Background: Hypertensive patients with type 2 diabetes mellitus are also at increased risk for diabetes mellitus–specific complications, including nephropathy. Even the smallest degree of albuminuria increases risk for cardiovascular diseases and all-cause death. The common conditions coexisting with type 2 diabetes (e.g., hypertension and dyslipidemia) are clear risk factors for cardiovascular diseases.Methods and materials: The first (I) group consists of 99 obtained patients with type 2 and AH, the second (II) includes 49 practically healthy people. We evaluated such markers of cardiovascular complications as glycated hemoglobin, lipid profile components by biochemical method and albumin excretion rate with the help of enzyme immunoassay.Result: The positive correlation between the level of albumin excretion rate and glycated hemoglobin (r = 0,23, p < 0,001) is confirmed that albuminuria is a main marker of diabetic nephropathy. The positive correlation between albuminuria and low density lipoproteins (r = 0,34, p < 0,001), triglycerides (r = 0,04, p < 0,001) is the definition of the important role of dyslipidemia in diabetic nephropathy.Conclusion: Determination of albumin excretion rate, glycated hemoglobin as markers of nephropathy, lipid profile components is necessary for patients with type 2 diabetes mellitus and arterial hypertension for prevention cardiovascular complications.Bangladesh Journal of Medical Science Vol.17(2) 2018 p.319-322

Background and aims. The purpose of our study was to determine the features of diabetic nephropathy, to identify the relationship between the level of albumin excretion, urine and lipid profile, genotype variants of the CYP7A1 gene in people with type 2 diabetes and diabetic nephropathy. Material and methods. Patients were divided into three groups. Normoalbinuria was detected in group I, and II - microalbuminuria, and III -macroalbuminuria. Determination of albumin to creatinine ratio was more accurate, although more expensive method. We examined single nucleotide polymorphism -204A> C [rs 3808607] of the promoter region of the CYP7A1 gene. Results. It was established that homozygotes by the major allele with genotype AA had lower values of albuminuria, atherogenic lipoproteins, total cholesterol, triglycerides and higher levels of anti-atherogenic lipoproteins than patients with AС and СС genotypes. Conclusion. The СС genotype was most unfavorable in the prognostic plan, since homozygotes for this minor allele were characterized by higher values of albuminuria, total cholesterol, triglycerides, and lower values of high-density lipoprotein

The aim is the analysis of hyperuricemia influence on the heart features in patients with arterial hypertension. Materials and methods: We include 75 patients with arterial hypertension which were divided in two groups according to the level of uric acid in the blood, 30 practically healthy people. Patients from the I group (n = 40) had arterial hypertension and coexistent hyperuricemia; ІІ (n = 35) – arterial hypertension. Left ventricular mass index was determined for left ventricular hypertrophy confirmation. We used clinical, anthropometric, biochemical, instrumental, statistical method. Serum uric acid level was observed by the reaction with uricase. Left ventricular mass index was calculated as left ventricular mass to body surface area ratio. The results were analyzed statistically by SPSS 21 and Graphpad. Results: Left ventricular mass index was significantly higher (р = 0,0498) in patients from the І group (109,7 ± 3,21) g/m2 comparable with the ІІ (97,6 ± 5,35) g/m2 and increased in proportion to the biggest level of uric acid (r = 0,31; p = 0,04) in patients with arterial hypertension and hyperuricemia. Conclusions: Concentric and excentric left ventricular hypertrophy, increased left ventricular mass index proportionally to uric acid levels (r = 0,31; p = 0,04) is the confirmation of important role of hyperuricemia in the left ventricular hypertrophy development in patients with arterial hypertension.

Arterial hypertension is one of the most common causes of atherosclerotic cardiovascular disease, which is still the reason of mortality for a lot of persons. Assessment of 10-year risk of atherosclerotic cardiovascular disease in hypertensive patients is very important for further treatment improvement. The aim is the absolute 10-year risk assessment of atherosclerotic cardiovascular disease in hypertensive patients for further correction of treatment. We included 61 patients with stage 1 to 2 arterial hypertension into our study. Most of them are women (70%). The patients were (56.84 ± 8.1) years old. The total cholesterol was (4.32 ± 1.0) mmol/l, high and low density lipoprotein cholesterol – (1.35 ± 0.2) mmol/l and (2.44 ± 0.7) mmol/l, respectively. Online calculator «ASCVD Risk Estimator Plus» was used. It included the assessment of age, sex, race, systolic and diastolic blood pressure, total cholesterol, high and low density lipoprotein cholesterol, presence of diabetes, smoking status, hypertension treatment, consumption of statins or aspirin. The risk was classified as low (< 5%), borderline (5% to < 7.5%), intermediate (≥ 7.5% to < 20%), or high (≥ 20%). The results were analyzed statistically using Microsoft Excel. For five persons it was not possible to calculate this risk using the online calculator because of too low values of total cholesterol and low density lipoprotein cholesterol. Low 10-year risk of atherosclerotic cardiovascular disease was confirmed in 30 (53.6%) people, borderline – in 2 (3.6 %), intermediate – in 11 (19.6%), high – in 13 (23.2%). Low absolute 10-year risk of atherosclerotic cardiovascular disease was determined in more than half (53.6%) of patients, high – in about quarter (23.2%), intermediate – in the fifth part (19.6%) of patients with arterial hypertension. For patients with borderline and intermediate risks, it is reasonable to continue therapy with moderate-intensity statins. For hypertensive patients with high risk, high-intensity statin therapy can be recommended and low-dose aspirin might be considered if bleeding risk is not increased. If the absolute 10-year risk of atherosclerotic cardiovascular disease is low, it is reasonable to assess additionally total cardiovascular risk categories and continue moderate-intensity statin therapy in the case of absence of low-density lipoprotein cholesterol goal levels with the next lipid profile assessment in 8 (± 4) weeks.

Волнушкіна Наталія Юріївна студент 6-го курсу, спеціальність-лікувальна справа Сумський державний університет «Медичний інститут», Україна Науковий керівник: Чернацька Ольга Миколаївна ORCID ID: 0000-0001-9093-6862 канд. мед. наук, асистент кафедри внутрішньої медицини з центром респіраторної медицини Сумський державний університет «Медичний інститут», Україна