Сердечно-сосудистые осложнения у больных первичным альдостеронизмом

Первичный альдостеронизм (ПА) является одной из наиболее распространенных причин вторичной артериальной гипертензии (АГ) и, как показано в ряде исследований, увеличивает риск развития сердечно-сосудистых заболеваний, хронической болезни почек, а также смерти больных. Цель исследования — сравнить встречаемость сердечно-сосудистых осложнений у больных ПА и гипертонической болезнью (ГБ) для выявления особенностей поражения кардиоваскулярной системы при альдостеронизме. Материалы и методы. В исследование были включены 191 (77,0  %) женщина и 57 (23,0  %) мужчин с подозрением на ПА в возрасте от 19 до 86 лет, у которых были исключены другие причины вторичной АГ. Диагностику ПА проводили согласно рекомендациям Международного общества эндокринологов от 2009 года. Результаты. Диагноз ПА подтвердили у 41 (16,5  %) больного. У пациентов с ПА значение систолического артериального давления было выше, а значение диастолического артериального давления не отличалось от данных показателей у лиц с ГБ. Микроальбуминурию чаще обнаруживали в группе больных ПА, чем ГБ (61,0 и 41,6  % соответственно, р < 0,05). Результаты исследования показали, что острое нарушение мозгового кровообращения, стенокардия напряжения, инфаркт миокарда, нарушения ритма сердца встречались с одинаковой частотой у больных ПА и ГБ. В то же время количество пациентов с хронической сердечной недостаточностью было выше в группе больных ПА, чем в группе больных ГБ (29,3 и 12,0  % соответственно, p < 0,05). Заключение. Таким образом, АГ, обусловленная автономной продукцией альдостерона, приводит к более частым осложнениям со стороны сердечно-сосудистой системы. В связи с этим ранняя диагностика и своевременное лечение больных ПА остаются актуальными вопросами современной медицины.

артериальная гипертензия, первичный альдостеронизм, сердечно-сосудистые осложнения

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