cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2013-3-85-88cardiovascular-201Research ArticleОБЗОРЫREVIEWSОЦЕНКА ЖЕСТКОСТИ АОРТЫ У БОЛЬНЫХ АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ И ОЖИРЕНИЕМAORTIC STIFFNESS ASSESSMENT IN PATIENTS WITH ARTERIAL HYPERTENSION AND OBESITYШупенинаЕ. Ю.ShupeninaE. Yu.

к. м.н., ассистент кафедры клинической функциональной диагностики

ЮщукЕ. Н.YushchukE. N.

д. м.н., профессор кафедры

ХадзеговаА. Б.KhadzegovaA. B.

д. м.н., профессор кафедры

ИвановаС. В.IvanovaS. V.

к. м.н., доцент кафедры

СадулаеваИ. А.SadulaevaI. A.

к. м.н., доцент кафедры

НадинаЕ. В.NadinaE. V.

аспирант 2-го года обучения на кафедре

ХучинаеваА. М.KhuchinaevaA. M.

аспирант 3-гг года обучения на кафедре

ВасюкЮ. А.VasyukYu. A.

д. м.н., профессор, заведующий кафедрой

tel.: 8–985–767–85–84

yvasyuk@yandex.ruМосковский государственный медико-стоматологический университет им. А. И. Евдокимова, МоскваA. I. Evdokimov Moscow State Medico-Stomatological University, Moscow2013200620131238588Copyright © Шупенина Е.Ю., Ющук Е.Н., Хадзегова А.Б., Иванова С.В., Садулаева И.А., Надина Е.В., Хучинаева А.М., Васюк Ю.А., 20132013Шупенина Е.Ю., Ющук Е.Н., Хадзегова А.Б., Иванова С.В., Садулаева И.А., Надина Е.В., Хучинаева А.М., Васюк Ю.А.Shupenina E.Y., Yushchuk E.N., Khadzegova A.B., Ivanova S.V., Sadulaeva I.A., Nadina E.V., Khuchinaeva A.M., Vasyuk Y.A.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/201

Сердечно-сосудистые заболевания (ССЗ) являются основной причиной смертности в большинстве развитых стран мира. Важную роль в патогенезе этих заболеваний играет морфофункциональное состояние крупных артерий. В настоящее время существует два основных метода оценки жесткости аорты: определение скорости распространения пульсовой волны (СРПВ), анализ центральной ПВ. С возрастом аорта становится более жесткой, что проявляется увеличением СРПВ, центрального артериального давления, параметров отраженной ПВ. Аналогичные изменения показателей могут выявляться в молодом возрасте при артериальной гипертонии. Информация о влиянии ожирения на жесткость аорты противоречива и требует дальнейшего уточнения. 

Cardiovascular disease (CVD) remains the leading cause of death in most developed countries. Morphological and functional status of large arteries plays an important role in the pathogenesis of CVD. At the moment, there are two main methods of aortic stiffness assessment: pulse wave velocity (PWV) measurement and central PW analysis. In advanced age, aortic stiffness increases, which manifests in increased PWV, elevated central blood pressure, and increased parameters of reflected PW. Similar changes can be observed in young patients with arterial hypertension. The existing evidence concerning obesity effects on aortic stiffness is contradictory and warrants further clarification. 

артериальная гипертонияожирениескорость пульсовой волныцентральное артериальное давлениеarterial hypertensionobesitypulse wave velocitycentral blood pressureReferencesO´Rourke M, Adji A. Arterial stiffness, its assessment, prognostic value and implications for treatment. State of art. Am J Hypertens 2011; 24 (1): 5–17.O´Rourke M, Adji A. Arterial stiffness, its assessment, prognostic value and implications for treatment. State of art. Am J Hypertens 2011; 24 (1): 5–17.Nichols W, O Rourke M, McDonald S. Blood flow in arteries. 5th ed. London: Arnold; 2005.Nichols W, O Rourke M, McDonald S. Blood flow in arteries. 5th ed. London: Arnold; 2005.Safar ME, Lacolley P. Disturbance of macro- and microcirculation: relations with pulse pressure and cardiac organ damage. Am J Physiol Heart Circ 2007; 293: 1–7.Safar ME, Lacolley P. Disturbance of macro- and microcirculation: relations with pulse pressure and cardiac organ damage. Am J Physiol Heart Circ 2007; 293: 1–7.Rogoza AN, Balahonova TV, Chihladze NM, et al. Modern methods of vessels assessment in arterial hypertension. Moscow: Atmosphere 2008; 70 p. Russian (Рогоза А. Н., Балахонова Т. В., Чихладзе Н. М. Современные методы оценки состояния сосудов у больных артериальной гипертонией. Москва: Атмосфера 2008; 70 с).Rogoza AN, Balahonova TV, Chihladze NM, et al. Modern methods of vessels assessment in arterial hypertension. Moscow: Atmosphere 2008; 70 p. Russian (Рогоза А. Н., Балахонова Т. В., Чихладзе Н. М. Современные методы оценки состояния сосудов у больных артериальной гипертонией. Москва: Атмосфера 2008; 70 с).Hughes TM, Althouse AD, Niemczyk NA, et al. Effects of weight loss and insulin reduction on arterial stiffness in the SAVE study. Cardiovasc Diabetol 2012; 11: 114.Hughes TM, Althouse AD, Niemczyk NA, et al. Effects of weight loss and insulin reduction on arterial stiffness in the SAVE study. Cardiovasc Diabetol 2012; 11: 114.Pannier BM, Avolio AP, Hoeks A. Methods and devices for measuring arterial compliance in humans. Am J Hypertens 2002; 15: 743–53.Pannier BM, Avolio AP, Hoeks A. Methods and devices for measuring arterial compliance in humans. Am J Hypertens 2002; 15: 743–53.Laurent S, Cockroft J, Van Bortel L, et al. European network for non-invasive investigation of large arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; (21): 2588–605.Laurent S, Cockroft J, Van Bortel L, et al. European network for non-invasive investigation of large arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; (21): 2588–605.Van Bortel LM, Duprez D, Safar ME. Applications of arterial stiffness, Task Force III: recommendations for user procedures. Am J Hypertens 2002; 15: 445–52.Van Bortel LM, Duprez D, Safar ME. Applications of arterial stiffness, Task Force III: recommendations for user procedures. Am J Hypertens 2002; 15: 445–52.Asmar R. Arterial stiffness and pulse wave velocity. Clinical applications. Paris: Elsevier 1999; 167.Asmar R. Arterial stiffness and pulse wave velocity. Clinical applications. Paris: Elsevier 1999; 167.Weber T, Rammer R, Eber B. Determination of travel distance for noninvasive measurement of pulse wave velocity: case closed? Hypertension 2009; 54.Weber T, Rammer R, Eber B. Determination of travel distance for noninvasive measurement of pulse wave velocity: case closed? Hypertension 2009; 54.Weber T, Ammer M, Rammer M, Adji A. Noninvasive determination of carotid-femoral pulse wave velocity depends critically on assessment of travel distance: a comparison with invasive measurement. J Hypertens 2009; 27: 1624–30.Weber T, Ammer M, Rammer M, Adji A. Noninvasive determination of carotid-femoral pulse wave velocity depends critically on assessment of travel distance: a comparison with invasive measurement. J Hypertens 2009; 27: 1624–30.Laurent S, Van Bortel LM. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 2012; 30 (3): 445–8.Laurent S, Van Bortel LM. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 2012; 30 (3): 445–8.Mitchell GF, Parise H, Benjamine EJ. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women. Hypertension 2004; 43: 1239–45.Mitchell GF, Parise H, Benjamine EJ. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women. Hypertension 2004; 43: 1239–45.O´Rourke M, Hashimoto J. Mechanical factors in arterial aging. JACC 2007; 50: 1–13.O´Rourke M, Hashimoto J. Mechanical factors in arterial aging. JACC 2007; 50: 1–13.Asmar R, Topouchian J, Pannier B, et al. Reversion of arterial abnormalities by long-term antihypertensive therapy in a large population. The Complior study. J Hypertens 1999; 17 Suppl 3: S9.Asmar R, Topouchian J, Pannier B, et al. Reversion of arterial abnormalities by long-term antihypertensive therapy in a large population. The Complior study. J Hypertens 1999; 17 Suppl 3: S9.Laurent S, Boutourie P, Asmar R. Aortic stiffness is an independenr predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37:1236.Laurent S, Boutourie P, Asmar R. Aortic stiffness is an independenr predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37:1236.Boutourie P, Tropeano A, Asmar R. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: longitududinal study. Hypertension 2002; 39: 10–5.Boutourie P, Tropeano A, Asmar R. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: longitududinal study. Hypertension 2002; 39: 10–5.Giannattasio C, Failla M, Lucchina S, et al. Arterial stiffening influence of sympathetic nerve activity: evidence from hand transplantation in humans. Hypertension 2005; 45: 608–11.Giannattasio C, Failla M, Lucchina S, et al. Arterial stiffening influence of sympathetic nerve activity: evidence from hand transplantation in humans. Hypertension 2005; 45: 608–11.Giannattasio C, Vincenti A, Failla M, et al. Effects of heart rate changes on arterial distensibility in humans. Hypertension 2003; 42: 253–6.Giannattasio C, Vincenti A, Failla M, et al. Effects of heart rate changes on arterial distensibility in humans. Hypertension 2003; 42: 253–6.Cruickshank K, Riste L. Aortic pulse wave velocity and its relationship tomortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation 2002; 106: 2085–90.Cruickshank K, Riste L. Aortic pulse wave velocity and its relationship tomortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation 2002; 106: 2085–90.Willum-Hansen T, Staessen JA. Prognostic value of ajrtic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006; 113: 664–70.Willum-Hansen T, Staessen JA. Prognostic value of ajrtic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006; 113: 664–70.Lurbe E, Torro I, Garcia-Vincent C, et al. Blood pressure and obesity exert independent influences on pulse wave velocity in youth. Hypertens 2012; 60 (2): 550–5.Lurbe E, Torro I, Garcia-Vincent C, et al. Blood pressure and obesity exert independent influences on pulse wave velocity in youth. Hypertens 2012; 60 (2): 550–5.Nichols WW. Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. Am J Hypertens 2005; 18 (1 Pt 2): 3–10.Nichols WW. Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. Am J Hypertens 2005; 18 (1 Pt 2): 3–10.Kelly R, Hayward C, Ganis J. Non-invasive registration of the arterial pressure pulse waveform using high fidelity applanation tonometry. J Vasc Med Biol 1999; 3: 142–9.Kelly R, Hayward C, Ganis J. Non-invasive registration of the arterial pressure pulse waveform using high fidelity applanation tonometry. J Vasc Med Biol 1999; 3: 142–9.Bos WJ, Verrij E, Vincent HH, et al. How to assess mean blood pressure properly at the brachial artery level. J Hypertens 2007; 25: 751–5.Bos WJ, Verrij E, Vincent HH, et al. How to assess mean blood pressure properly at the brachial artery level. J Hypertens 2007; 25: 751–5.Van Bortel LM, Balkestein EJ. Non-invasive assessment of local arterial pulse pressure: comparison of applanation tonometry and echo-tracking. J Hypertens 2001; 19: 1037–44.Van Bortel LM, Balkestein EJ. Non-invasive assessment of local arterial pulse pressure: comparison of applanation tonometry and echo-tracking. J Hypertens 2001; 19: 1037–44.Pauca AL, Wallenhaupt SL, Kon ND. Does radial artery pressure accurately reflect aortic pressure? Chest 1992; 102: 1193–8.Pauca AL, Wallenhaupt SL, Kon ND. Does radial artery pressure accurately reflect aortic pressure? Chest 1992; 102: 1193–8.O´Rourke M, Adji A. Basis for use of central blood measurement in office clinical practice. J Am Soc Hypertens 2008; 2: 28–38.O´Rourke M, Adji A. Basis for use of central blood measurement in office clinical practice. J Am Soc Hypertens 2008; 2: 28–38.Nichols W, Denardo S, Wilkinson I. Effects of arterial stiffness, pulse wave velocity and wave reflections on the central aortic pressure wave form. J Clin Hypertens 2008; 10: 295–303.Nichols W, Denardo S, Wilkinson I. Effects of arterial stiffness, pulse wave velocity and wave reflections on the central aortic pressure wave form. J Clin Hypertens 2008; 10: 295–303.O´Rourke M. Wave travel and reflection in the arterial system. J Hypertens 1999; 17 Suppl.: S45–7.O´Rourke M. Wave travel and reflection in the arterial system. J Hypertens 1999; 17 Suppl.: S45–7.O´Rourke M, Pauca AL. Augmentation of the aortic and central arterial pressure waveform. Blood Press. Monit 2004; 9 (4):179–85.O´Rourke M, Pauca AL. Augmentation of the aortic and central arterial pressure waveform. Blood Press. Monit 2004; 9 (4):179–85.Nichols W, Singh B. Augmentation index as a measure of peripheral vascular disease state. Am J Hypertens 2005; 18 (1): 3–10.Nichols W, Singh B. Augmentation index as a measure of peripheral vascular disease state. Am J Hypertens 2005; 18 (1): 3–10.O´Rourke M, Nichols W. Timing and amplitude of wave reflection. Hypertension 2007; p. 49.O´Rourke M, Nichols W. Timing and amplitude of wave reflection. Hypertension 2007; p. 49.Casey DP, Nichols WW, Braith RW. Impact of aging on central pressure wave reflection characteristics during exercise. Am J Hypertens 2008; 21 (4): 419–24.Casey DP, Nichols WW, Braith RW. Impact of aging on central pressure wave reflection characteristics during exercise. Am J Hypertens 2008; 21 (4): 419–24.Namasivayam M, Adji A, O´Rourke M. Aortic augmentation index and aging: mathematical resolution of a physiological dilemma? Hypertension 2010; 56Namasivayam M, Adji A, O´Rourke M. Aortic augmentation index and aging: mathematical resolution of a physiological dilemma? Hypertension 2010; 56Roman MJ, Devereux RB, Kizer JR, et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension 2007; 50: 197–203.Roman MJ, Devereux RB, Kizer JR, et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension 2007; 50: 197–203.Agabiti-Rosei E, Mancia G, Safar M. Central blood pressure measurements and antihypertensive therapy: a consensus document. Hypertension 2007; 50: 154–60.Agabiti-Rosei E, Mancia G, Safar M. Central blood pressure measurements and antihypertensive therapy: a consensus document. Hypertension 2007; 50: 154–60.Wallace S, McEniery C. Isolated systolic hypertension is characterized by increased aortic stiffness and endothelial dysfunction. Hypertension 2007; 50 (1): 228–33.Wallace S, McEniery C. Isolated systolic hypertension is characterized by increased aortic stiffness and endothelial dysfunction. Hypertension 2007; 50 (1): 228–33.Recio-Rodriges JI. Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive. Cardiovasc Disord 2012; 1 (12): 3.Recio-Rodriges JI. Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive. Cardiovasc Disord 2012; 1 (12): 3.Shim CY, Yang WI, Park S. Overweight and its association with aortic pressure wave reflection after exercise. Am J Hypertens 2010; 24: 1136–42.Shim CY, Yang WI, Park S. Overweight and its association with aortic pressure wave reflection after exercise. Am J Hypertens 2010; 24: 1136–42.

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