CARDIOMETABOLIC RISK AND MODERN METHODS OF ITS CORRECTION IN PREGNANT WOMEN WITH CHRONIC ARTERIAL HYPERTENSION
Abstract
Aim. To assess the effects of antihypertensive therapy on the dynamics of cardiometabolic risk factors among pregnant women with chronic arterial hypertension (AH) in the second trimester. Material and methods. In total, 37 pregnant women with chronic AH were examined. The clinical and anamnestic data were analysed, and the levels of office blood pressure, body mass index, blood lipids, systemic inflammation markers (C-reactive protein, fibrinogen), and glucose were measured. Subclinical pathology of target organs was assessed via the measurement of left ventricular myocardial mass index (echocardiography), glomerular filtration rate, and microalbuminuria. Results. Slow-release nifedipine therapy improved the parameters of lipid metabolism and target organ status. Metoprolol therapy was linked to an improvement in cardiovascular and renal structure and function. However, metildopa treatment was associated with some increase in glucose levels and a significant elevation in total cholesterol levels. Conclusion. The complex assessment of cardiometabolic risk factors and target organ status is particularly important for a differential choice of antihypertensive therapy in pregnant women.
About the Authors
A. V. Padyganova
Kirov State Medical Academy, Kirov
Russian Federation
Russian Federation
A. V. Padyganova
Kirov State Medical Academy, Kirov
Russian Federation
Russian Federation
References
1. Protopopova N.V., Kolesnikova L.I., Kravchuk N.V., et al. Change of carbohydrate, lipid exchanges and АОС at an arterial hypertension at pregnant women. Actual questions of obstetrics and gynecology 2001–2002; 1, 1. Russian (Протопопова Н.В., Колесникова Л.И., Кравчук Н.В. и др. Изменения углеводного, липидного обменов, ПОЛ и АОС при артериальной гипертензии у беременных. Актуальные вопросы акушерства и гинекологии 2001–2002;.1, 1).
2. Gajsin I.R., Maksimov N.I., Valeev R.M. Cardiorenal continuum at pregnant women with an arterial hypertension. Arterial hypertension 2009; 15, 5: 590–7. Russian (Гайсин И.Р., Максимов Н.И., Валеева Р.М. Кардиоренальный континуум у беременных женщин с артериальной гипертензией. Артериальная гипертензия 2009;.15, 5: 590–7).
3. Wilson B.J., Watson M.S., Prescott G.J. еt al. Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. Br. Med.J. 2003; 326, 7394: 845–51.
4. Baranova E.I., Bolshakova O.O. Prognostic value of high arterial pressure in pregnancy. Arterial hypertension 2008; 14, 1: 22–6. Russian (Баранова Е.И., Большакова О.О. Про гностическое значение высокого артериального давления в период беременности. Артериальная гипертензия 2008; 14, 1: 22–6).
5. Glezer M. G, Tkacheva O.N. References on depression of the general risk of development of diseases and complications at women. Moscow, 2010. 48p. Russian (Глезер М.Г., Ткачева О.Н. Рекомендации по снижению общего риска развития заболеваний и осложнений у женщин. Москва, 2010. 48 с.).
6. Catov J. Early pregnancy lipid concentrations and spontaneous preterm birth. Am J Obstet Gynecol 2007; 197: 610.e1–610.e7.
7. Tkacheva O.N., Prohorovich E.J., et al. Dyslipidemia at women.M.: the Medical book, 2007. 132 р. Russian (Ткачева О.Н., Прохорович Е.Ю. и др. Дислипидемия у женщин. М: Медицинская книга, 2007. 132 с.).
8. National references about diagnostics and treatment of cardiovascular diseases at pregnant women/the all-Russia scientific organization of cardiologists. Cardiovascular Therapy and Prevention 2010; 9 (6): attachment 2, Russian (Национальные рекомендации по диагностике и лечению сердечно-сосудистых заболеваний при беременности/Всероссийское научное общество кардиологов. Кардиоваскулярная терапия и профилактика 2010; 9 (6): приложение 2).
9. Zadionchenko V. S, Adasheva T.V., Demicheva O. J, et al. The metabolic syndrome and obesity. An arterial hypertension at a metabolic syndrome: a pathogenesis, therapy bases. Consilium medicum 2004; 6; 9. Russian (Задионченко В.С., Адашева Т.В., Демичева О.Ю. и др. Метаболический синдром и ожирение. Артериальная гипертония при метаболическом синдроме: патогенез, основы терапии. Consilium medicum 2004; 6, 9).
10. Arutyunov G. P, Oganezova L.G. Beta-blocker and a renal continuum. Clinical nephrology 2009; 2: 43–51. Russian (Арутюнов Г.П., Оганезова Л.Г. Бета-блокаторы и почечный континуум. Клиническая нефрология 2009; 2: 43–51).
11. Schiller Н., Osipov M.A. Clinical echocardiography. M: Practice, 2005. 344p. Russian (Шиллер Н., Осипов М.А. Клиническая эхокардиография. М: Практика, 2005. 344 с.).
12. Melnichenko G. A, Marova E.I., Dzeranova L.K. Giperprolaktinemia at women and men. Moscow, 2007. 33p. Russian (Мельниченко Г.А., Марова Е.И., Дзеранова Л.К. Гиперпрол актинемия у женщин и мужчин. Москва, 2007. 33 с.)
13. Melmed S., Casanueva F., Hoffman A. Diagnosis and treatment of hyperprolactinemia: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism, February 2011, 96 (2): 273–288.
14. Savelyeva I.V. Pregnancy and a metabolic syndrome: a problem condition. TheRussian bulletin ofthe obstetrician andgynecologist 2010; 2: 28–31.Russian (Савельева И.В. Беременность и метаболический синдром: состояние проблемы. Российский вестник акушера-гинеколога 2010; 2: 28–31).
Review
For citations:
Padyganova A.V., Padyganova A.V. CARDIOMETABOLIC RISK AND MODERN METHODS OF ITS CORRECTION IN PREGNANT WOMEN WITH CHRONIC ARTERIAL HYPERTENSION. Russian Journal of Cardiology. 2012;(5):75-80. (In Russ.)
Views:
389
Email this article 