Dyslipidemia in patients with arterial hypertension and extrasystoles
Abstract
The significant incidence of hypertensive disease among the Ukrainian population makes the search for new methods of management and treatment of patients suffering from this pathology a matter of high priority. Our research is focused on study of changes of some biochemical parameters in patients suffering from hypertensive disease as well as patients suffering from hypertensive disease and coexistent extrasystoles. Arterial hypertension leads to different structural and functional changes in the cardiovascular system. In many patients these changes may result in rhythm disorders. 120 patients have been examined (42 men and 78 women) between the ages of 27 to 81 (average 59.8) suffering from hypertensive disease of the II stage as defined by the Ukrainian Association of Cardiologists and from extrasystoles (more than 30 episodes per hour of research) of different topography and 30 persons (13 men and 17 women) suffering from hypertensive disease of the II stage between the ages 30 to 76 (average 56.4) without rhythm disturbance). The first clinical group was formed by 54 (45%) patients suffering from repeated supraventricular extrasystoles (SE) (average 62 ± 2 SE per hour of research). The second clinical group was formed by 42 (35%) patients suffering from repeated ventricular arhythmia (VA) (average 37 ± 2 VA per hour of research). The third group was formed by 24 (20%) patients suffering from both repeated SE and VA (average 48 ± 3 SE and 32 ± 3 VA per hour of research). We conducted 24 hours’ monitoring of blood pressure and electrocardiography using the “Dia Card”-system (“Solvaig”, Ukraine) for all patients. This revealed that ventricle extrasystoles and combined extrasystoles in patients with essential hypertension, II stage are associated with more unfavourable changes in 24 hours’ profile of blood pressure. The paper analyses the cardiac arhythmia structure of heart rate variability in patients with arterial hypertension (AH) and extrasystoles. The findings confirmed the presence of desynchronization in the activity of the neurohnmoral system. Thus, different mechanisms of arhythmogenesis were revealed in patients with arterial hypertension. In the results, frequent ventricular and combined extrasystoles were associated with an unfavourable blood pressure profile during 24-hours monitoring as well as higher end-diastolic left ventricular volume, diastolic dysfunction, aortic valve fibrosis, aorta remodeling, endothelial dysfunction and more prominent lipid disorders. Supraventricular extrasystoles were associated with hypertriglyceridemia, left ventricular diastolic dysfunction and left atrium enlargement.References
Agnoletti, D., Blacher, J., Safar, M.E., Borhi, C., Zhang, Y., 2013. Effects of antihypertensive drugs on central blood pleassure in humans: A preliminary observation. Am. J. Hypertens. 26(8), 1045–1052. >> doi.org/10.1093/ajh/hpt081
Balaeva, T.B., Vasilenko, V.S., 2011. Narushenie ritma serdtsa, parametryi repolyarizatsii zheludochkov i elektrokardiograficheskie pokazateli u bolnyih s arterialnoy giperetenziey i metabolicheskim sindromom [Violation of rhythm of heart, parameters of repolyrization of ventricles and nondipping pattern related tobprevalent sibclinical organ damage]. Am. J. hypertens. 24(3), 251.
Cheng, H.M., Sung, S.H., Yu, W.C., Chen, C.H., Pearson, A., Kardon, J., 2015. Cost-effectiveness of noninvasive central blood pressure monitoring in the diagnosis of hypertension. Am. J. Hypertens. 28(5), 604–614. >> doi.org/10.1093/ajh/hpu214
Didyk, N.V., 2009. Osobluvosti poryshennia lipidtransportnoi fynkcii krovi i variabelnosti sercevogo rutmy y hvoruh na gipertonichny hvoroby, yskladneny riznumu variantamu ekstrasustolii [The peculiarities of disorder of the lipid transport function of blood and the variations of cardiac rhythm for the patients with hypertension disease, which is complicated by different kind of extrasistole]. Visnuk Vinnutckogo Nacionalnogo Meduchnogo Yniversutety im. M.I. Pirogova 13(2), 527–530 (in Ukranian).
Didyk, N.V., Ivanov, V.P., 2010. Osobluvosti curkadnoi regylacii arterialnogo tusky i ritmy sercia, chastota reestracii epizodiv ichemii miokardy y hvoruh na gipertonichny hvoroby z riznumu variantamu ekstrasustolii [Features of circadian regulation and heart rhythm, registration frequency of episodes of myocardial ischemia in patients with essential hypertension and different forms of extrasystoles]. Arterialna Gipertenzia 3(11), 29–37 (in Ukranian).
Galema-Boers, J.M.H., Versmissen, J., Roeters Van Lennep, H.W.O., Dusault-Wijkstra, J.E., Williams, M., Roeters Van Lennep, J.E., 2015. Cascade screening of familial hypercholesterolemia must go on. Atherosclerosis 242(2), 415–417. >> doi.org/10.1016/j.atherosclerosis.2015.07.020
Graudal, N.A., Hubeck-Graudal, T., Jurgens, G., 2012. Effects of low-sodium diet vs. high-sodium diet on blood preassure, renin, aldosteron, catecholamines, cholesterol, and triglyceride (Cochrane review). Am. J. hypertens. 25, 1–5.
Hajhosseiny, R., Matthews, G.K., Lip, G.Y.H., 2015. Metabolic syndrome, atrial fibrillation, and stroke: Tackling an emerging epidemic. Heart Rhythm 12(11), 2332–2343. >> doi.org/10.1016/j.hrthm.2015.06.038
Huynh, Q.L., Nelson, M.R., Reid, C.M., Chowdhury, E.K., Huq, M.M., Billah, B., Tonkin, A.M., Wing, L.M.H., Simons, L.A., Beilin, L.J., Jennings, G.L., Johnston, C.I., Macdonald, G.S., Marley, S.E., Mcneil, J.J., Morgan, T.O., Ruan, P., West, M.J., 2015. Prediction of cardiovascular and all-cause mortality at 10 years in the hypertensive aged population. Am. J. Hypertens. 28(5), 649–656. >> doi.org/10.1093/ajh/hpu213
Izmozherova, N.V., 2011. Chastota narusheniy serdechnogo ritma u zhenschin v postmenopauze [Frequency of violations of cardiac rhythm for women in postmenopause]. Kardiovaskulyarnaya Terapiya i Profilaktika 10(3), 58–65 (in Russian).
Kozela, M., Dorynska, A., Stepaniak, U., Szafraniec, K., Topor-Madry, R., Misiowiec, W., Pajak, A., Bobak, M., 2015. Perceived control asa predictor of cardiovascular disease mortality in Poland. The Hapiee study. Cardiology Journal 22, 404–412. >> doi.org/10.5603/cj.a2015.0002
Krzych, L.J., Bochek, A., 2013. Blood pressure variability: Epidemiological and clinical issues. Cardiology Journal 20(2), 112–120. >> doi.org/10.5603/cj.2013.0022
Lim, S., Oh, P.C., Koh, K.K., Sakuma, I., 2015. How to balance cardiorenometabolic benefits and risk of statins. Atherosclerosis 235(2), 644–648. >> doi.org/10.1016/j.atherosclerosis.2014.06.001
Schauerte, P., 2013. Time for change: Cardiac neurophysiology meets cardiac electrophsiology. Heart Rhythm 10(5), 758–759. >> doi.org/10.1016/j.hrthm.2013.02.003
Schultz, M.G., Otahal, P., Cleland, V.J., Blizzard, L., Sharman, J.E., Marwick, T.H., 2013. Exercise-induced hypertension, cardiovascular events, and mortality in patients undergoing exercise stress testing: A systematic review and meta-analysis. Am. J. Hypertens. 26(3), 357–366. >> doi.org/10.1093/ajh/hps053
Shugushev, H.H., Vasilenko, V.M., Balaeva, T.B., 2011. Narushenie ritma serdtsa i elektrokardiologicheskie pokazateli u bolnyih s arterialnoy gipertoniey i metabolicheskim sindromom [Violation of rhythm of heart and electro-cardiologic indexes for patients with arterial hypertension and metabolic syndrome]. Rossiyskiy Kardiologicheskiy Zhurnal 87, 40–44 (in Russian).
Stevenson, W.G., 2013. Current treatment of ventricular arrhythmias: State of the art. Heart Rhythm 10(12), 1919–1926. >> doi.org/10.1016/j.hrthm.2013.10.019
Van Brussel, P.M., Lieve, K.V.V., De Winter, R.J., Wilde, A.A.M., 2015. Cardiorenal axis and arrhythmias: Will renal sympathetic denervation provide additive value to the therapeutic denervation provide additive value to the thrapeutic arsenal. Heart Rhythm 12(5), 1080–1087. >> doi.org/10.1016/j.hrthm.2015.01.046
Vornovitsky, M., Mcclintic, B.R., Ronald Beck, G., Bisognano, J.D., 2013. Ambulatory blood pressure monitoring: Is 24 hours necessary. Cardiology Journal 20(6), 662–664. >> doi.org/10.5603/cj.2013.0167
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons «Attribution» 4.0 License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.