Page 254 - Read Online

Nemtsova et al. Vessel Plus 2018;2:27 I http://dx.doi.org/10.20517/2574-1209.2018.48 Page 3 of 9

mechanisms are involved in the development of age-associated chronic inflammation is not definitively
established.

The age-associated increase in oxidative stress can contribute to the development of chronic inflammation
and the progression of various diseases. Today the theory of oxidative stress is considered one of the most
popular theories explaining not only aging, but also the initiation, as well as the progression of many
modern diseases, in particular cardiovascular and diabetes mellitus. Recently, oxidative stress has been
actively studied in order to better understand the mechanisms of protection and the relationship between
[6]
oxidative damage and the aging process .
[7]
Population aging became the leading demographic feature of Ukraine as well . Hypertension (HT),
T2DM, ischemic heart disease (IHD), cerebral vascular disease with different severity of clinical symptoms
[4,7]
and in different combinations are the most common in elderly people .
The purpose of this study was to evaluate plasma parameters of oxidant-antioxidant systems as markers of
vascular aging in patients of different age groups with a combined course of arterial HT and T2DM.

METHODS
126 patients (55 males and 71 females) from 45-75 years old (mean age: 57.8 ± 6.2 years) with stage II HT
(mean duration of disease 10.2 ± 3.7 years) and well controlled T2DM (mean duration of disease: 4.1 ± 2.4
[8]
years) were examined and according to the current World Health Organization (WHO) age classification
were divided into 2 subgroups: group 2a (n = 59) - patients with HT in combination with T2DM aged 45-
60 years; group 2b (n = 97) - patients with a combined course of HT and T2DM aged 61-75 years. As a
comparison group, patients with isolated stage II H (n = 30), identical in age and sex to the main group
(average age 53.8 ± 4.6 years) were studied. The control group consisted of 20 healthy individuals, matched
for age and sex.

The study did not include patients with symptomatic HT, uncontrolled HT, type 1 diabetes, decompensated
T2DM and other endocrine disorders, clinical signs of IHDs or severe concomitant chronic diseases. The
excluding criteria were also: taking iodine medications, glucocorticoids, amiodarone, lithium medications,
and medications containing estrogens and pregnancy. For patient selection, the diagnostic criteria of HT
[9]
approved by the European recommendations on diagnosis and treatment of HT were used. The diagnosis
of T2DM was established according to the approved by order of the Ministry of Health of Ukraine dated
on 21.12.2012 № 1118 “On Approval and implementation of medical-technological documents for the
[10]
standardization of medical aid in type 2 diabetes” and in accordance with the recommendations of the
[11]
American Diabetes Association and the European Association for the study of diabetes .
On a background of dietary recommendations, all patients received basic therapy in accordance
with international and national recommendations for the management of patients with appropriate
pathology [9-11] . Before being included in the study, all patients had been receiving antihypertensive therapy
for at least 6 months in individually selected doses with the use of angiotensin - converting enzyme
(ACE) inhibitors or angiotensin II receptors blockers (ACE inhibitors/ARBS), diuretics (indapamide
or torasemide). Some of the patients received calcium antagonists (amlodipine or lercanidipine). As an
antidiabetic therapy, patients with T2DM received metformin in individually selected doses from 1000-
2000 mg per day, 49 patients (29.51%) additionally were using sulfonylurea derivatives.

Blood pressure (BP) levels were assessed in all patients by means of blood pressure obtained from three
measurements at 2-min intervals in a sitting position.