Наукові праці. Кафедра внутрішньої медицини № 1

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Author: search.filters.author.Shalimova, Anna

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    Comparison of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease and two types of arterial hypertension
    (2023) Molodan, Volodymyr; Panchenko, Galyna; Prosolenko, Kostyantyn; Lapshyna, Kateryna; Shalimova, Anna
    Background: The aim was to conduct a comparative assessment of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease (NAFLD) and two types of arterial hypertension (HTN). Material and methods: The study included 329 patients 18–66 years old. All patients were divided into five groups: patients with comorbidity of NAFLD and primary HTN (121 subjects), patients with comorbidity of NAFLD and renal parenchymal HTN (88 subjects), patients with NAFLD (60 subjects), patients with primary HTN (30 subjects), patients with renal parenchymal HTN (30 people). The control group consisted of 20 healthy individuals of similar age and gender categories. Results: In the comparative analysis of the structural and functional ultrasonographic parameters of vessels, no significant differences between two comorbidity groups NAFLD + primary HTN and NAFLD + renal parenchymal HTN were found. The influence of AH and degree of liver steatosis on ultrasound indicators of arteries in examined patients with comorbidity was evaluated by MANOVA analysis. The influence of the HTN factor and the influence of the liver steatosis factor were evaluated separately, after which the influence of the comorbidity factor, i.e., the combined influence of these factors and one or another indicator, was evaluated. The additive effect of the factors of AH and liver steatosis was identified according to the parameters: intima media thickness, pulse wave velocity in the carotid artery, pulse wave velocity in the abdominal aorta and endothelial-related vasodilation, which indicates an important comorbid effect of NAFLD and primary/renal parenchymal HTN on the structural and functional state of arteries. Conclusions: There are no differences between the structural and functional indicators of arteries in patients with comorbidity of NAFLD + primary HTN and NAFLD + renal parenchymal HTN. The factor of the presence of HTN and the degree of liver steatosis significantly affect structural and functional indicators of the studied arteries.
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    Comparison of structural and functional vascular disorders in patients with comorbidity of non-alcoholic fatty liver disease and two types of arterial hypertension
    (2023) Prosolenko, Kostyantyn; Molodan, Volodymyr; Panchenko, Galyna; Lapshyna, Kateryna; Shalimova, Anna
    Background: The aim was to conduct a comparative assessment of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease (NAFLD) and two types of arterial hypertension (HTN). Material and methods: The study included 329 patients 18–66 years old. All patients were divided into five groups: patients with comorbidity of NAFLD and primary HTN (121 subjects), patients with comorbidity of NAFLD and renal parenchymal HTN (88 subjects), patients with NAFLD (60 subjects), patients with primary HTN (30 subjects), patients with renal parenchymal HTN (30 people). The control group consisted of 20 healthy individuals of similar age and gender categories. Results: In the comparative analysis of the structural and functional ultrasonographic parameters of vessels, no significant differences between two comorbidity groups NAFLD + primary HTN and NAFLD + renal parenchymal HTN were found. The influence of AH and degree of liver steatosis on ultrasound indicators of arteries in examined patients with comorbidity was evaluated by MANOVA analysis. The influence of the HTN factor and the influence of the liver steatosis factor were evaluated separately, after which the influence of the comorbidity factor, i.e., the combined influence of these factors and one or another indicator, was evaluated. The additive effect of the factors of AH and liver steatosis was identified according to the parameters: intima media thickness, pulse wave velocity in the carotid artery, pulse wave velocity in the abdominal aorta and endothelial-related vasodilation, which indicates an important comorbid effect of NAFLD and primary/renal parenchymal HTN on the structural and functional state of arteries. Conclusions: There are no differences between the structural and functional indicators of arteries in patients with comorbidity of NAFLD + primary HTN and NAFLD + renal parenchymal HTN. The factor of the presence of HTN and the degree of liver steatosis significantly affect structural and functional indicators of the studied arteries.
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    Comparison of structural and functional vascular disorders in patients with comorbidity of non-alcoholic fatty liver disease and two types of arterial hypertension
    (2023) Prosolenko, Kostyantyn; Molodan, Volodymyr; Panchenko, Galyna; Lapshyna, Kateryna; Shalimova, Anna
    Background: The aim was to conduct a comparative assessment of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease (NAFLD) and two types of arterial hypertension (HTN). Material and methods: The study included 329 patients 18–66 years old. All patients were divided into five groups:patients with comorbidity of NAFLD and primary HTN (121 subjects), patients with comorbidity of NAFLD and renal parenchymal HTN (88 subjects), patients with NAFLD (60 subjects), patients with primary HTN (30 subjects), patients with renal parenchymal HTN (30 people). The control group consisted of 20 healthy individuals of similar age and gender categories. Results: In the comparative analysis of the structural and functional ultrasonographic parameters of vessels, no significant differences between two comorbidity groups NAFLD + primary HTN and NAFLD + renal parenchymal HTN were found. The influence of AH and degree of liver steatosis on ultrasound indicators of arteries in examined patients with comorbidity was evaluated by MANOVA analysis. The influence of the HTN factor and the influence of the liver steatosis factor were evaluated separately, after which the influence of the comorbidity factor, i.e., the combined influence of these factors and one or another indicator, was evaluated. The additive effect of the factors of AH and liver steatosis was identified according to the parameters: intima media thickness, pulse wave velocity in the carotid artery, pulse wave velocity in the abdominal aorta and endothelial-related vasodilation, which indicates an important comorbid effect of NAFLD and primary/renal parenchymal HTN on the structural and functional state of arteries. Conclusions: There are no differences between the structural and functional indicators of arteries in patients with comorbidity of NAFLD + primary HTN and NAFLD + renal parenchymal HTN. The factor of the presence of HTN and the degree of liver steatosis significantly affect structural and functional indicators of the studied arteries. Key words: structural and functional vascular alterations; non-alcoholic fatty liver disease; hypertension
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    The impact of sleep disorders in the formation of hypertension
    (2022) Isayeva, Ganna; Buriakovska, Olena; Shalimova, Anna
    Hypertension is one of the most common chronic non-communicable diseases in the world. Risk factors, methods of prevention and treatment of hypertension have been sufficiently studied. However scientists are still looking for pathogenetic mechanisms of its development. At the same time, 36.9% of patients with hypertension had different sleep disorders. Patients with insomnia have a 21% higher risk of developing hypertension compared with those who have quality sleep. Hypnotics are given up to 15% of patients with hypertension. Hypnotics have been shown to increase the risk of cardiovascular events. As much as 44.1% of patients with established diseases of the cardiovascular system have problems with the quality or duration of sleep. At this time, hypertension and sleep disorders are considered mutually aggravating diseases.
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    Insufficient control of out-of-office blood pressure: the problem of masked uncontrolled hypertension
    (2021) Shalimova, Anna
    Despite significant advances in the diagnosis and treatment of arterial hypertension (AH), the problem of insufficient blood pressure (BP) control in hypertensive patients is quite acute. According to current guidelines, the effectiveness of antihypertensive therapy is mainly assessed by reaching the target levels of office BP, while masked uncontrolled hypertension (MUCH), which is diagnosed on the basis of insufficient control of out-of-office BP, increases the risk of cardiovascular events. Patients with insufficient out-of-office BP control have an increased risk of cardiovascular events compared to patients with both office and out-of-office BP control, therefore MUCH requires timely diagnosis and correction. This minireview summarizes the understanding of the nature of MUCH. A particular attention is paid to risk factors and ways of influencing the out-of-office BP control. The article also assessed the important contribution of ABPM to the control of out-of-office BP and to determining the overall risk of MUCH.
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    Different faces of resistant hypertension in obesity
    (2022) Shalimova, Anna
    Background: The aim was to conduct a comparative assessment between pseudo-resistant (due to different causes) and true resistant hypertension (RH) in obesity. Material and methods: The study included 302 patients with uncontrolled hypertension and obesity. Initial treatment efficacy was assessed 3 months after dual therapy was administered. Those patients who did not reach target blood pressure (BP) with dual therapy were switched to triple therapy. Among patients who received triple therapy, 69 people did not reach target BP (they received the fourth drug, spironolactone). All patients were additionally examined 6 months after the initiation of antihypertensive therapy. Results: Despite the achievement of target BP after 6 months of therapy, patients with resistant hypertension had significantly higher BP and more pronounced disturbances of the circadian rhythm compared with non-resistant patients. After 6 months of therapy, patients with true resistance had significantly higher SBP compared with pseudo-resistant patients. The normal circadian rhythm in patients with true resistance was significantly less common than in patients with pseudo-resistance. Compared with pseudo-resistance, the presence of true resistance in obesity was associated with higher SBP and aldosterone levels, as well as lower body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C). Conclusions: Even when target BP levels in antihypertensive therapy are achieved, obese resistant patients are characterized by more pronounced disturbances of the circadian rhythm and higher levels of office and out-of-office BP, compared with non-resistant patients. New data were obtained in the difference in the systolic blood pressure (SBP) levels (significantly higher with true resistance) and LDL-C (significantly lower with true resistance).
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    Features of the Severity of Cardiovascular Remodeling and Metabolic Disorders in Hypertensive Patients with Obesity in the Presence of Two Unfavorable Genotypes of the ADIPOQ and IRS-1 Genes
    (2020) Shalimova, Anna; Psarova, Valentyna; Kyrychenko, Nataliia; Kochuieva, Maryna
    The results of a number of studies have shown that in ar- terial hypertension (AH), G/T and T/T genotypes of the adiponectin gene (ADIPOQ) and Gly/Arg and Arg/Arg genotypes of the insulin receptor substrate 1 gene (IRS-1) are associated with a greater severity of metabolic disorders and hemodynamic parameters compared with G/G and Gly/ Gly genotypes of these genes. The aim of the study: to evaluate the severity of cardiovas- cular remodeling and metabolic disorders in hypertensive obese patients in the simultaneous presence of two unfa- vorable genotypes of the ADIPOQ and IRS-1 genes.
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    The effect of physical activity enlargement on anthropometric parameters and blood lipids depending on genetic polymorphisms of beta-2 and beta-3 adrenoreceptors
    (2020) Isayeva, Ganna; Shalimova, Anna; Vovchenko, Maryna; Buriakovska, Olena; Galchinska, V.
    Assessment of genetic factors, which determine the effect of physical exercise, allows to identify individuals that are not susceptible to positive effects of enlargement of physical activity. The aim of the study was to assess the effect of enlargement of physical activity on anthropometric parameters and blood lipids in individuals with- out cardiovascular diseases
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    Effect of amlodipine on the manifestations of chronic insomnia in hypertensive patients with type 2 diabetes mellitus
    (2020) Isayeva, Ganna; Buriakovska, Olena; Shalimova, Anna
    Background: The aim of the study was to assess the association between antihypertensive therapy and the manifestations of insomnia in patients with arterial hypertension (AH) and type 2 diabetes mellitus (T2DM). Material and methods: The study included 120 hypertensive patients with and without T2DM (among them there were 60 patients with insomnia). The study consisted of three stages. The first stage was conducted as a cross-sectional study, during which an association was established between different antihypertensive products and the presence of insomnia in the study population. The second and third stages were a prospective study, during which a modification of the therapy to reduce the manifestations of insomnia was performed. Results: It was found that patients receiving amlodipine in the combination antihypertensive therapy had insomnia manifestations much less frequently as compared to indapamide. A statically significant decrease in blood pressure (BP) and a higher proportion of patients with target BP were observed in both groups. Replacement of indapamide with amlodipine was shown to improve sleep quality. Thus, the number of patients with insomnia significantly decreased in both groups. After correction of antihypertensive therapy after 12 months, all patients were assessed for sleep disorders. The incidence of insomnia was found to be significantly reduced in both groups after changing therapy from indapamide to amlodipine. Conclusions: Correction of antihypertensive therapy, namely the replacement of indapamide with amlodipine, contributes to an improvement in BP, quality of life, and a reduction in the proportion of patients with insomnia.
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    Features of hemodynamic and metabolic disorders in obese patients with resistant hypertension
    (2020) Shalimova, Anna; Psarova, Valentyna; Kochuieva, Maryna; Kolesnikova, Olena; Isayeva, Ganna; Zlatkina, Vira; Nemtsova, Valeriya
    Background. The aim was to establish the features of hemodynamic and metabolic parameters in obese patients with true and pseudo-resistant arterial hypertension (AH). Material and methods. The study included 200 patients with uncontrolled AH and obesity. Patients were initially prescribed dual antihypertensive therapy. Those patients who did not reach target blood pressure (BP) levels after 3 months on dual therapy were additionally prescribed a third antihypertensive drug. Of the 98 patients who were assigned to triple therapy, 48 patients did not reach target BP (27 patients had pseudo-resistant and 21 patients had true resistant AH). These patients were additionally prescribed a fourth antihypertensive drug (spironolactone). The effectiveness of the treatment was evaluated 6 months after the start of antihypertensive therapy. Results. After 6 months of therapy, unlike patients without resistance, individuals with resistant AH had more pro- nounced cardiovascular remodeling and metabolic disorders, disbalance of oxidative stress-antioxidant protection, proinflammatory activity and higher activity of the renin-angiotensin-aldosterone system. Patients with true resist- ance differed from pseudo-resistant patients by having significantly lower body mass index (BMI); in the absence of differences in BP levels, cardiovascular remodeling, lipid and carbohydrate profiles, patients with true resistance had significantly higher levels of aldosterone, higher activity of oxidative stress system, lower levels of general antioxidant protection, higher adiponectin levels, and lower leptin level. Conclusions. Obese patients with true resistance differed from pseudo-resistant patients by having significantly lower BMI, higher aldosterone levels, more pronounced imbalance of the system of oxidative stress-antioxidant protection and less pronounced adipokine imbalance.