systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.26442/2075-082X_2018.3.32-38systhiper-556Research ArticleСТАТЬИARTICLESФакторы риска прогрессирования сосудистого ремоделирования сонных артерий у пациентов с артериальной гипертензиейThe progression of carotid vascular remodeling risk factors in patients with arterial hypertensionПавловаО. С.PavlovaO. S.olga.s_pavlova@yahoo.comКоробкоИ. Ю.KorobkoI. Yu.noemail@neicon.ruНечесоваТ. А.NechesovaT. A.noemail@neicon.ruЛивенцеваМ. М.LiventsevaM. M.noemail@neicon.ruЗатолокаН. В.ZatolokaN. V.noemail@neicon.ruКовшЕ. В.KovshE. V.noemail@neicon.ruОгурцоваС. Э.OgurtsovaS. E.noemail@neicon.ruМрочекА. Г.MrochekA. G.noemail@neicon.ruРНПЦ «Кардиология»РоссияRepublican Scientific and Practical Centre “Cardiology”Russian FederationИнститут биоорганической химииРоссияInstitute of Bioorganic Chemistry of the National Academy of Sciences of the Republic of BelarusRussian Federation2018231220221533238Copyright © Павлова О.С., Коробко И.Ю., Нечесова Т.А., Ливенцева М.М., Затолока Н.В., Ковш Е.В., Огурцова С.Э., Мрочек А.Г., 20222022Павлова О.С., Коробко И.Ю., Нечесова Т.А., Ливенцева М.М., Затолока Н.В., Ковш Е.В., Огурцова С.Э., Мрочек А.Г.Pavlova O.S., Korobko I.Y., Nechesova T.A., Liventseva M.M., Zatoloka N.V., Kovsh E.V., Ogurtsova S.E., Mrochek A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/556

Цель исследования - определить клинико-генетические факторы риска развития и прогрессирования сосудистого ремоделирования сонных артерий по данным проспективного 5-летнего наблюдения пациентов с эссенциальной артериальной гипертензией (АГ). Материал и методы. Повторное клинико-инструментальное обследование с оценкой сопутствующих факторов сердечно-сосудистого риска (ожирение, курение, употребление алкоголя, уровень физической активности, гипергликемия, гиперхолестеринемия, признаки депрессии) проведено у 78 пациентов с АГ. При ультразвуковом исследовании сонных артерий определялись толщина комплекса интима-медиа (КИМ) и наличие атеросклеротических бляшек. Для изучения полиморфизма генов ренин-ангиотензин-альдостероновой системы использовали метод полимеразной цепной реакции и полиморфизма длин рестрикционных фрагментов. Результаты. Прогрессирование сосудистого ремоделирования по результатам повторного обследования сонных артерий через 5 лет наблюдалось у 26 пациентов (33,3%). Возраст (r=0,53; p=0,001), степень АГ (r=0,43; p=0,001), уровень офисного систолического артериального давления (r=0,295; p=0,009), наличие мутантного С аллеля полиморфизма A1166C гена рецепторов 1-го типа к ангиотензину II - AGTR1 (r=0,387; p=0,0001), содержание глюкозы в крови (r=0,30; p=0,011), окружность талии (r=0,258; p=0,023) были ассоциированы с увеличением КИМ общей сонной артерии (ОСА) у пациентов с АГ. При проведении множественного линейного регрессионного анализа определены независимые факторы, влияющие на толщину КИМ ОСА - возраст (b=0,62; p=0,01), мужской пол (b=0,321; p=0,01) и носительство мутантного С аллеля полиморфизма A1166C гена AGTR1 (b=0,312; p=0,01). Выводы. Факторами риска прогрессирования сосудистого ремоделирования сонных артерий у пациентов с АГ являлись возраст, мужской пол и полиморфизм A1166C гена AGTR1.

Objective. To determine the clinical and genetic risk factors for the development and progression of carotid vascular remodeling according to the prospective observation after five years in patients with essential arterial hypertension (AH). Material and methods. The repeat clinical and instrumental examination with assessment of concomitant cardiovascular risk factors (obesity, smoking, alcohol consumption, physical activity level, hyperglycemia, hypercholesterolemia, signs of depression) was performed in 78 patients with AH. The ultrasound examination of carotid arteries included evaluation of intima-media complex thickness (IMT) and the presence of atherosclerotic plaques. The polymorphism of the genes of the renin-angiotensin-aldosterone system analyzed by polymerase chain reaction and polymorphism of restriction fragment lengths. Results. Progression of vascular remodeling was observed in 26 patients (33.3%) according to the results of carotid arteries examination after 5 years. Age (r=0.53; p=0.001), degree of AH (r=0.43; p=0.0001), level of office systolic blood pressure (r=0.295; p=0.0090), presence of the mutant C allele polymorphism A1166C of the angiotensin II type 1 receptor gene - AGTR1 (r=0.387; p=0.0001), blood glucose (r=0.30; p=0.010), waist circumference (r=0.258; p=0.023) were associated with an increase IMT common carotid artery (CCA) in patients with AH. The multiple linear regression analysis identified independent factors influencing on the IMT CCA - age (b=0.62; p=0.01), males (b=0.321; p=0.01) and the mutant C allele carrier polymorphism A1166C of AGTR1 gene (b=0.312; p=0.01). Conclusions. The progression of carotid vascular remodeling risk factors in patients with AH were age, male gender and polymorphism of A1166C gene AGTR1.

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The authors declare that there are no conflicts of interest present.