Symbiosis of cardiology and endocrinology

Abstract

In medical practice, there are often patients who have several diseases at once, both pathogenetically related to each other and not related. The article discusses endocrine diseases in which there are manifestations from the cardiovascular system - disorders of carbohydrate metabolism, pathology of the thyroid gland, adrenal glands and acromegaly. These diseases reduce the quality of life of patients and increase the risks of cardiovascular complications. The article also discusses the features of cardiovascular manifestations in these diseases and indications for differential diagnosis. Type 2 diabetes mellitus significantly increases the cardiovascular risks, which leads to a more rapid progression of atherosclerosis. Moreover, vascular disorders are detected already at the stage of prediabetes. Therefore, it is necessary to identify disorders of carbohydrate metabolism as early as possible and initiate appropriate therapy. When prescribing antihyperglycemic therapy, preference should be given to drugs with a low risk of hypoglycemia (metformin, glucagon-like peptide-1 agonists, type 2 sodium glucose co-transporter inhibitors). Thyroid dysfunctions - thyrotoxicosis and hypothyroidism - also have an adverse effect on the cardiovascular system. Hypothyroidism often has a blurred clinical picture and manifestations from various organs, and therefore it is diagnosed late. Therefore, an active diagnosis of this condition should be carried out in persons with a combination of a wide variety of diseases, especially in old age. Adrenal pathology (pheochromocytoma, hyperaldosteronism and hypercorticism) is manifested by an increase in blood pressure. Differential diagnosis is worthwhile in case of severe arterial hypertension or resistance to antihypertensive therapy. In acromegaly, lesions of the cardiovascular system are quite common and are the main cause of death in these patients. Therefore, early detection of this pathology is especially important. Thus, such patients should be monitored jointly by a cardiologist and an endocrinologist, and timely diagnosis and treatment of endocrine pathology will help reduce their cardiovascular risks.

Cardiac Complications of Endocrine Diseases: A Literature Review

“…Apart from the increased level of triglycerides, patients with DM2 have an elevated content of СS-LDLP, decreased concentration of high-density lipoproteins (HDLP) and apolipoprotein А1 (Apo A1), which is connected with insulin resistance. An intensifi ed fl ow of fatty acids from the fatty tissue to the liver worsens the liver insulin resistance and enhances dyslipidemia [3].…”

“…In some cases, antilipedimics are prescribed (ezetimibe, fi brate, proprotein convertase, subtilisin/kexin of type 9), inhibitors of sodium/glucose-2 cotransporter (SGLT2), as well as nutraceutical medications (berberine, omega-3 fatty acids, red yeast rice) complementing the main therapy. Patients with DM and acute myocardial infarction (MI) are recommended to undergo angioplasty/stenting and with multivessel disease -coronary artery bypass graft [3,6].…”