The present review summaries data describing the relationship between obesity and cardiovascular outcomes. Links between obesity and chronic coronary syndromes, acute coronary syndromes, coronary revascularization, ischemic stroke, heart failure, hypertension and atrial fibrillation were evaluated. Data from epidemiological studies, prospective studies with lifestyle modification or medical therapy, and results of the meta-analysis were evaluated. The majority of publications report the presence of an ‘obesity paradox’. According to this, overweight or obese patients with cardiovascular conditions have a better prognosis than patients with normal weight or underweight. At the same time, no information about comorbidities, concomitant medication, or other causes of low weight was not given in the majority of studies. Moreover, weight reduction as a result of medical intervention leads to improvement of the prognosis and patients’ quality of life. This analysis of the literature suggests that the ‘obesity paradox’ may not be an isolated medical phenomenon, but rather a corollary of the interpretation of the epidemiological data, and that medically-supervised weight loss should remain a key factor in recuing cardiovascular complications in obese people.
Objective: Post-traumatic stress disorder (PTSD) and its components have been associated with hypertension, particularly in military servants, war veterans and more recently in populations exposed to chronic violence. However, to our knowledge, this association has not been investigated in refugees. The objective of this study was to explore the potential association between high blood pressure and PTSD in Ukrainian women seeking asylum in Poland. Design and method: From September to December 2022, 55 Ukrainian women refugees were enrolled in dormitories from Sopot (Poland). Blood pressure (BP) was measured using validated oscillometric devices. Hypertension was defined as systolic BP > = 140 mmHg, diastolic BP > = 90 mmHg or being on antihypertensive treatment. Relevant demographic and clinical data were obtained. Furthermore, subjects filled validated questionnaires for depression, stress and anxiety (DASS) and post-traumatic stress disorder (PTSD) (PCL-5). Subjects with and without hypertension were compared for both general and psychological characteristics. Results: Thirty out of 55 subjects were found to be hypertensive. Compared to subjects with normal BP in absence of drugs (mean BP: 117.8/75.6 mmHg, n = 25), hypertensive subjects (mean BP: 138.1/85.8 mmHg, n = 30) were older (57.2 ± 11.1 vs. 39.1 ± 0.8 years, p < 0.00001) and had a higher BMI (29.0 ± 5.4 vs. 23.8 ± 4.4 kg/m2, p = 0.003). Furthermore, despite a similar personal situation (socio-economic background, direct exposure to war, time since arrival in Poland, with or without children/relatives), hypertensive subjects were more often feeling unsafe at the time of examination (4-items scale, p = 0.001) and scored higher for PTSD score (24.9 ± 17.0 vs. 16.3 ± 12.9, p = 0.038), particularly regarding intrusion (cluster B, p = 0.039) and hyper-arousal (cluster E, p = 0.002) dimensions, but not for DASS score (22.4 ± 14.2 vs. 17.2 ± 11.5, p = 0.14). Conclusions: This preliminary analysis is consistent with an association between high BP and both feeling of being unsafe and PTSD score in Ukrainian women refugees. Our results need confirmation using 24-hour BP monitoring and in a larger sample. In the absence of difference in personal background and exposure to war, these associations may reflect underlying differences in expression of emotions and coping abilities, as previously shown in other populations exposed to violence or with difficult-to-treat hypertension.
The peculiarities of the eating behavioral reactions of patients with chronic non-communicable diseases and the effect of group and individual therapy on them were evaluated. It was established, that with a tendency to positive changes in eating behavior, conducting both group and individual therapy for 1 year did not significantly change its indicators such as daily consumption of salt, vegetables and fruits, smoking and alcohol consumption, which confirms the complexity of the impact on the specified risk factor for the development and progression of chronic non-communicable diseases.
Introduction. Nowadays nonalcoholic fatty liver disease (NAFLD) consider as multisystem disease that is primarily associated with components of the metabolic syndrome and is associated with cardiovascular and renal impairment. The comorbidity of NAFLD with renoparenchymal arterial hypertension (RPAH) has not been sufficiently studied. The purpose of the study was to investigate the influence of G276T genetic polymorphism of ADIPOQ on the severity of metabolic disorders, inflammation, liver, artery and kidney damage in the comorbidity of NAFLD and RPAH. Materials and methods. The study included 87 patients with comorbidity of NAFLD and RPAH, grade 2. The mean age of patients was 50.78 ± 9.35 years. The vast majority of patients were overweight or obese. The control group was composed of 20 healthy volunteers. Parameters of carbohydrate and lipid metabolism, liver and kidney’s function, adiponectin, fetuin-A, cytokeratin-18, pro-inflammatory cytokines levels were investigated. For diagnostic of non-alcoholic steatosis and indication parameters of arteries, an ultrasound method was used. Results. It was found that the T allele was detected in 62 (35.6%) patients of the main group, which was significantly (p<0,05) different from the control group (22.5%). In the presence of patients with comorbidity NAFLD and RPAH G/T and T/T genotypes, carbohydrate metabolism disorders are more pronounced than in the G/G genotype. Thus, index HOMA in this group was 4.52 ± 0.87, which was significantly higher than patients with G/G genotype - 3.77 ± 0.53 (p <0.01).The G276T polymorphism of the ADIPOQ is not associated with markers of liver and kidney damage in patients with NAFLD + RPAH. The presence of G/T and T/T genotypes in patients with comorbidity of NAFLD and RPAH is associated with an increase in interleukin-6 and fetuin-A compared to the G/G genotype. Patients with comorbidity of NAFLD + RPAH and with the T allele of the polymorphic marker G276T of the ADIPOQ gene are more likely to have impaired endothelium-dependent vasodilation, indicating more significant vascular reactivity disorders - 7.72 ± 1.25% for the genotype G/G, and 7.00 ± 1.10% for the genotype G/T (p <0,01). Conclusions. The presence of the T allele of the polymorphic marker G276T of the ADIPOQ is associated with the development of comorbidity of NAFLD and RPAH.
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