The article substantiates the need for adequate fixed combination therapy for metabolic syndrome and arterial hypertension (AH). The issues of inflammation in the initiation and stabilization of arterial hypertension in patients with metabolic syndrome (MS) are considered. Taking into account the results of international and Russian studies, a differentiated approach is proposed to select a fixed combination of antihypertensive drugs for the treatment of hypertension and prevention of cardiovascular complications in patients with MS.
The increase in the prevalence of obesity in recent decades is an urgent medical and social problem for all countries, increasing the cost of medical care and worsening the quality of life of patients. Obesity is an independent risk factor for the development of a number of chronic non-infectious diseases, including respiratory diseases. The presence of excess body weight not only provokes the development of bronchopulmonary pathology, but also aggravates its course. The article discusses the mechanisms of the impact of obesity on the pathogenesis of diseases such as bronchial asthma, chronic obstructive pulmonary disease and coronavirus infection.
It is known that metabolic syndrome is currently the leading cause of the development of cardiovascular pathology, which occupies a leading position in the structure of mortality not only in the Russian population, but also in the world. The prevalence of MS is growing, which is associated with stressful professions, eating disorders. The presence of MS is associated with arterial hypertension and atherosclerosis of the arteries of any localization. In this regard, the purpose of our study was to study the quality of life in patients with MS, depending on the severity of coronary atherosclerosis. Materials and methods: The study included 239 patients (142 men, 97 women) with MS with atherosclerosis of the coronary and carotid arteries. The number of subjects in group 1 (n=141), of which 101 were men and 40 were women. The second group consisted of 84 male and 14 female patients (n=98). The control group consisted of 70 people (27 men, 43 women) with grade 1-3 hypertension. The age of the subjects was 31-56 years. All patients underwent: collection of complaints and anamnesis, assessment of body mass index (BMI); determination of the lipid spectrum, blood glucose, glycated hemoglobin. Microalbuminuria and glomerular filtration rate were determined. Instrumental studies were carried out: ultrasound examination of brachiocephalic vessels with determination of the thickness of the intima-media complex and the percentage of carotid artery stenosis; coronary angiography on the General Electric Innova 3100 angiographic complex. Based on the results of coronary angiography, the patients were divided into two subgroups: group 1 - with coronary artery stenosis of less than 50% (n=141), group 2 - with stenosis of 50% or more (n=98), group 3 (control) without stenotic lesions of the coronary arteries. A non-specific questionnaire “SF-36 Health Status Survey” was used to assess the quality of life. Results: assessing physical functioning and mental health, there was a significant decrease in these indicators in patients of group 2, in whom, according to coronary angiography, hemodynamically significant coronary artery stenoses were diagnosed, a strong correlation (r=0.730; p=0.005) was revealed between deterioration in quality of life and hemodynamically significant stenosis of the carotid and coronary arteries. Restriction of physical activity and reduction of daily activities were more significant in group 2 compared to groups 1 and 3. The feeling of uncertainty with restless expectation and fears, as well as a feeling of depression prevailed in men. However, patients after percutaneous coronary intervention, as well as with lipidogram correction, assessed the quality of life with some restriction of physical activity, but with significant social functioning. Conclusions: hemodynamically significant atherosclerosis of the carotid and coronary arteries is a predictor of deterioration in the quality of life, especially in men. The use of the international questionnaire “SF-36 Health Status Survey” is appropriate for assessing the health and vital activity in patients with MS and hypertension, with signs of atherosclerosis. The interaction of a cardiologist, an endocrinologist and a psychotherapist are justified for the most optimal management of patients with comorbid pathology.
Diabetes mellitus (DM) type 2 is the serious progressing chronic disease representing independent risk factor of development of cardiovascular complications. The mortality from cardiovascular diseases at the persons suffering from DM type 2 continues to grow around the world, despite constant augmentation of expenses on treatment and prophylaxis. In this article factors of cardiovascular risk at DM are analyzed and possible ways of their correction are surveyed.
Obesity is a serious medico-social and economic problem. Increased body mass index is associated with a rise in the general mortality rate and mortality due to cardiovascular diseases. In this article, modern views of the influence of obesity on the cardiovascular system are considered.
As of now, osteoporosis (OP) is one of the most important sociomedical problems because of its high prevalence and resultant disability, as well as significant mortality attributable to complications. The current strategy for providing care for patients of OP is its early diagnosis, by determining the high risk of fractures, and early pathogenetic treatment. The article gives an update on the epidemiology, risk factors, diagnosis, and treatment of OP.
Diabe tes mellitus is chronical disease, lead to vascular complications. The safety of hypoglycemic therapy influences on cardiovascular complications. In this review results of some large-scale clinic trials directed to prevention of cardiovascular complications are provided.
The basis of type 2 diabetes is obesity and insulin resistance. Fat tissue is hormonaly active system which produces adiponectin, resistin and other adipokines. These substances participate in development of insulin resistance. The article presents the results of a study conducted to examine the role of adiponectin, resistin in development of insulin resistance in patients with IGT and type 2 diabetes. The reduction of adiponectin level and insulin resistance was found in women suffering from IGF or type 2 diabetes and in men with only type 2 diabetes. Resistin levels were increased in the examined patients with IGT and with type 2 diabetes.
The basis of type 2 diabetes is obesity and insulin resistance. Fat tissue is hormonaly active system which produces adiponectin, resistin and other adipokines. These substances participate in development of insulin resistance. The article presents the results of a study conducted to examine the role of adiponectin, resistin in development of insulin resistance in patients with IGT and type 2 diabetes. The reduction of adiponectin level and insulin resistance was found in women suffering from IGF or type 2 diabetes and in men with only type 2 diabetes. Resistin levels were increased in the examined patients with IGT and with type 2 diabetes.