Kyrian O. A., Dorofeyev A. E., Tarasova V. І., Hurkalo Yu. Z., Babanina M. Yu.

FEATURES OF ARTERIAL HYPERTENSION CLINICAL COURSE IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE AND IRRITABLE BOWEL SYNDROME

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About the author:

Kyrian O. A., Dorofeyev A. E., Tarasova V. І., Hurkalo Yu. Z., Babanina M. Yu.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

The relevance of studying the problems of ischemic heart disease (IHD) is due to its significant prevalence worldwide and frequent loss of work capacity. The comorbidity of IHD with arterial hypertension (AHT) and irritable bowel syndrome (IBS) with their numerous common risk factors and pathogenic mechanisms, may be characterized by additional neurovegetative and metabolic imbalances, while also exhibiting distinct clinical symptoms. The aim of our studies was to identify the clinical features of AHT in patients with IHD combined with IBS. A total of 112 patients aged 39 to 68 years with stable ischemic heart disease (SIHD) and arterial hypertension were examined. Among them, 46.4% exhibited manifestations of IBS and 60 patients were with isolated IBS. A higher frequency of pain and radiating chest pain was observed in patients, with variability in pain characteristics, predominantly aching and pressing pain. Patients with SIHD and AHT combined with IBS reported a greater variety and frequency of symptoms compared to those without IBS. The pathogenesis of major complaints indicates the important role of autonomic nervous system imbalance in the development of AHT in these patients. Increased daytime and nighttime systolic (SBP) and diastolic blood pressure were recorded in patients with IHD, AHT and IBS, which serves as an unfavorable predictor of cardiovascular complications. Increased blood pressure variability and lack of adequate nocturnal dipping in SBP were also noted in patients with SIHD and AHT with IBS, potentially leading to target organ damage. Conclusion. Patients with IHD and AHT combined with IBS exhibit a range of clinical and pathogenetic features of AHT, affecting their overall condition and risk of complications. The presence of IBS in patients with IHD and AHT intensified the progression of hypertension, contributing to its rapid progression.

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1. Ministerstvo okhorony zdorovia Ukrainy. Nakaz № 2857 Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy Stabilna ishemichna khvoroba sertsia. Kyyiv: MOZ Ukrainy; 2021. 47 s. Dostupno: https:// moz.gov.ua/uploads/7/35063-dn_2857_23_12_2021_dod.pdf. [in Ukrainian].
2. Muscella A, Stefàno E, Marsigliante S. The effects of exercise training on lipid metabolism and coronary heart disease. Am J Physiol Heart Circ Physiol. 2020;319(1):H76-H88. DOI: 10.1152/ajpheart.00708.2019.
3. Chekalina NI. Resveratrol has a positive effect on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease. Wiad Lek. 2017;70(2.2):286-291.
4. Schuett K, Marx N, Lehrke M. The Cardio-Kidney Patient: Epidemiology, Clinical Characteristics and Therapy. Circ Res. 2023;132(8):902- 914. DOI: 10.1161/CIRCRESAHA.
5. Carbone S, Canada JM, Billingsley HE, Siddiqui MS, Elagizi A, Lavie CJ. Obesity paradox in cardiovascular disease: where do we stand? Vasc Health Risk Manag. 2019;15:89-100. DOI: 10.2147/VHRM.S168946.
6. Sugiharto F, Nuraeni A, Trisyani Y, Melati Putri A, Aghnia Armansyah N. Barriers to Participation in Cardiac Rehabilitation Among Patients with Coronary Heart Disease After Reperfusion Therapy: A Scoping Review. Vasc Health Risk Manag. 2023;19:557-570. DOI: 10.2147/VHRM.S425505.
7. Zhdan V, Khaymenova G, Shilkina L, Potyazhenko M, Martynyuk D, Kiriyan E. Modernization of therapy in patients with chronic obstructive pulmonary disease and ischemic heart disease. Clinical Practice (Therapy), London, United Kingdom. 2016;13(3):63.
8. Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, et al. Peer Review Committee Members. 2023 AHA/ACC/ACCP/ ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/ American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148(9):e9-e119. DOI: 10.1161/CIR.0000000000001168.
9. Fuchs FD, Whelton PK. High Blood Pressure and Cardiovascular Disease. Hypertension. 2020;75(2):285-292. DOI: 10.1161/HYPERTENSIONAHA.119.14240.
10. Yablonska VB, Kholopov LS, Khyzhniak OV, Batashova-Halynska VA. Novi perspektyvy v likuvanni ishemichnoi khvoroby sertsia u patsiientiv iz porushenniamy rytmu sertsia y arterialnoiu hipertenziieiu. Ukr. Med. Chasopys 2023;2(154):21-24. DOI: 10.32471/umj.1680-3051.154.241348. [in Ukrainian].
11. Cattaneo M, Halasz G, Cattaneo MM, Younes A, Gallino C, Sudano I, et al. The Central Nervous System and Psychosocial Factors in Primary Microvascular Angina. Front Cardiovasc Med. 2022;9:896042. DOI: 10.3389/fcvm.2022.896042.
12. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407-477. DOI: 10.1093/eurheartj/ehz425.
13. Aljeradat B, Kumar D, Abdulmuizz S, Kundu M, Almealawy YF, Batarseh DR, et al. Neuromodulation and the Gut-Brain Axis: Therapeutic Mechanisms and Implications for Gastrointestinal and Neurological Disorders. Pathophysiology. 2024;31(2):244-268. DOI: 10.3390/pathophysiology31020019.
14. Hasler WL, Grabauskas G, Singh P, Owyang C. Mast cell mediation of visceral sensation and permeability in irritable bowel syndrome. Neurogastroenterol Motil. 2022;34(7):e14339. DOI: 10.1111/nmo.14339.
15. Dorofeev AE, Tkach SM, Zhigal YV, Kyrian OA, Gurkalo YZ. Otsinka efektyvnosti zastosuvannia inulinu v terapii patsiientiv iz syndromom podraznenoho kyshechnyka iz zaporom. Modern Gastroenterology. 2023;2(130):51-8 DOI: https://doi.org/10.30978/MG-2023-2-51. [in Ukrainian].
16. Wu H, Chiou J. Potential Benefits of Probiotics and Prebiotics for Coronary Heart Disease and Stroke. Nutrients. 2021;13(8):2878. DOI: 10.3390/nu13082878.
17. Liu L, He X, Feng Y. Coronary heart disease and intestinal microbiota. Coron Artery Dis. 2019;30(5):384-389. DOI: 10.1097/MCA.0000000000000758.
18. Tanaka M, Itoh H. Hypertension as a Metabolic Disorder and the Novel Role of the Gut. Curr Hypertens Rep. 2019;21(8):63. DOI: 10.1007/s11906-019-0964-5.
19. Stergiou GS, Avolio AP, Palatini P, Kyriakoulis KG, Schutte AE, Mieke S, et al. European Society of Hypertension recommendations for the validation of cuffless blood pressure measuring devices: European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens. 2023;41(12):2074-2087. DOI: 10.1097/HJH.0000000000003483.
20. Ministerstvo okhorony zdorovia Ukrainy. Nakaz № 1581 Unifikovanyi klinichnyi protokol pervynnoi ta spetsializovanoi medychnoi dopomohy Hipertonichna khvoroba (Arterialna hipertenziia). Kyyiv: MOZ Ukrainy; 2024. 71 s. Dostupno: https://www.dec.gov.ua/wpcontent/uploads/2024/ 09/ykpmd_1581_12092024_dod.pdf. [in Ukrainian].
21. Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016;150(6):1262-1279. DOI: 10.1053/j.gastro.2016.02.032.
22. Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(10):908-917. DOI: 10.1016/S2468-1253(20)30217-X.

Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 1, 176, 200-211 pages, index UDC 616.12-008.331.1/-005.4-085

DOI:

10.29254/2077-4214-2025-1-176-200-211