No abstract

Background. Hypertension (HTN) is often combined with other diseases, that significantly complicate its course, worsen the prognosis, interfere with the therapeutic and preventive measures. Therefore, assessing the development and structure of polymorbidity (PM) in hypertension is a relevant issue. Objective. To study the structure and degree of PM in hypertensive patients depending on age and gender. Design and methods. We conducted an analysis of 20 560 case histories of patients with HTN and without HTN (men and women), inhabitants of West Siberia-Novosibirsk region, who underwent examination and treatment at the clinic of the Federal Research Center of Fundamental and Translational Medicine in Novosibirsk. All identified diagnoses (nosological forms and classes according to the International Classification of Diseases of the 10th revision, ICD‑10) were considered. Transnosological PM was assessed by the average number of nosologies corresponding to the three-digit ICD‑10 rubric. Results. An increase in the PM index by 16,8 % was found in HTN patients compared to patients without HTN. Among HTN patients, there was an increase in the incidence of comorbid diseases of the circulatory system (in the 16–39 age group in men — by 46 %, in women — by 42,8 %), the endocrine system, eating disorders and metabolism (in the age group 16–39 years for men — by 19,3 %, for women — by 45,2 %), the musculoskeletal system, urinary system (for men) and neoplasms (for women) compared with patients without HTN. Conclusions. We found a high rate of transnosological PM in HTN patients was found and defined its structure.

Introduction. Nowadays the problem of population health in the northern areas is of great importance. While evaluating human adaptation to the extreme geoecological northern conditions the state of the cardiovascular system can be used as an index of effective compensatory adaptation. Study design. The data on 24-hour BP monitoring, data of echocardiography and heliogeophysical factors in different periods of ontogenesis in 317 patients, living in the north of the Tyumen region, were analysed to estimate the morphofunctional and chronobiological peculiarities of arterial hypertension. Results. Considerable disorders of haemodynamic circadian rhythms, manifesting either insufficient decrease of BP at night are revealed in the examined subjects. Above 42.2% of such patients have myocardial hypertrophy. Insufficient night decrease of BP is typical for the examined patients, with coupling of the indices of haemodynamic and current geomagnetic activity. The peculiarities of heliogeophysical factors at early ontogenesis of the examined subjects with an increased variability and decreased circadian index of BP are defined using multivariate analysis. Conclusion. Thus, a combination of disorders of temporary haemodynamic organisation with the morphological changes of myocardium and peculiarities of biogeophysical coupling of the examined is shown. This anthropoecological approach can be used for the diagnostics and treatment of arterial hypertension under conditions of the northern ecosystem.

Сердечно-сосудистые заболевания (ССЗ) являются главной причиной преждевременной смерти, равно как и значимыми причинами нетрудоспособности не только в России, но и большинстве стран мира. В последнем докладе ВОЗ отмечается, что 1 / 3 всех причин смертности взрослого населения, а это около 15 млн смертей во всем мире, составляют ССЗ, связанные с атеросклерозом [1]. По данным Всероссийского научного общества кардиологов, заболевания сердца и сосудов являются причиной в среднем 56% всех смертей россиян (48% всех смертей у мужчин и 66,2%-у женщин). Всего болезнями сердца и сосудов в России страдают более 23 млн человек. Каждый год в нашей стране умирают 1 млн 300 тыс человек вследствие сердечно-сосудистых катастроф [2]. Среди заболеваний сердечно-сосудистой системы, являющихся причинами смерти, основными остаются ишемическая болезнь сердца (ИБС), в том числе инфаркт мио