Profile of Risk Factors for Hypertension Among Overweight Patients

Abstract

A third part of the world’s population has a steady increased blood pressure (BP). According to scientific data, there is a tendency to increase the incidence of arterial hypertension (AH) up to 60 %. It is important in AH treatment to perform an optimal control of BP level, for this purpose it is necessary to consider both the risk factors for the disease development and the risk factors for the development of pathology complications. The objective: to identify risk factors in patients with AH and body mass index (BMI) more than 25 kg/m2. Materials and methods. The study included 339 patients with AH. The I group involved 299 persons with BMI≥25 kg/m2, and 40 patients with AH and BMI <25 kg/m2 were included in the II group. The average age of the patients was 49.4±10.7 years, the average duration of the disease – 7.5 years. Anthropometric data, daily monitoring of BP, morphological and functional state of the heart, biochemical parameters of the blood (lipidogram, transaminase and bilirubin, urea and creatinine, glucose level) were determined in all patients. The levels of interleukin-1β, interleukin-10 and homocysteine were also detected. The speed of glomerular filtration was determined accord ing to the Cockroft–Hault formula, a psycho-emotional examination was done (a questionnaire for determining of anxiety and depression levels, the presence of alexitimia). Results. The analysis of the lipidogram indicators demonstrated a higher level of atherogenicity index in patients with excess body weight (respectively 3.4±1.3 versus 3.1±1.4; p<0.05). Among patients with AH and overweight or obesity compared to patients with normal body weight, significant differences have been revealed about the frequency of complications of targetorgans (AH stage II was 2 times more common among patients in the II group). Glycemia level on empty stomach was higher in patients with overweight (5.5±1.8 mmol/l versus 4.8±0.8 mmol/l; p>0.05) and 3 times more common among patients in the I group (35.6 % versus 11.5 % of patients; p<0.05). Hyperuricemia was found in 48 % of patients. In patients with normal BMI, the level of uric acid was within reference values (p=0.015). In 27 % of patients with overweight the increased IL-10 was determined, in 45 % – IL-1β, while in patients with normal BMI these indicators were normal (p<0.05). Patients with AH had increased levels of anxiety, and patients with excess weight had a risk of depression. Conclusions. The results of the study showed that there is a clear association of increased blood pressure (BP) with weight gain. Patients with AH and high body mass index (BMI) had additional risk factors that can cause high BP and require personalized treatment. Excessive body weight causes an acceleration of the development of target organs (1.5 times more often), in particular increases the risk of progression of systolic and diastolic dysfunction of the left ventricle and sudden cardiac arrest, leads the development of atherosclerosis and immune inflammation. The association of AH and high BMI with PPARG gene (33 % of cases) was determined.