Background. Hypertension (HTN) is often combined with other diseases, that significantly complicate its course, worsen the prognosis, interfere with the therapeutic and preventive measures. Therefore, assessing the development and structure of polymorbidity (PM) in hypertension is a relevant issue. Objective. To study the structure and degree of PM in hypertensive patients depending on age and gender. Design and methods. We conducted an analysis of 20 560 case histories of patients with HTN and without HTN (men and women), inhabitants of West Siberia-Novosibirsk region, who underwent examination and treatment at the clinic of the Federal Research Center of Fundamental and Translational Medicine in Novosibirsk. All identified diagnoses (nosological forms and classes according to the International Classification of Diseases of the 10th revision, ICD‑10) were considered. Transnosological PM was assessed by the average number of nosologies corresponding to the three-digit ICD‑10 rubric. Results. An increase in the PM index by 16,8 % was found in HTN patients compared to patients without HTN. Among HTN patients, there was an increase in the incidence of comorbid diseases of the circulatory system (in the 16–39 age group in men — by 46 %, in women — by 42,8 %), the endocrine system, eating disorders and metabolism (in the age group 16–39 years for men — by 19,3 %, for women — by 45,2 %), the musculoskeletal system, urinary system (for men) and neoplasms (for women) compared with patients without HTN. Conclusions. We found a high rate of transnosological PM in HTN patients was found and defined its structure.
Introduction. Nowadays the problem of population health in the northern areas is of great importance. While evaluating human adaptation to the extreme geoecological northern conditions the state of the cardiovascular system can be used as an index of effective compensatory adaptation. Study design. The data on 24-hour BP monitoring, data of echocardiography and heliogeophysical factors in different periods of ontogenesis in 317 patients, living in the north of the Tyumen region, were analysed to estimate the morphofunctional and chronobiological peculiarities of arterial hypertension. Results. Considerable disorders of haemodynamic circadian rhythms, manifesting either insufficient decrease of BP at night are revealed in the examined subjects. Above 42.2% of such patients have myocardial hypertrophy. Insufficient night decrease of BP is typical for the examined patients, with coupling of the indices of haemodynamic and current geomagnetic activity. The peculiarities of heliogeophysical factors at early ontogenesis of the examined subjects with an increased variability and decreased circadian index of BP are defined using multivariate analysis. Conclusion. Thus, a combination of disorders of temporary haemodynamic organisation with the morphological changes of myocardium and peculiarities of biogeophysical coupling of the examined is shown. This anthropoecological approach can be used for the diagnostics and treatment of arterial hypertension under conditions of the northern ecosystem.
Сердечно-сосудистые заболевания (ССЗ) являются главной причиной преждевременной смерти, равно как и значимыми причинами нетрудоспособности не только в России, но и большинстве стран мира. В последнем докладе ВОЗ отмечается, что 1 / 3 всех причин смертности взрослого населения, а это около 15 млн смертей во всем мире, составляют ССЗ, связанные с атеросклерозом [1]. По данным Всероссийского научного общества кардиологов, заболевания сердца и сосудов являются причиной в среднем 56% всех смертей россиян (48% всех смертей у мужчин и 66,2%-у женщин). Всего болезнями сердца и сосудов в России страдают более 23 млн человек. Каждый год в нашей стране умирают 1 млн 300 тыс человек вследствие сердечно-сосудистых катастроф [2]. Среди заболеваний сердечно-сосудистой системы, являющихся причинами смерти, основными остаются ишемическая болезнь сердца (ИБС), в том числе инфаркт мио
In Group I comorbidity pathology was frequently observed in male, in Group III-in female. It is necessary to develop regional strategies for observing patients with combined pathologies to improve prevention, rehabilitation and treatment of patients with arterial hypertension associated with diseases of gallbladder, biliary ducts and pancreas.
Purpose. To study regional features of the association of frequency of occurrence and the magnitude of the indices of the main risk factors for chronic non-communicable diseases (RF CNCD) with the degree of transnosological polymorbidity (PM) in male residents of the Novosibirsk Region (NR) and Saha (Yakutia) Republic. Methods. The analysis of 10 187 medical records of patients with therapeutic profile (men), examined and treated in the clinic of the Federal Research Center for Fundamental and Translational Medicine, Novosibirsk was carried out. The index of transnosological polymorbidity was assessed by the number of nosological forms in accordance with the ICD-10. According to the clinical and laboratory examination, the following RF CNCD were assessed: high blood pressure, increased blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, uric acid, decreased blood level of low-density lipoprotein cholesterol, obesity. Results. Both among the residents of the NR and of the Yakutia, with an increase in the index of polymorbidity, there was an increase in the severity and frequency of occurrence of the studied RF CNCD. There was an increase in the frequency of occurrence in persons with high PM in comparison with those with a low degree of PM: arterial hypertension among residents of NR and of the Yakutia - by 2 times (p < 0.001), increase in total cholesterol in the blood among residents of the NR and of the Yakutia - by 1.2 times (p < 0.001, p = 0.003 respectively), obesity - for residents of the NR by 2.4 times, for residents of the Yakutia - by 1.7 times (p < 0.001), hyperglycemia - in residents of NR - by 2 times (p < 0.001), hyperuricemia - among residents of NR - by 1.5 times (p < 0.001). Conclusion. The role of some hemodynamic and metabolic risk factors of RF CNCD in the development of polymorbid pathology among residents of the regions of Siberia and the North has been established. The obtained data indicate the need to take into account the region of residence of such patients in the course of personalized prophylaxis with mandatory detection and correction of the modifiable RF CNCD.
:
Comorbidity of hypertension and hepatobiliary pathology has negative medical and social consequences, including
increase in indicators of hospital admissions, disability and mortality.
Objective:
To study the occurrence of hypertension combined with hepatobiliary diseases depending on social status,
gender and age in 2003-2017 and the features of its influence on indicators of metabolic processes in patients of therapeutic
profile.
Method:
A cross-sectional study using the inpatients medical record database of the clinic of Federal Research Centre
for Basic and Translational Medicine (Novosibirsk, Russia), which collects demographics, diagnoses (using ICD-10
codes), procedures and examinations of all inpatients from 2003-2017 was conducted. A study of the incidence of
comorbidity of hypertension and hepatobiliary pathology depending on age, gender and social status, based on the analysis
of 13496 medical records was made. A comparative analysis of biochemical parameters characterizing the main types of
1
metabolism (lipid, protein, carbohydrate and purine) was carried out in 3 groups of patients: with hypertension; with
hepatobiliary pathology, with a combined pathology.
Results:
In 2003-2005 years there was the greatest frequency of this comorbidity in workers, in women, in the age
group 60 years and older. In 2009-2017 years the highest incidence was in male administrative staff. In patients with
this comorbidity more pronounced changes in carbohydrate, protein, lipid and purine metabolism were found in
comparison with groups of patients with isolated diseases,
Conclusion:
The results make it necessary to improve the system of prevention and treatment of comorbidity taking in
account sex, age, occupation and features of metabolism.
The results of the study with the inclusion of therapy with modulated sinusoidal currents together with total wrapping using the Rapan saline solution and sedative inhalations into the program of the combined treatment of the patients presenting with dorsopathy of the lumbar spine and concomitant irritable bowel syndrome provide a basis for recommending this physiotherapeutic modality for personalized rehabilitation of this group of patients under conditions of a therapeutic clinic.
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