systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.38109/2075-082X-2024-1-29-35systhiper-807Research ArticleОБЗОРНАЯ СТАТЬЯREVIEWИзучение различных диетических вмешательств у пациентов с артериальной гипертонией и метаболическим синдромомStudy of various dietary interventions in patients with hypertension and metabolic syndromehttps://orcid.org/0000-0002-0945-9665ХачатрянН. Т.KhachatryanM. T.

Хачатрян Нарине Тиграновна, к.м.н., младший научный сотрудник, отдел гипертонии, Институт клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, дом 15 А, г. Москва 121552

Narine T. Khachatryan, Cand. Of Sci. (Med.), Junior Researcher, the Hypertension Department, A.L. Myasnikov Scientific research institute of clinical cardiology

St. Academician Chazova, 15 a, Moscow 121552

naridoctor@gmail.comhttps://orcid.org/0000-0001-7895-9068ЖернаковаЮ. В.ZhernakovaJu. V.

Жернакова Юлия Валерьевна, д.м.н., ученый секретарь, Институт клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, дом 15 А, г. Москва 121552

Juliya V. Zhernakova, Dr. of Sci. (Med.), A.L. Myasnikov Scientific research institute of clinical cardiology

St. Academician Chazova, 15 a, Moscow 121552

juli001@mail.ruhttps://orcid.org/0000-0001-5215-4894БлиноваН. В.BlinovaN. V.

Блинова Наталия Владимировна, к.м.н., старший научный сотрудник, отдел гипертонии, Институт клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, дом 15 А, г. Москва 121552

Nataliia V. Blinova, Cand. Of Sci. (Med.), A.L. Myasnikov Scientific research institute of clinical cardiology

St. Academician Chazova, 15 a, Moscow 121552

nat-cardio1@yandex.ruhttps://orcid.org/0000-0002-9822-4357ЧазоваИ. Е.ChazovaI. E.

Чазова Ирина Евгеньевна, д.м.н., профессор, академик РАН, руководитель отдела гипертонии, заместитель генерального директора по научно-экспертной работе

ул. Академика Чазова, дом 15 А, г. Москва 121552

Irina E. Chazova, Dr. of Sci. (Med.), Prof., Acad. of RAS, Deputy General Director for Scientific and Expert Work, Head of Hypertension Department, A.L. Myasnikov Scientific research institute of clinical cardiology

St. Academician Chazova, 15 a, Moscow 121552

c34h@yandex.ruФГБУ «Национальный медицинский исследовательский центр кардиологии имени академика Е.И. Чазова» Минздрава РоссииРоссияE.I. Chazov National Medical Research Center of cardiologyRussian Federation2024290320242112935Copyright © Хачатрян Н.Т., Жернакова Ю.В., Блинова Н.В., Чазова И.Е., 20242024Хачатрян Н.Т., Жернакова Ю.В., Блинова Н.В., Чазова И.Е.Khachatryan M.T., Zhernakova J.V., Blinova N.V., Chazova I.E.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/807

Ожирение является независимым фактором риска сердечно-сосудистых заболеваний (ССЗ), сахарного диабета 2 типа и артериальной гипертензии (АГ). Оптимизация методов борьбы с ССЗ — одна из самых актуальных и неотложных проблем для России. Многие исследования показали, что масса тела коррелирует с АД, и данная взаимосвязь обусловлена сложными патогенетическими механизмами. В связи с чем терапевтические подходы у пациента с ожирением, метаболическим синдромом и АГ требуют учета всех патофизиологических изменений, связанных с данными заболеваниями. Нефармакологические методы лечения, такие как изменение образа жизни, включая снижение веса, соблюдение диетических рекомендаций и увеличение физической активности, может напрямую влиять на уровни АД и улучшать контроль АД. Широкий спектр диетологических вмешательств эффективен при лечении ожирения и сопутствующих заболеваний, врачи должны учитывать все варианты и проводить персонализированные вмешательства. Средиземноморская диета, вегетарианские диеты, DASH диета, нордическая диета и низкоуглеводная диета – все они были связаны с улучшением метаболического здоровья с изменениями массы тела или без них. Последние данные еще больше усиливают роль добавок пищевых

волокон к ежедневному рациону у больных с АГ и метаболическим синдромом, хотя не было обнаружено доказательств значительного их преимущества. С учетом национальных пищевых особенностей нами предложено исследование, в котором планируется изучить влияние русской диеты с добавлением клетчатки на метаболические показатели у пациентов с АГ. Планируется оценить влияние диетотерапии на показатели нарушения обмена кишечных метаболитов.

Obesity is an independent risk factor оf cardiovascular diseases (CVD), type 2 diabetes mellitus and arterial hypertension (HT). Optimization of CVD control methods is one of the most relevant and urgent problems for Russia. Many studies have shown that body weight correlates with blood pressure, and this relationship is due to complex pathogenetic mechanisms. Therefore, therapeutic approaches in a patient with obesity, metabolic syndrome and HT require consideration of all pathophysiologic changes associated with these diseases. Non-pharmacological treatments such as lifestyle changes including weight loss, following dietary guidelines and increasing physical activity can directly affect of BP levels and improve BP control. A wide range of nutritional interventions are effective in treating obesity and comorbidities, and clinicians must consider all options and provide personalized interventions. The Mediterranean diet, vegetarian diets, DASH-diet, Nordic diet, and low-carbohydrate diets have all been associated with improved metabolic health with or without changes in body weight. Recent evidence reinforce more the role of dietary fiber supplementation to the daily diet in patients with HT and metabolic syndrome, although no evidence of significant benefit has been found. Taking into account national dietary characteristics, we have proposed a study in which we plan to study the effect of the Russian diet with fiber supplementation on metabolic parameters in patients with HT. It is planned to evaluate the effect of diet therapy on indicators of metabolic disorders of intestinal metabolites.

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