hypertensionmetabolic syndromecarotid artery intima-media thicknessReferencesДиагностика и лечение метаболического синдрома. Рекомендации ВНОК. Москва 2007.Диагностика и лечение метаболического синдрома. Рекомендации ВНОК. Москва 2007.Alexander CM, Landsman PB, Teutsch SM, Haffner SM; Third National Healh Nutrition Examination Survey (NHANES III); National Cholesterol Education Program (NCEP). NCEP-defined metabolic syndrome, Diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003; 52(5): 1210-4.Alexander CM, Landsman PB, Teutsch SM, Haffner SM; Third National Healh Nutrition Examination Survey (NHANES III); National Cholesterol Education Program (NCEP). NCEP-defined metabolic syndrome, Diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003; 52(5): 1210-4.Weitzman S, Wang C, Rosamond WD, et al. ARIC (Atherosclerosis Rise in Communities) Surveillance Study Is diabetes an independent rise factor for mortality after myocardial infarction? The ARIC (Atherosclerosis Risk in Communities) Surveillance Study. Acta Diabetol 2004; 41(2); 77-83.Weitzman S, Wang C, Rosamond WD, et al. ARIC (Atherosclerosis Rise in Communities) Surveillance Study Is diabetes an independent rise factor for mortality after myocardial infarction? The ARIC (Atherosclerosis Risk in Communities) Surveillance Study. Acta Diabetol 2004; 41(2); 77-83.PDAY (Pathobiological Determinants of Atherosclerosis in Youth) Research Group. Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking. A preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA 1990; 264: 3018-24.PDAY (Pathobiological Determinants of Atherosclerosis in Youth) Research Group. Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking. A preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA 1990; 264: 3018-24.Kawamoto R, Tomita H, Oka Y, et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44(12): 1232-8.Kawamoto R, Tomita H, Oka Y, et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44(12): 1232-8.Профилактика, диагностика и лечение артериальной гипертензии Российские рекомендации (второй пересмотр). Москва 2004.Профилактика, диагностика и лечение артериальной гипертензии Российские рекомендации (второй пересмотр). Москва 2004.Verdeccia P. Prognostic value of ambulatory blood pressure. Current evidence and Clinical implications. Hypertension 2000; 35; 844-51.Verdeccia P. Prognostic value of ambulatory blood pressure. Current evidence and Clinical implications. Hypertension 2000; 35; 844-51.O'Brien E, Sheridan R, O'Malley K, et al. Dippers and non-dippers (letter). Lancet 1988: 2: 397-8.O'Brien E, Sheridan R, O'Malley K, et al. Dippers and non-dippers (letter). Lancet 1988: 2: 397-8.SorofJM, AlexandrovAV, GaramiZ,etal. Carotid ultrasonography for detection of vascular abnormalities in hypertensive children. Pediatr Nephrol 2003; 18: 1020-4.SorofJM, AlexandrovAV, GaramiZ,etal. Carotid ultrasonography for detection of vascular abnormalities in hypertensive children. Pediatr Nephrol 2003; 18: 1020-4.Litwin M, Trelewicz J, Wawer Z, et al. Intima-media thickness and arterial elasticity in hypertensive children: controlled study. Pediatr Nephrol 2004; 19: 767-74.Litwin M, Trelewicz J, Wawer Z, et al. Intima-media thickness and arterial elasticity in hypertensive children: controlled study. Pediatr Nephrol 2004; 19: 767-74.Vazquez-Padron RI, Lasko D, Li S, et al. Aging exacerbates neointimal formation, and increases proliferation and reduces susceptibility to apoptosis of vascular smooth muscle cells in mice. J Vase Surg 2004; 40: 1199-207.Vazquez-Padron RI, Lasko D, Li S, et al. Aging exacerbates neointimal formation, and increases proliferation and reduces susceptibility to apoptosis of vascular smooth muscle cells in mice. J Vase Surg 2004; 40: 1199-207.Tracy RE. Medial thickness of coronary arteries as a correlate of Atherosclerosis. Atherosclerosis 1998; 139: 11-8.Tracy RE. Medial thickness of coronary arteries as a correlate of Atherosclerosis. Atherosclerosis 1998; 139: 11-8.Liang YI, Shiel LM, Teeade H, et al. Effect of blood pressure, smoking and their interaction on carotid artery structure and function. Hypertension 2001: 37: 6-11.Liang YI, Shiel LM, Teeade H, et al. Effect of blood pressure, smoking and their interaction on carotid artery structure and function. Hypertension 2001: 37: 6-11.Tatsukawa M, Sawayama Y, Maeda N, et al. Carotid Atherosclerosis and cardiovascular risk factors: a comparison of residents of a rural area of Okinawa with residents of a typical suburban area Fukuoka, Japan. Atherosclerosis 2004; 172(2): 337-43.Tatsukawa M, Sawayama Y, Maeda N, et al. Carotid Atherosclerosis and cardiovascular risk factors: a comparison of residents of a rural area of Okinawa with residents of a typical suburban area Fukuoka, Japan. Atherosclerosis 2004; 172(2): 337-43.Kawamoto R, Tomita H, Ohtsuka N, et al. Metabolic syndrome, diabetes and subclinical atherosclerosis as assessed by carotid intima-media thickness. J Atheroscler Thromb 2007; 14(2): 78-85.Kawamoto R, Tomita H, Ohtsuka N, et al. Metabolic syndrome, diabetes and subclinical atherosclerosis as assessed by carotid intima-media thickness. J Atheroscler Thromb 2007; 14(2): 78-85.

The authors declare that there are no conflicts of interest present.