Authors
Chumak B.A., Dydyshko V.T., Yakovlev V.V., Barsukov A.V., Serdyukov D.Yu., Yakovlev V.А.
S.M. Kirov Military medical academy, St. Petersburg
Abstract
Arterial hypertension (AH) and its complications occupy a leading position in the structure of mortality and disability. Infectious-inflammatory factors, as well as related diseases and conditions, are important additional risk factors for the formation of AH and atherosclerosis-associated pathology.
Aim. To examine the role of infectious and inflammatory risk factors, concomitant diseases and states in the formation of AH in males of young and middle-aged age with low and medium cardiovascular risk, calculated on the Framingham scale.
Material and methods. 436 servicemen aged 30–50 years without clinically significant pathology were examined. The study participants were divided into 2 cohorts based on the Framingham Risk scale: 203 people with a low risk of cardiovascular diseases (CVD) and 233 — with an middle risk. Each of the cohort, depending on the office level of blood pressure (BP), was divided into 2 subgroups: 1st subgroup with BP 120–139 and / or 80–89 mm Hg, 2nd subgroup — with AH 1st degree (BP 140–159 and / or 90–99 mm Hg).
Results. In the subgroups of males with hypertension, obesity and burdened heredity in CVD were diagnosed. The connection of the deterioration of well-being in certain seasons of the year was significantly more often traced in persons with a middle (but not low) risk of CVD, especially with the presence of AH (p <0.01). A concomitant pathology with an infectious-inflammatory component (fatty hepatosis, gall-eyed disease, ulcerative disease, urolithiasis) (p>0.05) was observed. Persons with AH and the middle risk of CVD were significantly more often observed hypertrophy of the left ventricle (LV) and sinus tachycardia. In males without AH and with a low risk of CVD, an odontogenic infection prevailed and the nazo-faringeal infection compared with the surveyed persons with the middle risk (p<0.01). Acute respiratory infections were recorded with the same frequency in all groups of surveyed (p>0.05). Direct reliable bonds are established between the frequency of colds and age, a fraction of the emission of the LV, the final systolic volume of the LV, the heart rate and the level of systolic BP (p<0.05), which were more often observed in individuals with AH and the middle risk of CVD. Patients with AH revealed reliable direct links for the presence of foci of chronic infection with age and heart rate (p<0.05).
Conclusion. Males at the age of 30–50 years without clinically significant pathology have a variety of risk factors, indicating the preclinical stage of the formation of AH, among which chronic foci of infection are often found, recurrent diseases in history, communication with the season of the year and dislypidemia. Males with an middle age risk of CVD and AH 1 degree have closer correlations of clinical and anamnestic, metabolic and structural and functional cardiovascular indicators compared to low-risk males and AH 1 degree, as well as compared to people without AH having both low and middle cardiovascular risks in the Framingham scale.
Keywords: young and middle age, servicemen, prehypertension, arterial hypertension, low and middle cardiovascular risk according to the Framingham risk scale, infectious and inflammatory risk factors, comorbidities and conditions.
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