The study of vitamin D - dependent risk factors for the formation of essential arterial hypertension
(EAH) based on the assessment of serum levels of calcidiol (25 (OH) D), calcium and vasoconstrictor factor endothelin-1-21 in 132 students aged 13 to 16 years (average age 14.64 ± 0.19 years) with normal, high normal blood pressure and essential arterial hypertension (EAH) established the priority effect of vitamin D supply on the level of diastolic blood pressure in the group of children with labile arterial hypertension and in the group of children with stable on the parameters of systolic blood pressure. In the mechanism of EAH formation in children, an interdependence between vitamin D deficiency and the severity of endothelial dysfunction by the level of endothelin -1-21 was revealed. The following vitamin D were determined by diagnostic efficiency - dependent risk factors for the formation of EAH in children in decreasing importance: endothein-1-21> 0.41fmol / ml; vitamin D <20ng / ml; Ca <2.22 mmol / L.
The article provides information on the importance of adhering to the rules of targeted diet and rational nutrition, which are important elements of a healthy lifestyle in the prevention and treatment of arterial hypertension, and the implementation of the DASH diet program. Dietary approach and rational nutrition, which is one of the foundations of a healthy lifestyle, is widely used as a non drug treatment in many diseases of the cardiovascular system, including arterial hypertension. In the development of arterial hypertension, an excess of the recommended amount of salt increases the sensitivity of the resistive vascular wall to pressor factors. The result is an increase in peripheral resistance as well as arteriola tone. As a result, a steady increase in the level of arterial hypertension leads to an increase in the incidence of injuries to the target organs and the occurrence of hypertensive crises.
Chronic obstructive pulmonary disease (COPD) and severe bronchial asthma (BA) are some of the main causes of pulmonary arterial hypertension and account for more than 50% in the structure of pulmonary hypertension formation. The paper studies the state of central hemodynamics and endothelial function of peripheral vessels in patients with chronic obstructive pulmonary disease, bronchial asthma complicated by pulmonary hypertension (LH).
Atherosclerosis is a chronic lesion of the arteries caused by the growth of multiple dense nodular thickenings of the walls of the artery (plaques), narrowing its lumen and contributing to the formation of a blood clot - a thrombus, which can clog the vessel. Atherosclerosis develops as a result of complex structural changes that occur in the intima (inner layer) and in the media (muscle layer) of the arteries, and it is associated with the accumulation of lipids and mucopolysaccharides in the blood vessels, the growth of connective tissue and the deposition of calcium. Cardiovascular pathology, and this is ischemic heart and brain disease, occlusive diseases of peripheral arteries, is the most common cause of morbidity, mortality and disability in the population of industrialized countries. According to the statistics of the World Health Organization, in the structure of total mortality in Russia, cardiovascular diseases account for 57%. Most of these cases are associated with diseases caused by atherosclerosis [3]. The development of atherosclerotic lesions of the vascular wall is a complex multi-stage process. It has now been established that even before endothelial damage, blood components begin to interact with the endothelial surface. In particular, low-density lipoprotein cholesterol (LDL-C) and their active component apolipoproteins are able to penetrate into the subendothelial space and, being oxidized, affect endothelial cells. In this regard, the initial stage of atherosclerosis is characterized as a response to the retention of atherogenic particles [2]. The main risk factors that play a significant role in endothelial damage are smoking, arterial hypertension and hypercholesterolemia. It has been shown that with an increase in cholesterol levels of more than 8.5 mmol/l, the risk of fatal cardiovascular complications increases by 4 times, when combined with arterial hypertension by 9 times, with smoking, the presence of hypercholesterolemia and arterial hypertension by 16 times [1]. The problem of primary and secondary prevention of ischemic stroke is not only medical, but also of great social importance, since patients who have had it become disabled in more than 80% of cases and often need outside help. Statins are considered highly effective drugs with the greatest evidence in reducing the risk of cardiovascular events in patients with coronary artery disease.
This article presents otoneurological characteristics of pre-stroke cerebrovascular disorders in patients with hypertension. Among the problems of modern otorhinolaryngology, one of the leading places belongs to cochleovestibular disorders in some cardiovascular diseases, in particular, hypertension. The state of vestibular function in arterial hypertension was studied by many authors who noted a decrease in resistance in such patients. It has been established that one of the reasons for the formation of secondary cochleovestibular disorders is chronic hypertensive encephalopathy that develops in patients with arterial hypertension, often already in the early stages of the disease. In studying the features of the pathogenesis of cochleovestibular disorders, certain results have been achieved by studying the nature of the vestibulovascular interaction. In particular, the difference between vestibulovascular reactions in central and peripheral lesions of the vestibular analyzer was shown, which is important for the differential diagnosis of these pathological conditions.
Among modern cardiovascular drugs, amlodipine preparations occupy a significant place for the treatment of both arterial hypertension (AH) and coronary heart disease (CHD). The main merit in this belongs to Norvasc® (amlodipine besylate). According to the PIFAGOR III pharmacoepidemiological study, the proportion of amlodipine in the structure of antihypertensive drugs (AHP) taken by patients with hypertension reaches 15%.
The monograph presents modern aspects of syndialysis arterial hypotension: solved and unresolved problems of predicting, preventing and diagnosing this complication during dialysis. The characteristics of clinical and pathogenetic features, diagnosis, treatment, prognosis and prevention of syndialysis arterial hypotension are given. The data of the dynamics of clinical, functional and laboratory studies of syndialytic arterial hypotension in patients on dialysis are presented. An algorithm for verifying the status of hydration and preventing syndialysis hypotension is presented. The monograph is intended for nephrologists, doctors of related specialties, masters and students of medical institutes.