arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2015-21-1-6-15arthyper-168Research ArticleЛЕКЦИЯLECTUREПОРАЖЕНИЯ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ У ДЕТЕЙ С ОЖИРЕНИЕМCARDIOVASCULAR LESIONS IN CHILDREN WITH OBESITYКедринскаяА. Г.KedrinskayaA. G.

Кедринская Анастасия Георгиевна — научный сотрудник научно-исследовательской лаборатории диагностики и лечения патологии детского возраста, педиатр Института перинатологии и педиатрии ФГБУ «СЗФМИЦ» Минздрава России

Anastasia G. Kedrinskaya, MD, Researcher, Research Laboratory of Diagnostics and Treatment of Pediatric Diseases, Pediatrician, Institute of Perinatology and Pediatrics, Federal North-West Medical Research Centre

edleeva@almazovcentre.ruОбразцоваГ. И.ObraztsovaG. I.

Образцова Галина Игоревна — доктор медицинских наук, старший научный сотрудник научно-исследовательской лаборатории диагностики и лечения патологии детского возраста, детский кардиолог Института перинатологии и педиатрии ФГБУ «СЗФМИЦ» Минздрава России

Galina I. Obraztsova, MD, PhD, DSc, Senior Researcher, Research Laboratory of Diagnostics and Treatment of Pediatric Diseases, Pediatrician, Institute of Perinatology and Pediatrics, Federal North-West Medical Research Centre

edleeva@almazovcentre.ruНагорнаяИ. И.NagornayaI. I.

Нагорная Ирена Игоревна — кандидат медицинских наук, старший научный сотрудник научно-исследовательской лаборатории детской эндокринологии, детский эндокринолог Института эндокринологии ФГБУ «СЗФМИЦ» Минздрава России

Irena I. Nagornaya, MD, PhD, Senior Researcher, Research Laboratory of Pediatric Endocrinology, Institute of Endocrinology, Federal North-West Medical Research Centre

edleeva@almazovcentre.ruСеверо-Западный федеральный медицинский исследовательский центр, Санкт-ПетербургРоссияFederal North-West Medical Research Centre Ministry of Health of Russia Federation, St PetersburgRussian Federation201529042015211615Copyright © Кедринская А.Г., Образцова Г.И., Нагорная И.И., 20152015Кедринская А.Г., Образцова Г.И., Нагорная И.И.Kedrinskaya A.G., Obraztsova G.I., Nagornaya I.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/168

Доминирующая доля сердечно-сосудистых заболеваний в структуре смертности и инвалидизации населения развитых стран, рост сердечно-сосудистой патологии привели к формированию представления о сердечно-сосудистом континууме, основанном на клинической оценке факторов, влияющих на риск развития сердечно-сосудистых осложнений. В связи с этим актуальным является изучение начальных этапов этого процесса, а именно — детства и подросткового периода. В настоящее время стало очевидным, что ожирение у детей может рассматриваться как фактор сердечно-сосудистого риска в последующие зрелые годы. Такому взгляду способствуют накопившиеся сведения о поражении сердечно-сосудистой системы у детей и подростков с ожирением и их созвучность изменениям, обнаруживаемым у взрослых. Актуальности этого вопроса способствует и тот факт, что во всем мире наблюдается неуклонный рост доли детей с избытком массы тела, что может означать возможное увеличение сердечно-сосудистой патологии в недалеком будущем. В обзоре освещены ранние проявления поражения сердечно-сосудистой системы у детей с ожирением. Обсуждаются развитие эндотелиальной дисфункции, процессы ремоделирования артериальной стенки, возникновение атеросклеротических повреждений в аорте и периферических сосудах. Также уделено внимание особенностям развития и течения артериальной гипертензии, рассмотрены признаки ремоделирования сердца и критерии диагностики гипертрофии миокарда левого желудочка. Приведены направления профилактики и лечения кардиоваскулярных изменений у детей и подростков с ожирением.

The dominance of cardiovascular diseases in the structure of mortality and disability in developed countries as well as the increasing incidence of cardiovascular disorders led to development of conception of cardiovascular continuum based on the clinical evaluation of the risk factors for cardiovascular complications. In this regard studying of the initial stages of this process, i. e. childhood and adolescence, is of great interest. It is now apparent that childhood obesity may be regarded as a cardiovascular risk factor in adulthood. This fact also corresponds to the accumulated information on the cardiovascular disease in children and adolescents with obesity and its similarity with the changes found in adults. What also facilitates the importance of this issue is a steady worldwide increase of the percentage of infants with excess body weight, which may lead to possible increase in cardiovascular disease in the near future. The review covers early manifestations of cardiovascular disease in children with obesity, the development of endothelial dysfunction, remodeling of the artery wall and the progression of atherosclerotic lesions in the aorta and peripheral vessels. The review addresses the distinction of the hypertension development and course as well as the indication of cardiac remodeling and diagnostic criteria of left ventricular hypertrophy. The review provides directions in prevention and treatment of cardiovascular changes in children and adolescents with obesity.

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The authors declare that there are no conflicts of interest present.