Masked Hypertension in Young Persons: Prevalence, Significance of Cardiovascular Risk Factors and Prognosis by Gender Differences

Лямина, Н. П.; Наливаева, А. В.; Сенчихин, В. Н.; Липчанская, Т. П.

doi:10.15829/1560-4071-2017-4-7-12

Cited by 12 publications

(6 citation statements)

References 6 publications

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“…Среди клинических вариантов АГ особый интерес представляют её "скрытые" или "маскированные" (МАГ) формы. По материалам различных источников МАГ регистрируется у 10-49% обследованных, а широкая вариативность этих показателей в отдельных исследованиях зависит от гендерных, возрастных и антропометрических характеристик популяционных когорт, социального статуса, профессии, расовой принадлежности обследованных, наличия у них сопутствующей патологии и других факторов [3,4]. Диагностика МАГ базируется на анализе соотношений результатов измерений офисного (клинического) и внеофисного (амбулаторного) артериального давления (АД), а к ее индикаторам относят среднесуточный уровень амбулаторного АД ≥135/85 мм рт.ст.…”

Section: Discussionunclassified

Assessment of cardiometabolic risk factors in various phenotypes of masked hypertension

Гельцер

Орлова-Ильинская

Ветрова

et al. 2020

Cardiovasc Ther Prev

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Aim. To assess the relationship of cardiometabolic risk factors in patients with various phenotypes of masked hypertension (MH).Material and methods. The study included 207 men with a median age of 34,6 years [32,3; 36,3] being systematically stressed. All examined patients had normal clinical blood pressure (BP), and there was no history of its increase. We conducted 24-hour ambulatory blood pressure monitoring (ABPM), carotid duplex scan with determination of the intima- media thickness (IMT). The levels of total cholesterol (TC), low (LDLC) and high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) were determined. Body mass index, visceral adiposity index, lipid accumulation product index and waist-to-height ratio were calculated. We performed clustering of ABPM data, calculated the odds ratio of association between cardiometabolic risk factors and certain MH phenotypes.Results. MH was diagnosed in 142 (68,6%) patients examined, divided into 3 clusters: systolic-diastolic — SDMH (50,7%), isolated systolic — ISMH (27,5%) and isolated diastolic — IDMH (21,8%). Impaired lipid metabolism, visceral adiposity, IMT increase and atherosclerotic plaques were more often recorded in patients with SDMH and IDMH. The levels of TC, LDL-C and IMT were highest in individuals with IDMH. Odds ratio analysis indicated significant associations of SDMH and IDMH phenotypes with indicators of visceral adiposity, IMT, TG, TC, LDL-C and TG/HDL-Cl.Conclusion. Clustering of ABPM data in individuals with MH and comparing related phenotypes with cardiometabolic risk factors complements their clinical and functional characteristics and can be a useful tool for improving customized prevention and therapy programs.

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Section: Discussionunclassified

Assessment of cardiometabolic risk factors in various phenotypes of masked hypertension

Гельцер

Орлова-Ильинская

Ветрова

et al. 2020

Cardiovasc Ther Prev

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“…При этом медиана офисного систолического АД у молодых мужчин была достоверно выше, чем у молодых женщин (130 и 124 мм рт.ст., соответственно, p<0,0001). Использование стандартизированного опросника для идентификации ФР хронических неинфекционных заболеваний (STEPS ВОЗ) позволило устано-вить, что среди молодых людей с МАГ доминируют лица мужского пола с отклонениями от здорового образа жизни и погрешностями в питании [16]. По результатам широкомасштабного исследования IDACO, проводимого в 11 странах в течение 11 лет (9691 человек), распространенность МАГ среди лиц без сопутствующей патологии составила 18,8%, а при её наличии достигала 29,3% [11].…”

Section: распространенность маг в различных популяцияхunclassified

“…В японской популяции у больных МАГ повышение порога чувствительности к поваренной соли и больший объем ее потребления был характерен для женщин [17]. При этом в российской популяции взаимосвязь водно-солевой нагрузки и МАГ значительно чаще фиксировалась среди молодых мужчин [16]. Ожирение является одним из наиболее агрессивных ФР МАГ.…”

Section: факторы риска и патофизиологические детерминанты магunclassified

Masked arterial hypertension: prevalence, pathophysiological determinants and clinical significance

et al. 2019

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In most modern studies, masked arterial hypertension (MAH) is characterized as a poorly diagnosed, latent clinical condition predisposing to subclinical damage to target organs and an increased risk of cardiovascular complications. The prevalence of MAH among the population depends on gender, age, anthropometric and socioeconomic factors, profession, race and other characteristics. The most important risk factors (RF) of MAH and its pathophysiological determinants include genetic polymorphism, subclinical non-specific inflammation, hemostatic disorders, obesity, metabolic syndrome, water-salt imbalance, dyslipidemia, hyperuricemia. A defined value has latent dysfunction of the mechanisms that provide circulatory homeostasis, the detection of which is possible by the hemodynamic response to psycho-emotional, hypoxic, hypocapnic, orthostatic effects. Aggressiveness of RF exposure and the consequences of their implementation are evaluated by the rate of development of cardiovascular events and mortality, which indicate an unfavorable prognosis of “uncontrolled” MAH. The maximum reduction of the RF effects and rational pharmacotherapy can significantly improve its clinical prospects.

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“…Выявлены такие предикторы развития МАГ, как мужской пол, пожилой возраст, повышенный индекс массы тела, курение и употребление алкоголя, сахарный диабет 2-го типа и хроническая болезнь почек, дислипидемия и отягощенная наследственность [2,4,5]. Значение генетической детерминированности АГ доказано и не вызывает сомнений.…”

unclassified

“…В ряде исследований подтверждена и взаимосвязь полиморфных маркеров генов с развитием МАГ [1]. Однако роль генетических факторов установлена главным образом в отношении молодых людей и носит дискуссионный характер [1,5]. Кроме того, большинство исследований касается пациентов высокого сердечно-сосудистого риска (ССР) [6,7].…”

unclassified

The contribution of the AGT, GNB3, MTHFR, MTRR, ApoE, and PPARα polymorphisms to the development of masked arterial hypertension in patients with low and moderate cardiovascular risk

Козиолова

Chernyavina

2021

Alʹm. klin. med.

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Aim: To assess the probability of masked arterial hypertension (MAH) in patients with low and moderate cardiovascular risk depending on polymorphisms in selected genes.Materials and methods: Ninety two (92) patients (mean age, 41.93±8.92 years) with low and moderate cardiovascular risk without any documented cardiovascular disorders were assessed clinically and had 24-hour ECG monitoring performed, as well as genotyping on the following markers: AGT Thr174Met rs4762, GNB3 C825T rs5443, MTHFR C677T rs1801133, MTRR Ile22Met rs1801394, ApoE Cys130Arg rs 429358, and PPARα G/C rs4253778. Depending on the presence of MAH, the patients were divided into two groups: with newly diagnosed arterial hypertension corresponding to the MAH criteria (n=58, 63%) and with normal office-based and ambulatory blood pressure and normal blood pressure according to the results of 24-hour ECG monitoring (n=34, 37%).Results: Two groups were not different by their age, cardiovascular risk factors, concomitant diseases and clinical characteristics. There were more men than women in the MAH group (р=0.028). In MAH patients, the most prevalent was Ile22Met rs1801394 A/G polymorphism of the MTRR gene (the odds ratio (OR) and relative risk (RR) for MAH were 4.23 [95% сonfidence interval (CI) 1.56–11.72] and 2.17 [1.25–4.12], respectively). The Cys130Arg rs 429358 Т/С genotype polymorphism of the АроЕ gene was also significant. The probability of MAH in the patients with АроЕ Т/С genotype was more than 3-fold higher: OR 3.67 [95% CI 1.34–10.28], RR 2.15 [95% CI 1.17–4.36]. The correlation analysis showed a moderate association between MAH and MTRR and АроЕ gene polymorphisms (Q=0.62 and Q=0.57, respectively).Conclusion: In patients with low and moderate cardiovascular risk, the probability of MAH depends not only from their gender, but also from their genetic background. The candidate genes for MAH in such patients are Ile22Met rs1801394 A/G polymorphism of the MTRR gene and Cys130Arg rs 429358 Т/С polymorphism of the АроЕ gene.

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Masked Hypertension in Young Persons: Prevalence, Significance of Cardiovascular Risk Factors and Prognosis by Gender Differences

Cited by 12 publications

References 6 publications

Assessment of cardiometabolic risk factors in various phenotypes of masked hypertension

Assessment of cardiometabolic risk factors in various phenotypes of masked hypertension

Masked arterial hypertension: prevalence, pathophysiological determinants and clinical significance

The contribution of the AGT, GNB3, MTHFR, MTRR, ApoE, and PPARα polymorphisms to the development of masked arterial hypertension in patients with low and moderate cardiovascular risk

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