Жесткость сосудистой стенки у пациентов с артериальной гипертонией
Жесткость сосудистой стенки у пациентов с артериальной гипертонией
Остроумова О.Д., Кочетков А.И., Копченов И.И. и др. Жесткость сосудистой стенки у пациентов с артериальной гипертонией. Системные гипертензии. 2015; 12 (2): 43–48.
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Ostroumova O.D., Kochetkov A.I., Kopchenov I.I. et al. The hardness of the vessel wall in patients with arterial hypertension. Systemic Hypertension. 2015; 12 (2): 43–48.
Жесткость сосудистой стенки у пациентов с артериальной гипертонией
Остроумова О.Д., Кочетков А.И., Копченов И.И. и др. Жесткость сосудистой стенки у пациентов с артериальной гипертонией. Системные гипертензии. 2015; 12 (2): 43–48.
________________________________________________
Ostroumova O.D., Kochetkov A.I., Kopchenov I.I. et al. The hardness of the vessel wall in patients with arterial hypertension. Systemic Hypertension. 2015; 12 (2): 43–48.
В статье рассмотрена роль жесткости сосудистой стенки в патогенезе артериальной гипертонии, ее осложнений и сердечно-сосудистой смертности. Обсуждаются факторы, повышающие жесткость сосудистой стенки, – возраст, уровень артериального давления, атеросклероз, курение, сахарный диабет. Приведены показатели, которые отражают состояние сосудистой стенки и являются маркерами повышенного риска развития сердечно-сосудистых осложнений. Рассмотрены данные об улучшении параметров, характеризующих жесткость сосудистой стенки под влиянием антигипертензивной терапии блокатором рецепторов ангиотензина II 1-го типа кандесартаном. Обсуждаются возможные механизмы влияния кандесартана на эластические свойства сосудов. Подчеркивается, что эффект антигипертензивных медикаментов, даже относящихся к одному классу, на жесткость артерий разный, что, по-видимому, обусловлено различием в фармакокинетических свойствах.
Ключевые слова: артериальная гипертония, сахарный диабет, жесткость сосудистой стенки, скорость пульсовой волны, блокаторы рецепторов ангиотензина II, кандесартан.
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The article deals with the role of the hardness of the vessel wall in the pathogenesis of arterial hypertension and its complications and cardiovascular mortality. We discussed the factors increasing the hardness of the vessel wall, such as age, blood pressure level, atherosclerosis, smoking and diabetes mellitus. We showed the indicators reflecting the status of the vascular wall and which could play a role of markers of increased risk of cardiovascular complications. We reviewed the data concerning the improvement of the parameters of the hardness of the vessel wall under the influence of antihypertensive therapy using the angiotensin II type 1 receptor blocker – candesartan. We discussed the possible mechanisms of the candesartan influence on the elastic properties of the vessels. We stressed that the effect on the hardness of the arteries on using antihypertensive drugs, even within the same class, was different, which, apparently, was associated with the difference in the pharmacokinetic properties.
Key words: arterial hypertension, diabetes mellitus, the hardness of the vessel wall, pulse ware velocity, angiotensin II receptor blockers, candesartan.
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1. Blacher J, Guerin A, Pannier B et al. Impact of aortic stiffness on survival in end-stage renal disease. Circulation 1999; 99: 2434–9.
2. Williams B, Lacy PS, Thom SM et al. CAFE Investigators; Anglo-Scandinavian Cardiac Outcomes Trial Investigators; CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113 (9): 1213–25.
3. Agafonov A.V., Tuev A.V., Nekrutenko L.A., Bochkova Iu.V. Arterial'noe remodelirovanie u bol'nykh arterial'noi gipertenziei pozhilogo i starshego vozrasta. Ros. kardiol. zhurn. 2005; 3: 25–8. [in Russian]
4. Rebrov A.P. Zhestkost' arterii v zavisimosti ot nalichiia faktorov riska razvitiia serdechno-sosudistykh zabolevanii. Terapevt. arkh. 2009: 81 (3): 54–7. [in Russian]
5. Orlova Ia.A. Zhestkost' arterii, kak prediktor serdechno-sosudistykh oslozhnenii pri IBS. Terapevt. arkh. 2010: 82 (1): 68–73. [in Russian]
6. Mathiassen ON, Buus NH, Sihm I. Small artery structure is an independent predictor of cardiovascular events in essential hypertension. J Hypertens 2007; 25: 1021–6.
7. Boitsov S.A. Chto novogo nam daet informatsiia o zhestkosti stenki arterii i ob otrazhennoi pul'sovoi volne? Ros. fiziol. zhurn. im. I.M.Sechenova. 2009; 95(5): 516–31. [in Russian]
8. Вlacher J, Asmar R, Djane S. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 2001; 33: 1111–7.
9. Laurent S, Boutouyrie P, Asmar R et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236–41.
10. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55:1318–27.
11. Mancia G, De Backer G, Dominiczak A et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–87.
12. Diagnostika i lechenie arterial'noi gipertenzii. Rossiiskie rekomendatsii (tretii peresmotr). Kardiovask. terapiia i profilaktika (Pril. 2). 2008; 7 (6). [in Russian]
13. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertеns 2013; 31: 1281–357.
14. Glezer M.G. Pul'sovoe AD: pochemu eto vazhno? M.: Medikom, 2013. [in Russian]
15. Matsui Y, O’Rourke MF, Ishikawa J et al. Association of changes in ambulatory arterial stiffness index and pulse wave velocity during antihypertensive treatment: the J-CORE study. Am J Hypertens 2012; 25 (8): 862–8.
16. Laurent S, Cockcroft J, Van Bortel L et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588–605.
17. Sehestedt T, Jeppesen J, Hansen TW et al. Risk prediction is improved by adding markers of subclinical organ damage to SCORE. Eur Heart J 2010; 31: 883–91.
18. Sehestedt T, Jeppesen J, Hansen TW et al. Thresholds for pulse wave velocity, urine albumin creatinine ratio and left ventricular mass index using SCORE, Framingham and ESH/ESC risk charts. J Hypertens 2012; 30: 1928–36.
19. Tomiyama H, Yamashina A, Arai T et al. Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement – a survey of 12517 subjects. Atherosclerosis 2003; 166 (2): 303–9.
20. Ohmori K, Emura S, Takashima T. Risk factors of atherosclerosis and aortic pulse wave velocity. Angiology 2000; 51 (1): 53–60.
21. Fernandez MJ, Menendez A et al. Factors associated with arterial distensibility in hypertension. Aten Primaria 2000; 25 (9): 613–7.
22. Li AE, Kamel I, Rando F et al. Using MRI to assess aortic wall thickness in the multiethnic study of atherosclerosis: distribution by race, sex, and age. Am J Roentgenol 2004; 182 (3): 593–7.
23. Takazawa K, Tanaka N, Fujita M et al. Assessment of vasoactive agents and vascular aging by the second derivative of photoplethysmogram waveform. Hypertension 1998; 32: 365–70.
24. Safar ME, London GM. Therapeutic studies and arterial stiffness in hypertension: Recommendations of the European Society of Hypertension. J Hypertens 2000; 18: 1527–35.
25. McEniery CM, Yasmin, Hall IR et al. Normal vascular aging: differential effect on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). J Am Coll Cardiol 2005; 46: 1753–60.
26. Nichols WW, O’Rounkle MF. McDonald’s Blood Flow in Arteries: Theoretical, Experimental and Clinical Principals. 4th edition. London: Arnold, 1998.
27. Mitchell GF, Parise H, Benjamin EJ et al. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women: the Framingham Heart Study. Hypertension 2004; 43:1239–45.
28. Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003; 107: 2864–9.
29. Airaksinen KE, Salmela PI, Linnaluoto MK et al. Diminished arterial elasticity in diabetes: association with fluorescent advanced glycosylation end products in collagen. Cardiovasc Res 1993; 27(6): 942–5.
30. Chappey O, Dosquet C, Wautier MP, Wautier JL. Advanced glycation end products, oxidant stress and vascular lesions. Eur J Clin Invest 1997; 27 (2): 97–108.
31. Lehmann ED. Arterial wall compliance in diabetes. Diab Med 1992; 9 (2): 114–9.
32. Schram MT, Henry RM, Van Dijk RA et al. Increased central arterial stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn study. Hypertension 2005; 43: 176–81.
33. Schram MT, Schalwijk CG, Bootsma AH et al. Advanced glycation end products are associated with pulse pressure in type 1 diabetes: the EURODIAB Prospective Complications Study. Hypertension 2005; 46: 232–7.
34. McEleavy OD, McCallum RW, Petrie JR et al. Higher carotidradial pulse wave velocity in healthy offspring of patients with Type 2 diabetes. Diab Med 2004; 21 (3): 262–6.
35. Kool MJ, Hoeks AP, Struijker-Boudier H et al. Short- and longterm effects of smoking on arterial wall properties in habitual smokers. J Am Coll Cardiol 1993; 22: 1881–6.
36. Mahmud A, Feely J. Reduction in arterial stiffness with angiotensin II antagonist is comparable with and additive to ACE inhibition. Am J Hypertens 2002; 15: 321–5.
37. Levenson J, Simon AC, Cambien FA, Beretti C. Cigarettes smoking and hypertension. Factors independently associated with blood hyperviscosity and arterial rigidity. Arteriosclerosis 1987; 7: 572–8.
38. Aggoun Y, Bonnet D, Sidi D et al. Arterial mechanical changes in children with familial hypercholesterolemia. Arteriocler Thromb Vasc Biol 2000; 20: 2070–5.
39. Wilkinson IB, Prasad K. Hall IR et al. Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia. J Am Coll Cardiol 2002; 39: 1005–11.
40. Van Popele NM, Grobbee DE, Bots M et al. Association Between Arterial Stiffness and Atherosclerosis. Stroke 2001; 32: 454–60.
41. Bortolotto LA, Safar ME, Billaud E et al. Plasma homocysteine, aortic stiffness, and renal function in hypertensive patients. Hypertension 1999; 34: 837–42.
42. Blacher J, Guerin AP, Pannier B et al. Aortic Pulse Wave Velocity as a Marker of Cardiovascular Risk in Hypertensive Patients. Hypertension 1999; 33: 1111–7.
43. Hirai T, Sasayama S, Kawasaki T, Yagi S. Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. Circulation 1989; 80: 78–86.
44. Drechsler D. Assessment of Carotid Arteries and Pulse Wave Velocity in Patients with Three-Vessel coronary Artery Disease. Polish Heart J 2002; 57 (9): 254–9.
45. Booth AD, Wallace S, McEniery CM et al. Inflammation and arterial stiffness in systematic vasculites: a model of vascular inflammation. Arthritis Rheum 2004; 50: 581–857.
46. Yasmin, McEniery CM, Wallace S. C-reactive protein is associated with arterial stiffness in apparently healthy individuals. Arteriocler Thromb Vasc Biol 2004; 24: 969–74.
47. Laurent S, Cockcroft J, Van Bortel L et al, on behalf of the European Network of Non-invasive Investigation of Large Arteries. Expert consensus document on arterial stiffness: methodological issues and clinical application. Eur Heart J 2006; 27: 2588–605.
48. O’Rourke MF. Arterial function in health and disease. Edinburgh: Churchill, 1982.
49. Simon AC, Levenson J, Safar ME, Avolio AP. Evidence of early degenerative changes in large arteries in human essential hypertension. Hypertension 1985; 7: 675–80.
50. Lantelme P, Milon H, Gharib C et al. White coat effect and reactivity to stress: cardiovascular and autonomic nervous system responses. Hypertension 1998; 31: 1021–9.
51. Benetos A, Adamopoulos C, Bureau JM et al. Determinants of progression of arterial stiffness in normotensive subjects and treated hypertensive subject over a 6-year period. Circulation 2002; 105: 1202–7.
52. Uеhara G, Takeda H. Relative effects of telmisartan, candesartan and losartan on alleviating arterial stiffness. J Intern Med Res 2008; 36: 1094–102.
53. Sasamura H, Kitamura Y, Nakamura M, Ryuzaki M. Effects of angiotensin receptor blocker candesartan on arterial stiffness and markers of extracellular matrix metabolism in patients with essential hypertension. Сlin Experim Hypertens 2006; 28: 511–20.
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1 ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ostroumova.olga@mail.ru
1 A.I.Evdokimov Moscow State Medical and Dental University of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ostroumova.olga@mail.ru