Long-term complications in hypertensive patients associated with type 2 diabetes mellitus with hypertensive crises
https://doi.org/10.18705/1607-419X-2007-13-1-44-49
Abstract
The aim of the research is to study remote (3 years) forecast of the patients with arterial hypertension (AH) with crisis current associated with type 2 diabetes and without diabetes, and to estimate the efficiency of the antihypertension therapy.
Comparison analysis of cardiovascular complications in 120 patients with AH with type 2 diabetes (n=60) and without diabetes (n=60) was carried out. Initially the groups were identical on AH duration and the current of cardiovascular complications, hi 3 years a higher frequency of cardiovascular complications in patients with AH with diabetes compared to the patients without diabetes was detected. Besides, the patients with chronic cardiac failure increased by 21,7%, with stenocardia by 20%, with myocardial infraction by 13,4%, with cerebral stroke by 11,7%, the mass of left ventricle myocardium has increased by 15%, lethality is 8,3%.
The showings of the patients with AH without diabetes were 11,7%, 15,0%, 6,7%, 6,7%, 5,9%, and 3,2% accordingly. A low efficacy of secondary drug prophylaxis of AH in the patients of both groups has been marked. Among the patients with AH and diabetes only 58,3% underwent a regular treatment, without diabetes - 31,7%. 41,7% and 68,3% patients underwent a treatment on an irregular basis. Target levels of AH were reached in 18,3% and 15,0% patients correspondingly.
Comparison analysis of cardiovascular complications in 120 patients with AH with type 2 diabetes (n=60) and without diabetes (n=60) was carried out. Initially the groups were identical on AH duration and the current of cardiovascular complications, hi 3 years a higher frequency of cardiovascular complications in patients with AH with diabetes compared to the patients without diabetes was detected. Besides, the patients with chronic cardiac failure increased by 21,7%, with stenocardia by 20%, with myocardial infraction by 13,4%, with cerebral stroke by 11,7%, the mass of left ventricle myocardium has increased by 15%, lethality is 8,3%.
The showings of the patients with AH without diabetes were 11,7%, 15,0%, 6,7%, 6,7%, 5,9%, and 3,2% accordingly. A low efficacy of secondary drug prophylaxis of AH in the patients of both groups has been marked. Among the patients with AH and diabetes only 58,3% underwent a regular treatment, without diabetes - 31,7%. 41,7% and 68,3% patients underwent a treatment on an irregular basis. Target levels of AH were reached in 18,3% and 15,0% patients correspondingly.
About the Authors
Y. L. Nesterov
ГОУ ВПО Кемеровская государственная медицинская академия
Russian Federation
Russian Federation
I. N. Bondareva
ГОУ ВПО Кемеровская государственная медицинская академия
Russian Federation
Russian Federation
A. T. Teplyakov
ГОУ ВПО Кемеровская государственная медицинская академия
Russian Federation
Russian Federation
References
1. Шестакова М.В. Сахарный диабет и артериальная гипертония: каковы препараты первого ряда выбора? Consilium Mtdicum 2005;1: 12-16.
2.
3. Bartol T. Diabetes Updates. Prograns and abstracts of the National Conference for Practitioners; 2002 November 3-6 Nashville Tennessee. Sessions 305, 317, 406.
4.
5. Дедов И.И, Шестакова М.В. Сахарный диабет. Москва, 2003; 454 с.
6.
7. Wysocki J. и соавт. (Wysocki J. Beljwski, Kalina M., et al, Effects of micronizet fenofibrate on insulin resistance in patients with metabolic syndrome. Int J Clin Pharmacol Ther 2004; 42 (4): 212-217.
8.
9. Терещенко С.Н., Голубева А.В. Клинические аспекты поражения сердца при сахарном диабете (диабетическая болезнь сердца). Кардиология 2003; 1: 106-111.
10.
11. Шестакова М.В. Артериальная гипертония при сахарном диабете: эпидемиология, патогенез и стандарты лечения. Consilium Medicum 2001; 2 (3): 83-86.
12.
13. Маколкин В.И. Метаболический синдром и значение АПФ в его терапии: возможности трандолаприла. Артериальная гипертензия 2006; 2 (12): 121-124.
14.
15. Панова Е.И., Корнева К.Г. Особенности аритмии сердца у больных сахарным диабетом 2-го типа. Клин. мед. 2006; 7: 21-24.
16.
17. Мычка В.Б., Горностаев В.В., Богиева Р.М, Чазова И.Е. Артериальная гипертония у больных сахарным диабетом 2 типа и метаболическим синдромом. Consilium medicum (приложение). 2001; 25-31.
18.
19. Рекомендации по лечению гипертонии (1999) Всемирной организации здравоохранения и Международного общества гипертонии. Подкомитет по рекомендациям. Клин. фармакол. и тер. 1999; 8: 18-22.
20.
21. R Devereux, Reichek N. Endocardargraphic assessment of left ventricular mass in man. Circulacion 1997; 55: 616-618.
22.
23. Worid Healrh Organizacion (WHO) Internacional Society of Hypertension (ISH) statement on management of hypertension. Hypertens 2003; 21: 1983-1992.
24.
25. Профилактика, диагностика и лечение артериальной гипретензии Российские рекомендации (второй пересмотр). ВНОК. Кардиоваскул. тер. и профилактика (приложение) 2004; 20 с.
26.
27. Chobanian A.V., Bakris G.L., Black H.R. et al. The Seventh Report of the Joint Nacional Cjmmittee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. JAMA 2003; 289: 2560-2572.
28.
29. De Henauw s., De Bacguer d., Fonteyne W. et al. Trends in the prevalance, detection, treatment and cjntrol of arterial hypertension in the Belgianalult population. J Hypertensi 1998; 16: 277-84.
30.
31. Mancia G., Sega R., Milesi C et al. Blood pressure control in the hypertensive population. Langet 1997; 349: 454- 457.
32.
33. Нестеров Ю.И., Лазарева О.А., Хорошая Л.Н. и др. Сравнительная характеристика качества лечения больных артериальной гипертонией в первичном звене здравоохранения. Тер. арх. 2006; 1: 16-19.
34.
35. Mektzer J.I. A specialist in clinical hypertension critigues АLLHAT. Am. J. Hypertens. 2003; 16: 416-420
36.
37. Кобалова Ж.Д., Ефремовцева М.А. Комбинированная антигипертензивная терапия перврой линии как стратегия успешного контроля артериальной гипертонии. Кардиология 2005, 8: 54-59.
38.
39. Глезер М.Г. Комбинированная терапия как первый шаг при лечении артериальной гипертонии. Тер. арх. 2005; 10: 93-96.
40.
41. Ruitenberg A., Skoog I., Ott A. et al. Blood pressure and risk of dementia results from the Rotterbam study and the Gothenburg. H-70 Study. Dement. Geriatr. Cegh. Disord. 2001; 12 (1): 33-39.
42.
43. Джахангиров Т.Ш. Сердечная недостаточность и сахарный диабет: распространенность, заболеваемость и прогноз. Сердечная недостаточность 2005; 3 (31): 124-131.
44.
45. Ito H., Hiroe M., Hirata Y. et al. Insulin-like groth factor-I induces hypertrophy with enhanget expression jf muscle espresific genes in cultured rat cardiomiocytes. Circulation. 1993; 87 (5): 1715-1721.
46.
47. Джахангиров Т.Ш. Сердечная недостаточность и сахарный диабет: распространенность, заболеваемость и прогноз. Серд ечная недостаточность 2005; 3 (31): 124-131.
48.
Review
For citations:
Nesterov Y.L., Bondareva I.N., Teplyakov A.T. Long-term complications in hypertensive patients associated with type 2 diabetes mellitus with hypertensive crises. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2007;13(1):44-49. (In Russ.) https://doi.org/10.18705/1607-419X-2007-13-1-44-49
Views:
1043
Email this article 