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Влияние степени нарушений углеводного обмена на тяжесть артериальной гипертонии, распространенность и выраженность поражения органов-мишеней у больных с метаболическим синдромом
Влияние степени нарушений углеводного обмена на тяжесть артериальной гипертонии, распространенность и выраженность поражения органов-мишеней у больных с метаболическим синдромом
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Аннотация
В настоящее время все шире обсуждается вопрос о влиянии различных метаболических нарушений и их сочетания на распространенность и выраженность поражения органов-мишеней (ПОМ) у больных артериальной гипертонией (АГ). С целью изучения влияния варианта (степени) нарушений углеводного обмена на тяжесть АГ (степень АГ и показатели суточного мониторирования артериального давления – СМАД), распространенность и выраженность ПОМ обследованы 403 пациента с метаболическим синдромом. В результате исследования установлено, что у пациентов, имеющих нарушение толерантности к глюкозе (НТГ) по сравнению с пациентами с нарушением гликемии натощак и тем более по сравнению с пациентами без явных нарушений углеводного обмена, регистрируются более выраженные изменения параметров СМАД, они страдают более тяжелой степенью АГ, у них выявляются более тяжелые поражения сердца и почек, однако это не относится к атеросклеротическому поражению экстракраниальных артерий. Таким образом, НТГ, являясь более тяжелой степенью (вариантом) нарушения углеводного обмена, может сопровождаться возрастанием риска сердечно-сосудистой заболеваемости и сахарного диабета типа 2 у данных больных.
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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17. Verdecchia P, Schillaci G, Borgioni C et al. Adverse prognostic significance of concentric remodeling of the left ventricle in hypertensive patients with normal left ventricular mass. J Am Coll Cardiol 1995; 25: 871–78.
18. Agabiti-Rosei E, Muiesan ML, Salvetti M. Evaluation of subclinical target organ damage for risk assessment and treatment in the hypertensive patients: left ventricular hypertrophy. J Am Soc Nephrol 2006; 17 (4 Suppl. 2): S104–8.
19. Ferrara LA, Cardoni O, Mancini M, Zanchetti A. Metabolic syndrome and left ventricular hypertrophy in a general population. Results from the Gubbio Study. J Hum Hypertens 2007; 21 (10): 795–601.
20. Chang Y, Yoo T, Ryu S et al. Abdominal obesity, systolic bood pressure and MAU in normotensive and euglicemic Korean men. Int. Obes (lond) 2006; 30 (5): 800–4.
21. Takiuchi S, Kamide K, Miwa Y et al. Diagnostic value of carotid intima–media thickness and plaque score for predicting target organ damage in patients with essential hypertension. J Hum Hypertens 2004; 18 (1): 17–23.
22. Cirillo M, Senigalliesi L, Laurenzi M et al. Microalbuminuria in nondiabetic adults; relations of blood pressure, body mass index, plasma cholesterol levels and smoking The GUBBIO Population Study. Arch Intern Med 1998; 158 (17): 1933–39.
23. 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.
24. De Simone G, Olsen MH, Wachtell K et al. Clusters of metabolic risk factors predict cardiovascular events in hypertension with target-organ damage: the LIFE study. J Hum Hypertens 2007; 21 (8): 625–32.
2. Reaven GM. Banting Lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–607.
3. Carr DB, Utzschneider KM, Hull RL et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004; 53: 2087–94.
4. Julius S, Gudbrandsson T, Jamerson K et al The hemodynamic link between insulin resistance and hypertension. J Hypertens 1991; 9: 983–86.
5. Mule G, Nardi E, Cottone S et al. Influence of metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503–13.
6. Schilacci G, Pirro M, Vaudo G et al. Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension. Hypertension 2005; 45: 1978–82.
7. 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.
8. Kavamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44: 1232–38.
9. Cuspidi C, Meani S, Fusi V et al. Ambulatory blood pressure, target organ damage and left atrial size in never-treated essential hypertensive individuals. J Hypertens 2005; 23: 1589–95.
10. 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.
11. 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.
12. 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.
13. 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.
14. Cuspidi C, Valerio C, Giudici V et al. Metabolic syndrome and multiple organ damage in essential hypertension. Blood Pressure 2008; 17: 195–203.
15. 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.
16. Recommendations for Chamber Quantification: A Report from the American Society of Еchocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with European Association of Echocardiography. J Am Soc Echocardiogr 2005; 18: 1446–7.
17. Verdecchia P, Schillaci G, Borgioni C et al. Adverse prognostic significance of concentric remodeling of the left ventricle in hypertensive patients with normal left ventricular mass. J Am Coll Cardiol 1995; 25: 871–78.
18. Agabiti-Rosei E, Muiesan ML, Salvetti M. Evaluation of subclinical target organ damage for risk assessment and treatment in the hypertensive patients: left ventricular hypertrophy. J Am Soc Nephrol 2006; 17 (4 Suppl. 2): S104–8.
19. Ferrara LA, Cardoni O, Mancini M, Zanchetti A. Metabolic syndrome and left ventricular hypertrophy in a general population. Results from the Gubbio Study. J Hum Hypertens 2007; 21 (10): 795–601.
20. Chang Y, Yoo T, Ryu S et al. Abdominal obesity, systolic bood pressure and MAU in normotensive and euglicemic Korean men. Int. Obes (lond) 2006; 30 (5): 800–4.
21. Takiuchi S, Kamide K, Miwa Y et al. Diagnostic value of carotid intima–media thickness and plaque score for predicting target organ damage in patients with essential hypertension. J Hum Hypertens 2004; 18 (1): 17–23.
22. Cirillo M, Senigalliesi L, Laurenzi M et al. Microalbuminuria in nondiabetic adults; relations of blood pressure, body mass index, plasma cholesterol levels and smoking The GUBBIO Population Study. Arch Intern Med 1998; 158 (17): 1933–39.
23. 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.
24. De Simone G, Olsen MH, Wachtell K et al. Clusters of metabolic risk factors predict cardiovascular events in hypertension with target-organ damage: the LIFE study. J Hum Hypertens 2007; 21 (8): 625–32.
Авторы
Ю.В.Жернакова, И.Е.Чазова, Г.Х.Шарипова, С.П.Олимпиева, В.В.Киликовский
Институт клинической кардиологии им. А.Л.Мясникова ФГУ РКНПК Минздравсоцразвития РФ, Москва
A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health and Social Development of the Russian Federation, Moscow
Институт клинической кардиологии им. А.Л.Мясникова ФГУ РКНПК Минздравсоцразвития РФ, Москва
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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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