Search

Aim. To study the relationship between central arterial pressure (BP) and cystatin C in patients with arterial hypertension and comorbid pathology, depending on gender differences. Materials and methods. The study involved 162 patients aged 39 to 82 years, suffering from hypertension and comorbid pathology. The average age of the surveyed was 58.610.3 years. The following nosological forms were revealed: coronary heart disease 40.7% of the examined, overweight 33.9%, 1st degree obesity 30.8%, type 2 diabetes mellitus 29.0%, chronic obstructive disease lungs 16.6%, cerebrovascular diseases 13.5%. All participants underwent general clinical examinations. The concentration of the lipid spectrum was investigated: the levels of total cholesterol, triglycerides, cholesterol high density lipoproteins (HDL cholesterol) and low density lipoprotein cholesterol (LDL cholesterol) and plasma cystatin C. Glomerular filtration rate (GFR) was calculated according to F. Hoek's formula (80.35/cystatin C 4.32=GFR). Study of central aortic pressure (CAP), mm Hg Art., was carried out using the device "AngioScan". Echocardiography was performed on a "Vivid q" apparatus (USA, 2014) according to the generally accepted technique. All examined patients were divided into 2 subgroups. The 1st subgroup includes women, the 2nd men. Results. In patients with hypertension and comorbid pathology, the most common abnormalities were an increased level of LDL cholesterol (58%), a decreased level of HDL cholesterol (51.8%), hypercholesterolemia (54.3%), hypertriglyceridemia (43.8%) and tachycardia (40.7%). In 51.8% of the surveyed, and more among males, the achievement of the target blood pressure level was detected. In women, the indicators of average age, body mass index, the content of total cholesterol, LDL cholesterol and HDL cholesterol were significantly higher. In male patients, the indicators of the diameter of the aortic outflow tract, end systolic and diastolic dimensions of the left ventricle (LV) significantly exceeded those of women, and the ejection fraction of the LV was significantly lower. The prevalence of LV hypertrophy (LVH) was 37% in the total sample, and it was higher in women than in men (45.9 and 26.6%, respectively, p=0.012). At the same time, the frequencies of concentric and eccentric types of LVH in both subgroups were similar. The incidence of LV concentric remodeling in women and men was 5.7 and 13.3%, respectively (p=0.001). In both subgroups, a negative correlation was found between the LV myocardial mass index and the calculated GFR. A positive correlation was noted between the levels of systolic blood pressure and CAP, the concentrations of cystatin C and plasma triglycerides. Conclusion. In hypertension, the structure of comorbid pathology is dominated by coronary heart disease, obesity and type 2 diabetes mellitus, when hyper- and dyslipidemia were often detected. The incidence of LVH in the general group of subjects was 37.0%, and in women this indicator was higher. In the subgroup of men, cases of LV concentric remodeling were significantly more frequent. An increase in the level of CAP and systolic blood pressure, as well as the concentration of cystatin C, was associated with an increase in the LV myocardial mass index, especially in the subgroup of women.

Objective: To study the prevalence of cardiovascular (CV) risk factors (RFs) in the rural population of the Chui region of Kyrgyzstan (Central Asia). Methods: The sample was representative of the population in terms of age and sex and included at least 10% of the population aged 18-65 y. Of the 1,672 people included in the cohort, 1.330 people responded to the invitation (79.5% of the total sample population). All study participants were interviewed using standardized questionnaires and examined by a cardiologist. Blood pressure (BP), weight, height, waist circumference (WC), fasting serum glucose, and fasting lipid level were measured. Results: The prevalence of major CV RFs in the examined sample was as follows: arterial hypertension 34.1%, obesity 25.7%, and abdominal obesity 52.3%; the factors were significantly more prevalent in women (68.2%) and increased with age. The frequency of lipid metabolism disorders was 88.4% in the examined subjects, and an increased level of low-density cholesterol (70.5%) was common. Hypodynamia was detected in 15.6% of the subjects, diabetes mellitus in 3.76%, and a family history of cardiovascular disease was present in 34.8% of the examined subjects. The frequency of smoking was 24.6% and was significantly higher in men (46.9%). Conclusion: Abdominal obesity, followed by hypercholesterolemia and arterial hypertension were the most common RFs among the rural population of the Chui region of Kyrgyzstan. Smoking was the most common RF among men. The prevalence of traditional CV RFs, except smoking, increased with age.

Objective: To define epidemiological and nosological structure of patients with chronic heart failure (CHF) according to hospitals of tertiary level of the Kyrgyz Republic (National Center of Cardiology and Therapy and Scientific Research Institute of Heart Surgery and Organs Transplantation). Methods: Overall, 25415 patients medical records, patients of all ages provided treatment in the period of 2017 - 2018 in hospitals of tertiary level of the city of Bishkek were studied and analyzed. We also retrospectively studied cases with CHF referred to SRIHSOT outpatients department from city of Bishkek, observed from 2005 to 2018. In total, we included 3420 outpatient cards in the analysis. Results: According to National Center of Cardiology and Therapy, patients with NYHA FC I-II - 57.18% (14533) prevail and in this category, female persons - 57.60% prevail. The basic etiological reason of development of CHF in adult patients with FC – I-II is coronary heart disease in 33.00% of cases. Arterial hypertension, which occurred in 5624 patients (24.43%), was the most frequent accompanying pathology. According to Scientific Research Institute of Heart Surgery and Organs Transplantation among the referred patients with CHF the females (1930, 56.4%) prevail and patients with CHF and preserved ejection fraction (50% and more) (2706, 79.1%) prevail. Conclusion: Thus, in patients with CHF referred to NCCT, patients with FC I-II prevail and in this category female sex prevail. The main etiological reason of development of CHF in adult patients with FC – I-II is coronary artery disease followed by arterial hypertension. Among patients with CHF referred to SRIHSOT, female sex and CHF with preserved ejection fraction prevail. The 1st stage of CHF is registered in the majority of patients. Overall 72.4% of patients referred to SRIHSOT with CHF underwent surgery.

Objective: The data on the relationship between the level of TNF-α and interleukin-10 with the presence of left ventricular hypertrophy and myocardial remodeling in patients with essential hypertension is presented. Methods: Overall, 156 patients with essential hypertension aged 40 to 75 years (with mean age 55.8 ± 7.5 years) were examined; of which 57 were women and 99 were men. All patients were divided into two groups. The first group included 73 patients showing the presence of left ventricular hypertrophy (LVH), established by echocardiography; the second group included 83 patients who showed no signs of LVH on the echocardiogram. Results: According to the study, no relationship was found between the concentration of tumor necrosis factor α (TNF-α) and the development of LVH. It was also shown that only men, but not women with, were associated with the presence of LVH with low levels of interleukin-10 ( IL-10). In addition, a negative correlation was found between the concentration of tumor necrosis factor α (TNF-α) and IL-10 with the thickness of the left ventricular walls at the initial stages of myocardial remodeling on the echocardiography. Conclusion: Thus, our study demonstrates the modulating role of inflammation on the processes of myocardial remodeling in hypertension.