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Риск поражения органов-мишеней у больных артериальной гипертонией с разным числом компонентов метаболического синдрома
Риск поражения органов-мишеней у больных артериальной гипертонией с разным числом компонентов метаболического синдрома
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Аннотация
Метаболический синдром (МС) является одной из наиболее социально значимых и приоритетных проблем клинической медицины. Известно, что наличие МС способствует более раннему и выраженному поражению органов-мишеней у больных артериальной гипертонией (АГ). Однако связь числа одновременно встречающихся компонентов МС с поражением органов-мишеней, выделение отдельных компонентов МС, влияющих на выраженность поражения органов-мишеней, изучены недостаточно. В проведенной нами работе установлено, что с увеличением числа компонентов МС происходит рост частоты и выраженности поражения сердца, почек и сосудов, что сопровождается повышенным риском развития сердечно-сосудистых осложнений у больных с максимальным числом компонентов МС. Кроме того, выявлено, что относительный риск одновременного поражения сердца, почек и сосудов у больных АГ с МС помимо повышенного АД и абдоминального ожирения ассоциируется с увеличением уровня глюкозы натощак.
Ключевые слова: метаболический синдром, компоненты метаболического синдрома, ожирение, артериальная гипертония, органы-мишени, относительный риск.
Key words: metabolic syndrome, components of metabolic syndrome, obesity, arterial hypertension, organ damage, relative risk.
Ключевые слова: метаболический синдром, компоненты метаболического синдрома, ожирение, артериальная гипертония, органы-мишени, относительный риск.
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Key words: metabolic syndrome, components of metabolic syndrome, obesity, arterial hypertension, organ damage, relative risk.
Полный текст
Список литературы
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17. Azevedo 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. MC Cardiovascular Disorders 2007; 7: 17.
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19. Kawamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44: 1232–8.
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21. Redon J, Rovira E, Miralles A et al. Factorsrelated to the occurrence of microalbuminuria during antihypertensivetreatment in essential hypertension. Hypertension 2002; 39: 794–8.
22. Segura J, Campo C, Roldan C et al. Hypertensive renal damage in metabolic syndrome is associated with glucose metabolism disturbances. J Am Soc Nephrol 2004; 1: 37–42.
2. 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.
3. 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.
4. Kavamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern med 2005; 44: 1232–8.
5. 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.
6. 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.
7. Cuspidi C, Valerio C, Giudici V et al. Metabolic syndrome and multiple organ damage in essential hypertension. Blood Pressure 2008; 17: 195–203.
8. 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.
9. Шарипова Г.М. Особенности поражения органов-мишеней у больных артериальной гипертонией в зависимости от наличия и отсутствия метаболического синдрома. Дис. д-ра мед. наук. М., 2009.
10. 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.
11. Саидова М.А., Сергакова Л.М., Атауллаханова Д.М. и др. Современные эхокардиографические подходы к оценке гипертрофии миокарда и структурного состояния левого желудочка у больных артериальной гипертонией. Методическое пособие для врачей. М., 2007.
12. 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: 1446–47.
13. Stein J, Korcarz CE, Hurst RT et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by Society for vascular Medicine. J Am Soc Echocardiogr 2008; 21 (2): 93–111.
14. Mancia G, Bombelli M, Corrao G et al. Metabolic syndrome in thePressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: dailylife blood pressure, cardiac damage, and prognosis. Hypertension 2007; 49: 40–7.
15. Cuspidi C, Meani S, Valerio C et al. Ambulatory blood pressure, target organ damage and left atrial size innever-treated essential hypertensive individuals. J Hypertens 2005; 23: 1589–95.
16. 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.
17. Azevedo 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. MC Cardiovascular Disorders 2007; 7: 17.
18. Mule G, Nardi E, Cottone S et al. Influenceof metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503–13.
19. Kawamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44: 1232–8.
20. 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): 795–801.
21. Redon J, Rovira E, Miralles A et al. Factorsrelated to the occurrence of microalbuminuria during antihypertensivetreatment in essential hypertension. Hypertension 2002; 39: 794–8.
22. Segura J, Campo C, Roldan C et al. Hypertensive renal damage in metabolic syndrome is associated with glucose metabolism disturbances. J Am Soc Nephrol 2004; 1: 37–42.
2. 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.
3. 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.
4. Kavamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern med 2005; 44: 1232–8.
5. 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.
6. 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.
7. Cuspidi C, Valerio C, Giudici V et al. Metabolic syndrome and multiple organ damage in essential hypertension. Blood Pressure 2008; 17: 195–203.
8. 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.
9. Шарипова Г.М. Особенности поражения органов-мишеней у больных артериальной гипертонией в зависимости от наличия и отсутствия метаболического синдрома. Дис. д-ра мед. наук. М., 2009.
10. 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.
11. Саидова М.А., Сергакова Л.М., Атауллаханова Д.М. и др. Современные эхокардиографические подходы к оценке гипертрофии миокарда и структурного состояния левого желудочка у больных артериальной гипертонией. Методическое пособие для врачей. М., 2007.
12. 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: 1446–47.
13. Stein J, Korcarz CE, Hurst RT et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by Society for vascular Medicine. J Am Soc Echocardiogr 2008; 21 (2): 93–111.
14. Mancia G, Bombelli M, Corrao G et al. Metabolic syndrome in thePressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: dailylife blood pressure, cardiac damage, and prognosis. Hypertension 2007; 49: 40–7.
15. Cuspidi C, Meani S, Valerio C et al. Ambulatory blood pressure, target organ damage and left atrial size innever-treated essential hypertensive individuals. J Hypertens 2005; 23: 1589–95.
16. 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.
17. Azevedo 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. MC Cardiovascular Disorders 2007; 7: 17.
18. Mule G, Nardi E, Cottone S et al. Influenceof metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503–13.
19. Kawamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44: 1232–8.
20. 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): 795–801.
21. Redon J, Rovira E, Miralles A et al. Factorsrelated to the occurrence of microalbuminuria during antihypertensivetreatment in essential hypertension. Hypertension 2002; 39: 794–8.
22. Segura J, Campo C, Roldan C et al. Hypertensive renal damage in metabolic syndrome is associated with glucose metabolism disturbances. J Am Soc Nephrol 2004; 1: 37–42.
________________________________________________
2. 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.
3. 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.
4. Kavamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern med 2005; 44: 1232–8.
5. 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.
6. 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.
7. Cuspidi C, Valerio C, Giudici V et al. Metabolic syndrome and multiple organ damage in essential hypertension. Blood Pressure 2008; 17: 195–203.
8. 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.
9. Шарипова Г.М. Особенности поражения органов-мишеней у больных артериальной гипертонией в зависимости от наличия и отсутствия метаболического синдрома. Дис. д-ра мед. наук. М., 2009.
10. 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.
11. Саидова М.А., Сергакова Л.М., Атауллаханова Д.М. и др. Современные эхокардиографические подходы к оценке гипертрофии миокарда и структурного состояния левого желудочка у больных артериальной гипертонией. Методическое пособие для врачей. М., 2007.
12. 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: 1446–47.
13. Stein J, Korcarz CE, Hurst RT et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by Society for vascular Medicine. J Am Soc Echocardiogr 2008; 21 (2): 93–111.
14. Mancia G, Bombelli M, Corrao G et al. Metabolic syndrome in thePressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: dailylife blood pressure, cardiac damage, and prognosis. Hypertension 2007; 49: 40–7.
15. Cuspidi C, Meani S, Valerio C et al. Ambulatory blood pressure, target organ damage and left atrial size innever-treated essential hypertensive individuals. J Hypertens 2005; 23: 1589–95.
16. 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.
17. Azevedo 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. MC Cardiovascular Disorders 2007; 7: 17.
18. Mule G, Nardi E, Cottone S et al. Influenceof metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503–13.
19. Kawamoto R, Tomita H, Oka Y et al. Metabolic syndrome amplifies the LDL-cholesterol associated increases in carotid atherosclerosis. Intern Med 2005; 44: 1232–8.
20. 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): 795–801.
21. Redon J, Rovira E, Miralles A et al. Factorsrelated to the occurrence of microalbuminuria during antihypertensivetreatment in essential hypertension. Hypertension 2002; 39: 794–8.
22. Segura J, Campo C, Roldan C et al. Hypertensive renal damage in metabolic syndrome is associated with glucose metabolism disturbances. J Am Soc Nephrol 2004; 1: 37–42.
Авторы
Ю.В.Жернакова*, Г.Х.Шарипова, И.Е.Чазова
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ РКНПК Минздрава России, Москва
*juli001@mail.ru
*juli001@mail.ru
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ РКНПК Минздрава России, Москва
*juli001@mail.ru
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*juli001@mail.ru
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