HEALTH OF WOMAN. 2019.6(142): 37–40; doi 10.15574/HW.2019.142.37

N.M. Kyrychenko
Sumy State University

The objective: was to establish the peculiarities of heart and vascular remodeling in the females with hypertension and obesity of different grades.
Materials and methods. We examined 142 patients with hypertension at the age of 40–60 years. The first group included 25 patients with normal body weight, the second – 45 patients with grade 1obesity, the third group – 45 patients with grade 2obesity, and the fourth – 27 patients with grade 3 obesity.
Results. As a result of the conducted research, it is established that the values of the studied parameters in patients with normal body weight and grade 1obesitydo not have a significant difference. In patients with grade 2 obesity, the size of the intima-media complex is statistically significantly higher, and the degree of endothelium-dependent vasodilation of the shoulder arteries is less than in patients with normal body weight.
Unlike other groups, the patients with grade 3 obesity have the intima-media complex thickness, their pulse wave velocity in the carotid arteries and the abdominal aorta and the final diastolic size of the left ventricle of the heart are higher, but the endothelium-dependent vasodilation degree of the brachial arteries is significantly less.
Conclusion. With the increase of the body weight, hypertensive females tend to increase the average pressure in the pulmonary artery and decrease the left ventricular ejection fraction.
Key words: hypertension, obesity, heart and vascular remodeling.

REFERENCES

1. Lim S, Vos T, Flaxman A et al. 2012. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380 (9859): 2224-60. https://doi.org/10.1016/S0140-6736(12)61766-8

2. Marie N, Fleming T, Robinson M et al. 2014. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384: 766-81.

3. The GBD. 2015. Obesity Collaborators. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 377: 13-27. 2017. https://doi.org/10.1056/NEJMoa1614362; PMid:28604169 PMCid:PMC5477817

4. Jedrychowski W, Mroz E, Bojanczyk M, Jedrychowska I. 1991. Excessive weight and hypertension in the elderly – the results of the community study. Arch Gerontol Geriatr 13(1): 61-9. https://doi.org/10.1016/0167-4943(91)90016-J

5. Kanai H, Tokunaga K, Fujioka S et al. 1996. Decrease in intra-abdominal visceral fat may reduce blood pressure in obese hypertensive women. Hypertension 27(1): 125-9. https://doi.org/10.1161/01.HYP.27.1.125; PMid:8591874

6. Piepoli М, Hoes А, Agewall S et al. 2016. European Guidelines on cardiovascular disease prevention in clinical practice (version 2016). European Heart Journal 37 (29): 2315­81.

7. The Global BMI Mortality Collaboration. Body-mass index and all-cause mortality: individual participant-data meta-analysis of 239 prospective studies in four continents. Lancet 388: 776-86. 2016.

8. Aune D, Sen A, Prasad M et al. 2016. BMI and all-cause mortality: systematic review and non­linear dose-response metaanalysis of 230 cohort studies with 3,74 million deaths among 30,3 million participants. BMJ 353: i2156. https://doi.org/10.1136/bmj.i2156; PMid:27146380 PMCid:PMC4856854

9. Antonopoulos A, Tousoulis D. 2017. The molecular mechanisms of obesity paradox. Cardiovascular Research 113: 1074-86. https://doi.org/10.1093/cvr/cvx106; PMid:28549096

10. Samocha-Bonet D, Dixit V, Kahn C et al. 2014. Metabolically healthy and unhealthy obese: the 2013 Stock Conference report. Obes Rev 15: 697-708. https://doi.org/10.1111/obr.12199; PMid:25059108 PMCid:PMC4519075

11. Nuttall F. 2015. Body mass index: obesity, BMI, and health: a critical review. Nutr Today 50: 117-28. https://doi.org/10.1097/NT.0000000000000092; PMid:27340299 PMCid:PMC4890841

12. Nakamura K, Fuster J, Walsh K. 2014. Adipokines: a link between obesity and cardiovascular disease. J Cardiol 63 (4): 250-9. https://doi.org/10.1016/j.jjcc.2013.11.006; PMid:24355497 PMCid:PMC3989503

13. Titov VN, Dmitriev VA. 2015. Obesity is a pathology of adipocytes: cell number, arterial bed volume, local circulation pools in vivo, natriuretic peptides and arterial hypertension. Translational Medicine 1: 26-38.

14. Sun K, Kusminski C, Scherer P. 2011. Adipose tissue remodeling and obesity. J Clin Invest 121 (6): 2094-101. https://doi.org/10.1172/JCI45887; PMid:21633177 PMCid:PMC3104761

15. Vecchie A, Dallegri F, Carbone F et al. 2018. Obesity phenotypes and their paradoxical association with cardiovascular diseases. Eur J Intern Med 48: 6-17. https://doi.org/10.1016/j.ejim.2017.10.020; PMid:29100895

16. Molica F, Morel S, Kwak B et al. 2015. Adipokines at the crossroad between obesity and cardiovascular disease. Thromb Haemost 113 (3): 553-66. https://doi.org/10.1160/TH14-06-0513; PMid:25338625

17. Badimon L, Bugiardini R, Cenko E et al. 2017. Position paper of the European Society of Cardiology-working group of coronary pathophysiology and microcirculation: obesity and heart disease. Eur Heart J 38: 1951-8. https://doi.org/10.1093/eurheartj/ehx181; PMid:28873951

18. Druzhilov MA, Druzhilova OYu, Kuznetsova TYu et al. 2015. Obesity as cardiovascular risk factor: accent on quality and functional activity of adipose tissue. Russ J Cardiol 4: 111-7. https://doi.org/10.15829/1560-4071-2015-4-111-117

19. Chumakova GA, Veselovskaya NG. 2016. Metodyi otsenki vistseralnogo ozhireniya v klinicheskoy praktike. Rossiyskiy kardiologicheskiy zhurnal 4: 89-96. https://doi.org/10.15829/1560-4071-2016-4-89-96

20. Morelli M, Gaggini M, Daniele G et al. 2013. Ectopic fat: the true culprit linking obesity and cardiovascular disease? Thromb Haemost 110 (4): 651-60. https://doi.org/10.1160/TH13-04-0285; PMid:23884194

21. 2018 ESC/ESH Guidelines for the management of arterial hypertension  European Heart Journal. 39: 3021–3104. 2018.

22. Bodnar PN, Dyinnik OB, Mihalchishin GP, Beregovaya TV, Kobyilyak NN, Kuharskiy VM, Pribyitko IYu, Kondro MM. 2011. Otsenka elastografii volnyi sdviga v diagnostike eksperimentalnoy nealkogolnoy zhirovoy bolezni pecheni. Zhurn. NAMN Ukrainy 17; 4: 422–430.

23. Ryibakova MK, Alehin MN, Mitkov VV. 2008. Prakticheskoe rukovodstvo po ultrazvukovoy diagnostike. Ehokardiografiya. M, Izdatelskiy dom Vidar:512.