Clinico-laboratory and instrumental features of hypertonic disease in conjunction with obliterative atherosclerosis of the lower extremities in out-patient practice
Keywords:hypertonic disease, obliterative atherosclerosis of the lower extremities, comorbidity, intima-media thickness, lipidograma, intracardiac haemodynamics
Background. The article is devoted to the features of obliterative atherosclerosis of the lower extremities (OALE), as well as the high-quality management of patients with hypertension and OALE comorbidity, especially after undergoing reconstructive operations on occlusion of the arteries of the lower extremities, which is an important part of the activity of primary care physicians. The purpose of the study was to evaluate the risk factors, the indicators of daily monitoring and the profile of blood pressure, intracardiac hemodynamics (according to the echocardiogram), the thickness of the intima-media complex (according to sonography of the carotid arteries) and lipidograms of patients with hypertension in combination with OALE. Results. It was found that the presence of hypertensive patients with concomitant obliterative atherosclerosis of the lower extremities complicated the clinical course of the disease (the higher average daily SAP level was 4.17%, DAP - 2.97%, and heart rate - 11.54%, p<0,05), was accompanied by a more significant violation of intracardiac haemodynamics: with an increase in echocardiographic parameters of the end-diastolic and end-systolic volumes, the end-diastolic and ultimate systolic dimensions, respectively, at 8.25%, 5.58%, 4.54%, 6.80%, thickening of the rear wall of the left ventricle at 16,18% and the interventricular membrane at 9.76% compared with those with isolated hypertension (p<0,05), the progression of atherosclerosis: in violation of lipidograma (elevated cholesterol by 11.32% and triglycerides per 29.17%, decrease in LPHD by 21.43%) and an increase in the thickness of the intima-media complex in sonographic examination of carotid arteries by 29.09% (p<0.001). Conclusions. The presence in hypertensive patients with concomitant obliterative atherosclerosis of the lower extremities complicated the clinical course of the disease.
Артеріальна гіпертензія. Стандарти надання медичної допомоги лікарями первинної ланки. – Укр. мед. часопис. – 2018. - №5 (127), т.1, ІХ/Х. – С. 2-10.
Долженко М.М., Давидова І.В., Шершнева О.В.. Європейські рекомендації з ведення хворих на артеріальну гіпертензію 2018: фокус на ішемічну хворобу серця / М.М. Долженко, І.В. Давидова, О.В. Шершнева //Здоров'я України. – 2018. - №15-16 (436-437). -
Наказ МОЗ України від 13.06.2016 р. №564 «Уніфікований клінічний протокол первинної, вторинної (спеціалізованої) та третинної (високоспеціалізованої) медичної допомоги. Профілактика серцево-судинних захворювань». [Електронний ресурс]. Шлях доступу: http://moz.gov.ua/ua/portal/dn_20060703_436.html.
Волошина О.Б. Сучасні рекомендації щодо діагностики та лікування захворювань артерій нижніх кінцівок у практиці сімейного лікаря (огляд літератури) / О.Б. Волошина //Сімейна медицина. – 2017. - №4 (72).–
Сімейна медицина: навчальнй посібник / [Гощинський В.Б., Бабінець Л.С., Стародуб Є.М. та ін.]; за ред. В.Б. Гощинського, Л.С. Бабінець, Є.М. Стародуба. - 2-ге вид., доп. і перероб. – Тернопіль: ТДМУ, 2014. –
Шлант Р.К., Александер Р.В. Клиническая кардиология. – М.: СПб.: Издательство БИНОМ – Невский проспект, 2017. – 576 с.
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines // Hypertension. – 2018. – Vol. 71, No. 6. – P. 13–115.
2018 ESC/ESH Guidelines for themanagement of arterial hypertension //European Heart Journal. – 2018. – Vol. 39, Issue 33. – P. 3021–3104.
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR) / A. L. Catapano, I. Graham, G. De Backer [et al.] // Eur. Heart J. - 2016. - Vol. 37 (38). - P. 2999–3058.
AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology, and U.S. Department of Health and Human Services/ Arnett DK, Goodman RA, Halperin JL, et al./ Circulation. 2014; 130:1662–1667.
2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines/ M.D. Gerhard_Herman D, H.L. Gornik L, C. Barrett C [et al.] // J.Am.Col. Cardiol. 2017 Mar 21; 69(11):1465_1508.
Peripheral arterial disease and critical limb ischaemia: still poor outcomes and lack of guideline adherence / H.Reinecke, M. Unrath, E. Freisinger [et al.] // Eur Heart J. 2015; 36: 932–938.
ESC Committee for Practice Guidelines. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. The Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC) / M. Tendera, V. Aboyans, M.L. Bartelink [et al.] // Eur Heart J 2011;32:2851–
World Health Organization. Global atlas on cardiovascular disease prevention and control. http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/. Accessed August 12, 2014.
World Health Organization. Global Health Observatory: raised blood pressure. http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/. Accessed August 12, 2014.
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