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Влияние числа одновременно встречающихся компонентов метаболического синдрома на тяжесть артериальной гипертонии, распространенность и выраженность поражения органов-мишеней у данных больных
Влияние числа одновременно встречающихся компонентов метаболического синдрома на тяжесть артериальной гипертонии, распространенность и выраженность поражения органов-мишеней у данных больных
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Аннотация
В данной статье приведен обзор литературы, посвященный анализу связи числа одновременно встречающихся компонентов метаболического синдрома (МС) с тяжестью артериальной гипертонии (АГ), распространенностью и выраженностью поражения органов-мишеней у больных с МС. Известно, что МС усиливает риск сердечно-сосудистых заболеваний и сахарного диабета типа 2 независимо от ряда традиционных факторов сердечно-сосудистого риска. Однако немногочисленные исследования, посвященные возможной связи числа одновременно встречающихся компонентов МС с уровнем артериального давления (АД) и нарушением структуры суточного профиля АД (СПАД), содержат противоречивые данные. Рядом исследований установлено, что с увеличением числа компонентов МС происходит достоверное изменение СПАД – повышаются средние значения АД во все периоды суток, возрастает нагрузка давлением и вариабельность АД, происходит перестройка суточного ритма на прогностически неблагоприятные non-dipper и night-peaker. Тогда как в других работах связь количества компонентов МС с уровнем АД и структурой СПАД отрицается. Известно, что наличие МС способствует более раннему и выраженному поражению органов-мишеней у больных АГ. Однако дискутабельным остается вопрос о возможной связи числа одновременно встречающихся компонентов МС с распространенностью и выраженностью поражения органов-мишеней, работы, посвященные изучению данной проблемы, немногочисленны и противоречивы.
Ключевые слова: метаболический синдром, компоненты метаболического синдрома, артериальная гипертония, органы-мишени.
Key words: metabolic syndrome, metabolic syndrome components, arterial hypertension, target organs.
Ключевые слова: метаболический синдром, компоненты метаболического синдрома, артериальная гипертония, органы-мишени.
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Key words: metabolic syndrome, metabolic syndrome components, arterial hypertension, target organs.
Полный текст
Список литературы
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2. Isomaa B, Lahti K, Almengren P et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–9.
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13. Cuspidi C, Meani S,Valerio C et al. Metabolic syndrome score and ambulatory blood pressure in untreated essential hypertension. Blood Pressure Monitoring 2005; 10 (4): 175–80.
14. Mulè G, Nardi E, Cottone S et al. Influence of metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257 (6): 503–13.
15. Kawamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44: 1232–38.
16. Schillaci G, Pirro M, Vaudo G et al. Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension. Hypertension 2005; 45: 1978–82.
17. Cuspidi C, Meani S, Fusi V et al. Prevalence and correlates of left atrial enlargement in essential hypertension: role of ventricular geometry and the metabolic syndrome: the Evaluation of Target Organ Damage in Hypertension study. J Hypertens 2005; 23: 875–82.
18. Cuspidi C, Meani S, Valerio C et al. Ambulatory blood pressure, target organ damage and left atrial size in never-treated essential hypertensive individuals. J Hypertens 2005; 23: 1589–95.
19. Sega R, Trocino G, Lanzarotti A et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: data from the general population (Pressione Arteriose Monitorate e Loro Associazioni [PAMELA] Study). Circulation 2001; 104: 1385–92.
20. Cuspidi C, Valerio C, Giudici V et al. Metabolic syndrome and multiple organ damage in essential hypertension. Blood Pressure 2008а; 17: 195–203.
21. Navarro J, Redón J, Cea-Calvo L et al. Metabolic syndrome, organ damage and cardiovascular disease in treated hypertensive patients. The ERICHTA study. Blood Press 2007; 16 (1): 20–7.
22. Eguchi K, Schwartz JE, Roman MJ et al. Metabolic syndrome less strongly associated with target organ damage than syndrome components in a healthy, working population. J Clin Hypertens (Greenwich) 2007; 9 (5): 337–44.
23. Cuspidi C, Meani S, Valerio C et al. Age and target organ damage in essential hypertension: role of the metabolic syndrome. Am J Hypertens 2007; 20 (3): 296–303.
24. Cuspidi C, Sala C, Zanchetti A. Metabolic syndrome and target organ damage: role of blood pressure. Expert Rev Cardiovasc Ther 2008; 6 (5): 731–43.
25. Tatasciore A, Renda G, Zimarino M et al. Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects. Hypertension 2007; 50 (2): 325–2.
26. Шарипова Г.М. Особенности поражения органов-мишеней у больных артериальной гипертонией в зависимости от наличия и отсутствия метаболического синдрома. 2009.
27. Azeveda A, Bettencourt P, Almeida PB et al. Increasing number of components of the metabolic syndrome and cardiac structural and functional abnormalities – cross-sectional study of the general population. BMS Cardiovascular Disorders 2007; 7: 17.
28. Leoncini G, Ratto E, Viazzi F et al. Metabolic syndrome is associated with early signs of organ damage in non-diabetic, hypertensive patients. J Intern Med 2005; 257: 454–60.
29. Kincaid-Smith P. Hypothesis: obesity and the insulin resistance syndrome play a major role in end stage renal failure attributed to hypertension and labeled «hypertensive nephrosclerosis». J Hypertens 2004; 22: 105–55.
30. Mykkanen L, Zaccaro DJ, Wagenknecht LE et al. Microalbuminuria is associated with insulin resistance in nondiabetic subjects: the Insulin Resis-tance Atherosclerosis Study. Diabetes 1998; 47: 793–800.
31. Abuaisha B, Kumar S, Malik R, Boulton AJ. Relationship of elevated urinary albumin excretion to components of the metabolic syndrome in non-insulin-dependent diabetes mellitus. Diabetes Res Clin Pract 1998; 39 (2): 93–9.
32. Cuspidi C, Meani S, Fusi V et al. Metabolic syndrome and target organ damage in untreated essential hypertensives. J Hypertens 2004; 22: 1991–98.
33. Chen J, Muntner P, Hamm LL et al. The metabolic syndrome and chronic kidney disease in US adults. Ann Intern Med 2004; 140: 167–74.
2. Isomaa B, Lahti K, Almengren P et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–9.
3. Eschwege E. The dysmetabolic syndrome, insulin resistance and increased cardiovascular morbidity and mortality in type 2 diabetes: etiological factors in the development of CV complications. Diabetes Metab 2003; 29: 19–27.
4. Golden SH, Folsom AR, Coresh J et al. Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes 2002; 51: 3069–76.
5. Chobanian AV, Bakris GL, Black HR et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report. JAMA 2003; 289: 2560–72.
6. European Society of Hypertension-European Society of Cardiology Guidelines Committee. European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011–53.
7. Schillaci G, Pirro M, Vaudo G et al. Prognostic value of the metabolic syndrome in essential hypertension. J Am Coll Cardiol 2004; 19: 1817–22.
8. McNeill AM, Rosamond WD, Girman CJ et al. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care 2005; 28: 385–90.
9. Ford ES. The metabolic syndrome and mortality from cardiovascular disease and all-causes: Findings from the National Health and Nutrition Examination Survey II Mortality Study. Atherosclerosis 2004; 173: 309–14.
10. Иевлева Г.И., Тесля Е.Ф., Биктимирова Д.М. и соавт. Показатели суточного артериального давления у больных с метаболическим синдромом. Клиническая медицина 2009; 6: 15–9.
11. Eguchi K. Ambulatory blood pressure monitoring in diabetes and obesity – a review. Int J Hypertens 2011; doi:10.4061/2011/954757.
12. Soylu A, Güleç H, Alihanoğlu Yİ et al. The effect of nondipper blood pressure pattern on target organ damage in patients with metabolic syndrome. Türk Kardiyol Dern Arş 2009; 37: 454–60.
13. Cuspidi C, Meani S,Valerio C et al. Metabolic syndrome score and ambulatory blood pressure in untreated essential hypertension. Blood Pressure Monitoring 2005; 10 (4): 175–80.
14. Mulè G, Nardi E, Cottone S et al. Influence of metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257 (6): 503–13.
15. Kawamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44: 1232–38.
16. Schillaci G, Pirro M, Vaudo G et al. Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension. Hypertension 2005; 45: 1978–82.
17. Cuspidi C, Meani S, Fusi V et al. Prevalence and correlates of left atrial enlargement in essential hypertension: role of ventricular geometry and the metabolic syndrome: the Evaluation of Target Organ Damage in Hypertension study. J Hypertens 2005; 23: 875–82.
18. Cuspidi C, Meani S, Valerio C et al. Ambulatory blood pressure, target organ damage and left atrial size in never-treated essential hypertensive individuals. J Hypertens 2005; 23: 1589–95.
19. Sega R, Trocino G, Lanzarotti A et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: data from the general population (Pressione Arteriose Monitorate e Loro Associazioni [PAMELA] Study). Circulation 2001; 104: 1385–92.
20. Cuspidi C, Valerio C, Giudici V et al. Metabolic syndrome and multiple organ damage in essential hypertension. Blood Pressure 2008а; 17: 195–203.
21. Navarro J, Redón J, Cea-Calvo L et al. Metabolic syndrome, organ damage and cardiovascular disease in treated hypertensive patients. The ERICHTA study. Blood Press 2007; 16 (1): 20–7.
22. Eguchi K, Schwartz JE, Roman MJ et al. Metabolic syndrome less strongly associated with target organ damage than syndrome components in a healthy, working population. J Clin Hypertens (Greenwich) 2007; 9 (5): 337–44.
23. Cuspidi C, Meani S, Valerio C et al. Age and target organ damage in essential hypertension: role of the metabolic syndrome. Am J Hypertens 2007; 20 (3): 296–303.
24. Cuspidi C, Sala C, Zanchetti A. Metabolic syndrome and target organ damage: role of blood pressure. Expert Rev Cardiovasc Ther 2008; 6 (5): 731–43.
25. Tatasciore A, Renda G, Zimarino M et al. Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects. Hypertension 2007; 50 (2): 325–2.
26. Шарипова Г.М. Особенности поражения органов-мишеней у больных артериальной гипертонией в зависимости от наличия и отсутствия метаболического синдрома. 2009.
27. Azeveda A, Bettencourt P, Almeida PB et al. Increasing number of components of the metabolic syndrome and cardiac structural and functional abnormalities – cross-sectional study of the general population. BMS Cardiovascular Disorders 2007; 7: 17.
28. Leoncini G, Ratto E, Viazzi F et al. Metabolic syndrome is associated with early signs of organ damage in non-diabetic, hypertensive patients. J Intern Med 2005; 257: 454–60.
29. Kincaid-Smith P. Hypothesis: obesity and the insulin resistance syndrome play a major role in end stage renal failure attributed to hypertension and labeled «hypertensive nephrosclerosis». J Hypertens 2004; 22: 105–55.
30. Mykkanen L, Zaccaro DJ, Wagenknecht LE et al. Microalbuminuria is associated with insulin resistance in nondiabetic subjects: the Insulin Resis-tance Atherosclerosis Study. Diabetes 1998; 47: 793–800.
31. Abuaisha B, Kumar S, Malik R, Boulton AJ. Relationship of elevated urinary albumin excretion to components of the metabolic syndrome in non-insulin-dependent diabetes mellitus. Diabetes Res Clin Pract 1998; 39 (2): 93–9.
32. Cuspidi C, Meani S, Fusi V et al. Metabolic syndrome and target organ damage in untreated essential hypertensives. J Hypertens 2004; 22: 1991–98.
33. Chen J, Muntner P, Hamm LL et al. The metabolic syndrome and chronic kidney disease in US adults. Ann Intern Med 2004; 140: 167–74.
Авторы
Ю.В.Жернакова, И.Е.Чазова
Отдел системных гипертензий Института клинической кардиологии им. А.Л.Мясникова, ФГУ Российский кардиологический научно-производственный комплекс Минздравсоцразвития РФ
Department of Systemic Hypertensions, A.L.Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health and Social Development of the Russian Federation, Moscow
Отдел системных гипертензий Института клинической кардиологии им. А.Л.Мясникова, ФГУ Российский кардиологический научно-производственный комплекс Минздравсоцразвития РФ
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Department of Systemic Hypertensions, A.L.Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health and Social Development of the Russian Federation, Moscow
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