Page 30 - Read Online

Bilovol Arterial hypertension and type 2 diabetes progression

Sample, there was a 25% increase in the number of obese. Similarly, the risk of hypertension is 50% higher
people visiting emergency rooms for hypertension- in obese patients compared to those in normal weight
related procedures between 2006 and 2011. A ranges.
[5]
25-year epidemiological study has been devoted to
situational dynamics related to AH in the Ukraine. In the last few years, inflammatory mechanisms have
The report enrolled urban residents aged 18-64 years been shown to regulate initiation, maintenance, and
and indicated that AH prevalence grew from 30.6% to development of cardiovascular disease. Associations
35.3% (P > 0.05) over the observation period, probably between cardiovascular diseases and obesity are
due to increased average systolic arterial pressure mediated, in part, by secretory regulation of adipose
levels. The study also revealed a preponderance tissue. Adipose tissue secretes bioactive peptides
[6]
of risk factors among patients with AH. Only 5.6% of (adipokines), which have local and distal influences
AH patients exhibited zero risk factors. Strikingly, on organ systems through autocrine, paracrine,
25.4% of AH patients had one risk factor, 33.2% of and endocrine functions. Increased production of
patients had 2 risk factors, and 3 or more risk factors adipokines in obese patients impacts multiple bodily
were reported in 35.8% of patients. Unfortunately, the functions, many of which are linked with cardiovascular
epidemiologic environment contributing to AH remains diseases, such as: insulin sensitivity, immunity,
unfavorable. The Ukrainian data suggest that the AH angiogenesis, hemostasis, lipid metabolism, and
high-risk profile is common. Thus, it is unlikely that a blood pressure. Adipocytes, like T-lymphocytes and
[6]
noticeable decline in the death rate of this population macrophages, produce cytokines and are involved
will occur in the near future. A significant number of in complement activation-stimulating inflammatory
individuals with AH are unaware of their disease. signaling cascades. [3,8] Cytokine imbalance is a well-
Among those with diagnosed hypertension, treatments established mechanism contributing increased risk
are frequently inadequate and incidence of deaths due of vascular complications. Therefore, elucidating the
to hypertension complications is high. interaction between adipokines, interleukins, and
metabolic disorders in patients with AH and T2DM is
Isolated AH is currently rare. More commonly, physicians relevant.
encounter clinical situations in which cases of AH are
associated with endocrinopathies. The turn of the 21st The present study was undertaken to investigate the
century was marked by significant prevalence of type effects of adipokine and interleukin imbalances on the
2 diabetes mellitus (T2DM). Increases in incidence development and progression of metabolic disorders
worldwide led to discussions about the global diabetes in patients managing hypertension with comorbid type
epidemic. The World Health Organization reported in 2 diabetes.
2016 that the number of people with diabetes mellitus
rose from 108 million in 1980 to 422 million in 2014. METHODS
Among adults over 18 years of age, diabetes mellitus
rates rose from 4.7% in 1980 to 8.5% in 2014. Given Patients
[7]
that diabetes mellitus disables patients at very early Ninety-five patients with stage II second degree
ages and leads to high mortality rates, the fight against arterial hypertension (53 males and 42 females) were
diabetes has been elevated to a top priority for national assessed. The mean age of the cohort was 54.7 ± 5.4
health care systems across the world. years. The patients were sub-divided into 2 groups.
Group 1 (n = 48) consisted of hypertensive patients
According to epidemiological studies, in patients with without T2DM. Group 2 (n = 47) was a comorbid
a combination of hypertension and T2DM the risk of population with both AH and T2DM. The control group
fatal coronary heart disease increases 3 to 5 times, consisted of 20 age- and gender-matched healthy
stroke increases 3 to 4 times, complete loss of vision subjects. AH diagnoses were conducted according to
increases 10 to 20 times, uremia increases 20 to 25 guidelines for the management of arterial hypertension
times, and gangrene of lower extremities becomes 20 from the European Society of Cardiology (ESC) and
times more likely. [8] the European Society of Hypertension (2013), as well
as Ukrainian Cardiology Association recommendations
One explanation for the frequent observation of (2013). [10]
comorbid type 2 diabetes in hypertensive patients is
that the prevalence of overweight and obesity in the Criteria supporting diagnosis of abdominal obesity
population has increased. Prospective studies have were established based on recommendations by the
[9]
shown a strong relationship between obesity and type World Health Organization (1997). Anthropometric
2 diabetes. Almost 90% of patients with T2DM are measurements were used to calculate body mass
Vessel Plus ¦ Volume 1 ¦ March 31, 2017 23