Polymorbidity in hypertensive patients

Севостьянова, Е. В.; Nikolaev, Yu. A.; Митрофанов, И. М.; Polyakov, V. Ya.

doi:10.18705/1607-419x-2019-25-2-200-208

Cited by 2 publications

(2 citation statements)

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“…Recent studies indicate that amongst the 40-59 years old adult group more than 70% of patients with hypertension have musculoskeletal system and connective tissue pathologies (Sevostyanova et al, 2019). Hypertension formation may be associated with cervical spine pathology, including neck fibromyalgia.…”

Section: The Relationship Between Hypertension and Neck Fibromyalgiamentioning

confidence: 99%

Possible relations between arterial hypertension and cervical spine fibromyalgias (literature review)

Kovaleva

Khudetskyy

Kovalyova

2022

USMYJ

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The literature review analyses and systematises currently available information on fibromyalgia etiology and pathogenesis, hypertension classification and causes, and considers possible relationships between cervical fibromyalgia and hypertension. Statistical data on mortality in Ukraine related to cardiovascular diseases, including hypertension, are highlighted. A concise classification of arterial hypertension according to the International Classification of Diseases-10 (ICD-10) and the International Classification of Diseases-11 (ICD-11) is provided, and its pathogenesis (emission hypertension, resistance hypertension and hypervolemia) is outlined. Physiological relations between cervical spine and cardiovascular system are considered. The main diagnostic criteria for fibromyalgia classification and its development stages are described. Prevalence of fibromyalgia is identified and its forms are classified in accordance with ICD-11. The available data on the likely causes of fibromyalgia pain and any established mechanisms of fibromyalgia pathogenesis, including, but not limited to peripheral and central sensitisation, neurogenic inflammatory processes occurring in the disease-associated peripheral tissues, spinal cord and brain, as well as potential involvement of genetic, endocrine, psychopathological factors and sleep disorders in fibromyalgia development are discussed. The current formal criteria for fibromyalgia classification (revised in 2016), together with assessment of the main pharmacological and non-pharmacological fibromyalgia treatment methods and approaches based upon available published clinical trials outcomes are described. The main directions of fibromyalgia research are identified, and further prospective studies covering different relationship aspects between hypertension and cervical fibromyalgia are evaluated. Among the available literature sources, the only study of patients with comorbid fibromyalgia (fibromyalgia was diagnosed using 1990 American College of Rheumatology criteria and evaluated by Revised fibromyalgia impact questionnaire (FIQR)) and hypertension (blood pressure levels were assessed using the WHO protocol) has been reported. However, this group has only studied the dynamics of changes in cortisol, melatonin and serotonin blood levels, which accompany these pathologies, and these authors have found that fibromyalgia tender points’ quantity and FIQR scores are much higher in hypertensive patients with fibromyalgia in comparison with the rest, which has led them to the conclusion that hypertension prevalence in patients with fibromyalgia could be related to fibromyalgia severity. Thus, this thorough literature review demonstrates that clinical studies examining possible relationships between hypertension and cervical spine fibromyalgia are at lack and require further considerations.

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Section: The Relationship Between Hypertension and Neck Fibromyalgiamentioning

confidence: 99%

Possible relations between arterial hypertension and cervical spine fibromyalgias (literature review)

Kovaleva

Khudetskyy

Kovalyova

2022

USMYJ

View full text Add to dashboard Cite

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“…В прогрессировании АГ также немаловажное значение имеет нарушение межклеточных эндотелиальных взаимодействий, опосредованных VE-кадгерином, провоспалительная активация эндотелиоцитов, сопровождающаяся повышением экспрессии молекул адгезии, в частности, ICAM-1, VCAM-1, Е-селектина и т.п. [5][6][7][8][9]. Показано, что провоспалительная активация эндотелия, а также иммунокомпетентных клеток периферической крови поддерживается компонентами РААС, в частности АТ II, что также определяется активацией AT1R и опосредуется внутриклеточной активацией G-белков [10,11].…”

Section: Introductionunclassified

Relationship between the expression of angiotensin II receptors type 1 and vasoactive regulators in arterial hypertension

et al. 2020

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In the pathogenesis of arterial hypertension (AH), the renin-angiotensin-aldosterone system plays a key role in helping to maintain elevated blood pressure. At the same time, the state of angiotensin-II production (AT II) and the expression level of its receptors on target cells determine the formation of most of the effects underlying the pathogenesis of associated clinical conditions in such patients. Thus, the study of the pathogenesis of AH, namely the study of the role of the AT II axis, the AT II receptor, is an actual scientific and practical task. Aim. Given the important role of type 1 receptors for AT II in the formation of pathological changes in arterial hypertension, the purpose of this study was to study the peculiarities of the effect of their expression on biochemical processes in patients with arterial hypertension. Material and methods. In the course of the clinical study, 60 patients of both sexes with hypertension aged 45 to 55 years old were admitted to the clinic for planned treatment. Depending on the initial level of expression of receptors for AT II (AT1R), determined by the serum concentration of the soluble form of type 1 receptors for AT II, the patients were divided into two subgroups with conditionally low (corresponding to the concentration of the soluble form of the receptor for AT II 0.66 ng/ml) and conditionally high (1.57 ng/ml) expression. The analysis showed that high expression of AT1R is associated with elevated plasma levels of renin by 30.8% (p=0.0005), AT II by 48.1% (p=0.00001), E-selectin by 47.9% (p=0.0001), VCAM-1 by 29.1% (p=0.00001), ICAM-1 by 52.9% (p=0.00001), VE-cadherin by 50.9% (p=0.00001), endothelin-1 by 48.8% (p=0.0005), an ACE inhibitor by 13.6% (p=0.047), and CRP by 74.1% (p=0.00002 ) and endoperoxide by 29.7% (p=0.009). Against this background, there was a decrease in the level of apoA1 by 21.6% (p=0.027), ACE by 20.1% (p=0.1), the level of antioxidants by 22.3% (p=0.00001). The analysis showed that in the group with initially high expression of AT1R, there was an increased blood pressure, the level of which, on average, exceeded the values of patients with low expression of the indicated receptor by 24.5 mm Hg (p=0.011). Against the background of therapy in the group with high expression of AT1R, plasma renin activity decreased by 20.3% (p=0.013), endoperoxide by 8.4% (p=0.038), an ACE inhibitor by 14.6% (p=0.02). At the same time, the level of apoA1 increased by 8.5% (p=0.036), antioxidants by 8.6% (p=0.036), ICAM-1 by 5.3% (p=0.05), VE-cadherin by 2.5% (p=0.07). The level of the remaining factors was not statistically significant. In the subgroup with low expression of the AT II receptor, during treatment, there was a decrease in endoperoxide by 12.8% (p=0.031), an ACE inhibitor by 5.5% (p=0.044) without significant changes in other indicators. Conclusion. In hypertensive patients, higher expression of AT1R is associated with high activation of immune-inflammatory mechanisms, dyslipidemia, an imbalance of the lipid peroxidation system and antioxidant protection, as well as higher renin-angiotensin-aldosterone system activity and increased arterial pressure. On the background of antihypertensive therapy, partial compensation of the identified changes is achieved, including a moderate increase in the level of antioxidants, a decrease in the concentration of endoperoxide, renin activity and an increase in the level of apoA1, while maintaining an increased level of AT II, high expression of receptors to it. These changes indicate the need for further search for effective antihypertensive therapy strategies aimed at limiting the activity of renin-angiotensin-aldosterone system in patients with hypertension.

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Polymorbidity in hypertensive patients

Cited by 2 publications

References 20 publications

Possible relations between arterial hypertension and cervical spine fibromyalgias (literature review)

Possible relations between arterial hypertension and cervical spine fibromyalgias (literature review)

Relationship between the expression of angiotensin II receptors type 1 and vasoactive regulators in arterial hypertension

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