mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical Universitymvjr-1259Research ArticleОБЗОРЫREVIEWПорознь или вместе. Как лучше? О влиянии нарушений метаболизма на течение артериальной гипертензииAppart or together. How is better? About the influence metabolic abnormalities on course of hypertantionДжериеваИ. С.DzherievaI. S.

кафедра внутренних болезней № 3

344022, г. Ростов-на-Дону, пер. Нахичеванский, 29

Department of Internal Medicine № 3

29 Nakhichevansky st., Rostov-on-Don, 344022

dgerieva@yandex.ruВолковаН. И.VolcovaN. I.

кафедра внутренних болезней № 3

344022, г. Ростов-на-Дону, пер. Нахичеванский, 29

Department of Internal Medicine № 3

29 Nakhichevansky st., Rostov-on-Don, 344022

Ростовский государственный медицинский университетРоссияRostov State Medical UniversityRussian Federation20103003201001912Copyright © Джериева И.С., Волкова Н.И., 20102010Джериева И.С., Волкова Н.И.Dzherieva I.S., Volcova N.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1259

Ассоциация артериальной гипертензии и метаболических нарушений ускоряет развитие органных поражений, повреждая больше органов-мишеней. Современными проспективными исследованиями доказано, что скорость гипертрофии миокарда тесно коррелирует с выраженностью метаболических нарушений, при этом толщина межжелудочковой перегородки и задней стенки сильнее зависит от выраженности нарушений метаболизма, чем увеличение полости левого желудочка, а рост размеров левого предсердия связан с уровнем гликемии натощак и избыточным весом. Влияние нарушений метаболизма прослеживается при выяснении причин поражений почечной ткани: микроальбуминурия тесно ассоциирует с уровнем гиперинсулинемии, установлена линейная связь между числом компонентов метаболического синдрома и скоростью клубочковой фильтрации менее чем 60 мл/мин. Помимо этого, получены доказательства, что жесткость артерий есть новый независимый фактор сердечно-сосудистых осложнений, связанный с ожирением. Кроме того, метаболические нарушения способствуют развитию разнообразных аффективных расстройств, снижающих качество жизни пациентов и их мотивации к лечению.

The association of arterial hypertension and metabolic abnormalities increases the risk of cardiovascular events. It damages more organs. The correlation between the speed of myocardial hypertrophy and degreeses of metabolic abnormalities has been demonstrated in prospective studies. Interventricular septal thickness depends more significantly on metabolic abnormalities than on the left ventricular chamber size. Besides atrial enlargement has also been associated with overweight and high fasting glucose. Renal events depend on metabolic abnormalities Microalbuminuria has been associated with hyperinsulinemia. The linear link between the prevalence of GFR and the number of metabolic syndrome components has been established. Furthermore, the evidence that artery stiffening is new independent risk factor has been found. This marker connected with obesity. Besides metabolic abnormalities produce a lot of different affective decoders, which can decrease patients quality life and motivations to their treatment.

гипертензиянарушения метаболизмаорганы-мишениаффективные расстройстваhypertensionmetabolic abnormalitiesorgans-targetsaffective decodersReferencesШальнова С.А., Баланова Ю.А., Константинов В.В. и др. Артериальная гипертензия: распространенность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения Российской Федерации //Рос. Кард. Журнал. – 2006. - №4:45050Шальнова С.А., Баланова Ю.А., Константинов В.В. и др. Артериальная гипертензия: распространенность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения Российской Федерации //Рос. Кард. Журнал. – 2006. - №4:45050Оганов. Р.Г., Погосова Г.В., Колтунов И.Е., Белова Ю.С., Выгодин В.А., Соколова Я.В. РЕЛИФ – РЕгулярное Лечение И проФилактика – ключ к улучшению ситуации с сердечно-сосудистыми заболеваниями в России: результаты российского многоцентрового исследования. Часть I. Кардиология. – 2007. - №12. – С.58-66.Оганов. Р.Г., Погосова Г.В., Колтунов И.Е., Белова Ю.С., Выгодин В.А., Соколова Я.В. РЕЛИФ – РЕгулярное Лечение И проФилактика – ключ к улучшению ситуации с сердечно-сосудистыми заболеваниями в России: результаты российского многоцентрового исследования. Часть I. Кардиология. – 2007. - №12. – С.58-66.Диагностика и лечение метаболического синдрома. Национальные клинические рекомендации под редакцией проф. Чазова И.Е. //Кардиоваскулярная терапия и профилактика. – 2007. - №6 (6). Приложение 2.Диагностика и лечение метаболического синдрома. Национальные клинические рекомендации под редакцией проф. Чазова И.Е. //Кардиоваскулярная терапия и профилактика. – 2007. - №6 (6). Приложение 2.Dekker JM, Girman C, Rhodes T, Nijpels G, Stehouwer CD, Bouter LM, Heine RJ. Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn Study //Circulation. – 2005. - №112. – P. 666-673.Dekker JM, Girman C, Rhodes T, Nijpels G, Stehouwer CD, Bouter LM, Heine RJ. Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn Study //Circulation. – 2005. - №112. – P. 666-673.Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) //JAMA. – 2001. №285. – P.2486–2497.Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) //JAMA. – 2001. №285. – P.2486–2497.Grundy SM, Hansen B, Smith SC, Cleeman JI, Kahn RA, for the Conference Participants. Clinical Management of Metabolic Syndrome. Report of the American Heart Association/National Heart, Lung, and Blood Institute //American Diabetes Association Conference on Scientific Issues Related to Management. Circulation. – 2004. - №109. – P. 551-556Grundy SM, Hansen B, Smith SC, Cleeman JI, Kahn RA, for the Conference Participants. Clinical Management of Metabolic Syndrome. Report of the American Heart Association/National Heart, Lung, and Blood Institute //American Diabetes Association Conference on Scientific Issues Related to Management. Circulation. – 2004. - №109. – P. 551-556Сuspidi C, Valero C, Giudici V, Negri F, Sala C, Zanchetti A, Mancia G. Metabolic syndrome and multiple organ damage in essential hypertension //Blood Press. – 2008. №17 (4). – P.195-203.Сuspidi C, Valero C, Giudici V, Negri F, Sala C, Zanchetti A, Mancia G. Metabolic syndrome and multiple organ damage in essential hypertension //Blood Press. – 2008. №17 (4). – P.195-203.de Simone G. State of the heart in the metabolic syndrome //Nurt Metab Cardiovasc Dis. – 2005. - №15. – P.239-241.de Simone G. State of the heart in the metabolic syndrome //Nurt Metab Cardiovasc Dis. – 2005. - №15. – P.239-241.Leoncini G, Ratto E, Viazzi F, Vaccaro V, Parodi D, Parodi A, et al. Metabolic syndrome is associated with early sings of organ damage in nondiabetic, hypertensive patients //J Intern Med. – 2005. - №257. – P.454-460.Leoncini G, Ratto E, Viazzi F, Vaccaro V, Parodi D, Parodi A, et al. Metabolic syndrome is associated with early sings of organ damage in nondiabetic, hypertensive patients //J Intern Med. – 2005. - №257. – P.454-460.Mule G, Nardi E, Cottone S, Cusimano P, Volpe V, Piazza G, et al. Influence of metabolic syndrome on hypertension-related target organ damage //J Intern Med. – 2005. - №257. – P.503-513.Mule G, Nardi E, Cottone S, Cusimano P, Volpe V, Piazza G, et al. Influence of metabolic syndrome on hypertension-related target organ damage //J Intern Med. – 2005. - №257. – P.503-513.Burchfiel CM, Skelton TN, Andrew ME, Garrison RJ, Arnett DK, Jones DW, Taylor HA Jr. Metabolic syndrome and echocardiographic left ventricular mass in blacks: the Atherosclerosis Risk in Communities (ARIC) Study //Circulation. - 2005 - №112. – P.819-827.Burchfiel CM, Skelton TN, Andrew ME, Garrison RJ, Arnett DK, Jones DW, Taylor HA Jr. Metabolic syndrome and echocardiographic left ventricular mass in blacks: the Atherosclerosis Risk in Communities (ARIC) Study //Circulation. - 2005 - №112. – P.819-827.Cuspidi C, Meani S, Fusi V, Valerio C, Catini E, Sala C, 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. – P.875-882Cuspidi C, Meani S, Fusi V, Valerio C, Catini E, Sala C, 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. – P.875-882Mancia G, Bombelli M, Corrao G, Facchetti R, Madotto F, Gian- nattasio C, et al. . Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazoni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis //Hypertension. – 2007. - №49. – P.40-47.Mancia G, Bombelli M, Corrao G, Facchetti R, Madotto F, Gian- nattasio C, et al. . Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazoni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis //Hypertension. – 2007. - №49. – P.40-47.Cuspidi C, Meani S, Fusi V, Severgnini B, Valerio C, Catini E, et al. Metabolic syndrome and target organ damage in untreated essential hypertensives //J Hypertens. – 2004. - №22. – P.1991-1998.Cuspidi C, Meani S, Fusi V, Severgnini B, Valerio C, Catini E, et al. Metabolic syndrome and target organ damage in untreated essential hypertensives //J Hypertens. – 2004. - №22. – P.1991-1998.Bianchi S, Bigazzi R, Valtriani C, Chiaponni I, Sgherri G, et al. Elevated serum insulin levels in patients with essential hypertension and microalbuminuria //Hypertension. – 1994. - №23. – P.681-687.Bianchi S, Bigazzi R, Valtriani C, Chiaponni I, Sgherri G, et al. Elevated serum insulin levels in patients with essential hypertension and microalbuminuria //Hypertension. – 1994. - №23. – P.681-687.Palaniappan L, Carnethon M, Fortmann SP. Association between microalbuminuria and the metabolic syndrome //Hypertension. – 1994. - №23. – P.681-687.Palaniappan L, Carnethon M, Fortmann SP. Association between microalbuminuria and the metabolic syndrome //Hypertension. – 1994. - №23. – P.681-687.Redon J, Miralles A, Pascual JM, Baldo E, Garcia Robles R, Carmena R. Hyperinsulinemia as a determinant of microalbuminuria in essential hypertension //J Hypertens. – 1997. - №15. – P.79-86.Redon J, Miralles A, Pascual JM, Baldo E, Garcia Robles R, Carmena R. Hyperinsulinemia as a determinant of microalbuminuria in essential hypertension //J Hypertens. – 1997. - №15. – P.79-86.Ferreira I, Henry RM, Twisk JW, van Machelen W, Kemper HC, Stehouwer CD, Amsterdam Growth and Health Longitudinal Study. The Metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam Growth and Health Longitudinal Study //Arch Intern Med. – 2005. - №165. – P.875-882.Ferreira I, Henry RM, Twisk JW, van Machelen W, Kemper HC, Stehouwer CD, Amsterdam Growth and Health Longitudinal Study. The Metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam Growth and Health Longitudinal Study //Arch Intern Med. – 2005. - №165. – P.875-882.Schillaci G, Pirro M, Vaudo G, Mannarino MR, Savarese G, Pucci G, et al. Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension //Hypertension. – 2005. - №45. – P.1078-1082.Schillaci G, Pirro M, Vaudo G, Mannarino MR, Savarese G, Pucci G, et al. Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension //Hypertension. – 2005. - №45. – P.1078-1082.Scuteri A, Najjar SS, Muller DC, Andres R, Hougaku H, Mettr EJ, Lakatta EG. Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness //J Am Coll Cardiol. – 2004. - №43. – P.1388-1395.Scuteri A, Najjar SS, Muller DC, Andres R, Hougaku H, Mettr EJ, Lakatta EG. Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness //J Am Coll Cardiol. – 2004. - №43. – P.1388-1395.Nagaya T, Yoshida H, Takahashi H, Kawai M. Markers of insulin resistance in day and shift workers aged 30-59 years //Int Arch Occup Environ Health. – 2002. - №75. – P.562-568.Nagaya T, Yoshida H, Takahashi H, Kawai M. Markers of insulin resistance in day and shift workers aged 30-59 years //Int Arch Occup Environ Health. – 2002. - №75. – P.562-568.Tropeano AI, Boutouyrie P, Katsahian S, Laloux B, Laurent S. Glucose level is a major determinant of carotid intima-media thickness in patients with hypertension and hyperglycemia // J Hypertens. – 2004. - №22. – P.2153-2160.Tropeano AI, Boutouyrie P, Katsahian S, Laloux B, Laurent S. Glucose level is a major determinant of carotid intima-media thickness in patients with hypertension and hyperglycemia // J Hypertens. – 2004. - №22. – P.2153-2160.Heiskanen TY., Niskanen LK., Hitikka JJ et al. Metabolic syndrjme and depression: a cross-section analysis //J.Clin. Psychiatry. - 2006 Sep. - №67(9). – P.1422-1427.Heiskanen TY., Niskanen LK., Hitikka JJ et al. Metabolic syndrjme and depression: a cross-section analysis //J.Clin. Psychiatry. - 2006 Sep. - №67(9). – P.1422-1427.Koponen Y., Jokelain J., at al. Metabolic syndrome predispouses to depressive symptoms: a population-based 7 year follow-uh study // J Clin. Psychiatry. - 2008 Feb. - №69(2). – P.178-82Koponen Y., Jokelain J., at al. Metabolic syndrome predispouses to depressive symptoms: a population-based 7 year follow-uh study // J Clin. Psychiatry. - 2008 Feb. - №69(2). – P.178-82

The authors declare that there are no conflicts of interest present.