Arterial hypertension, obesity and non-alcoholic fatty liver disease: is there any connection?

The combination of hypertension, obesity and non-alcoholic fatty liver disease occurs in medical practice very often. A number of studies have shown that non-alcoholic fatty liver disease increases the risk of cardiovascular disease independently of other predictors and manifestations of the metabolic syndrome. Current issues of research and identification of common pathogenic relationships of obesity, hypertension, and liver steatosis are investigated in the article. According to the analysed literature, it is indicated that insulin resistance and compensatory hyperinsulinaemia are considered as one of the key factors in the development of this comorbidity. The processes of chronic inflammation are increasing with the growth of adipose tissue volume. Some researchers believe that non-specific systemic inflammation combines arterial hypertension, increased body weight (especially abdominal obesity), steatosis, dyslipidaemia, atherogenesis and arteriosclerosis into a single syndrome. The role of non-alcoholic fatty liver disease in the growth of the thickness of the intima-media complex was studied. It is known that adipose tissue functions as an endocrine organ, expresses genes encoding bioactive substances, and secretes certain cytokines. A strong link between dysfunction of adipose tissue in patients with non-alcoholic fatty liver disease and in such conditions as metabolic syndrome and cardiovascular disease was demonstrated. The dysfunction of the endothelium is also advisable to consider as the connecting link between liver disease, obesity and hypertension. Despite some understanding of common pathogenic mechanisms for the development of non-alcoholic fatty liver disease and hypertension, this comorbid pathology remains the subject of much debate and a variety of studies

Characteristics of changes and clinical and instrumental predictors of the severity of structural remodelling of carotid arteries in hypertensive patients

Background. Mechanisms of activation of the process of vascular wall remodelling in patients affected by arterial hypertension have not been studied in depth and require clarification. Materials and methods. The study included 381 patients with hypertension — 212 men and 169 women of the average age 53.0 (47; 60) years. The structural-functional vessel status was determined by the method of duplex scanning and colour duplex mapping of blood flow with the Logiq 500 MO apparatus (GE, USA). Statistical analyses were made using Microsoft Excel software kit, Statistica for Windows 6.0. Results. The patients with hypertension presented some left-right asymmetry of remodelling extracranial carotid arteries. Unlike the impact of remodelling of the right carotid artery, the most essential effect on the left carotid artery was the impact of daytime pulse arterial pressure and variability of the nocturnal systolic arterial pressure (the strength of impact 25.0 and 13.9%, respectively. The processes of remodelling of the right carotid artery are more sensible to the impact of high values of nocturnal diastolic arterial pressure (the strength of impact 16.4%). The beginning of some brain complication is associated with the significant increase in atherosclerotic affection not only of the left, but also of the right carotid artery. Conclusions. Remarkable remodelling of the right carotid artery is often associated with the severity of the disease and to some extent reflects the severity of the flow of the disease and can be regarded as an additional unfavourable feature

Charakterystyka zmian oraz klinicznych i instrumentalnych czynników prognostycznych ciężkości przebudowy strukturalnej tętnic szyjnych u pacjentów z nadciśnieniem

Wstęp. Mechanizmy aktywacji procesu przebudowy ścian naczyń u pacjentów chorujących na nadciśnienie tętnicze nie były dogłębnie zbadane i wymagają wyjaśnienia. Materiał i metody. Badaniem objęto 381 pacjentów z nadciśnieniem tętniczym — 212 mężczyzn i 169 kobiet w średnim wieku 53,0 (47; 60) lat. Stan strukturalno- funkcjonalny naczyń określono, stosując metodę badania za pomocą skanowania dupleksowego oraz kolorowego mapowania dupleksowego przepływu krwi za pomocą urządzenia Logiq 500 MO (GE, USA). Wykonano analizy statystyczne za pomocą zestawu oprogramowania Microsoft Excel, Statistica dla Windows 6.0. Wyniki. Pacjenci z nadciśnieniem tętniczym wykazywali pewną asymetrię lewo- i prawostronną przebudowy tętnic szyjnych zewnątrzczaszkowych. Inaczej niż w przypadku przebudowy prawej tętnicy szyjnej, na lewą tętnicę szyjną wpływały wartość ciśnienia tętniczego pulsu dziennego oraz zmienność nocnego skurczowego ciśnienia tętniczego (siła oddziaływania odpowiednio 25,0 i 13,9%). Procesy przebudowy prawej tętnicy szyjnej są bardziej wrażliwe na wpływ wysokich wartości nocnego rozkurczowego ciśnienia tętniczego (siła oddziaływania 16,4%). Początek pewnych komplikacji związanych z mózgiem wiąże się ze znacznym wzrostem choroby miażdżycowej nie tylko lewej, ale także prawej tętnicy szyjnej. Wnioski. Znaczna przebudowa prawej tętnicy szyjnej jest często związana z ciężkością choroby i do pewnego stopnia odzwierciedla ciężkość przebiegu choroby i może być postrzegana jako dodatkowa niekorzystna cecha

Peculiarities Of Changes Of Apelin-13 Concentration In Patients With Essential Hypertension And Extrasystole

Introduction. Hypertension is one of the leading causes of disability and mortality among cardiovascular diseases, so today new metabolic markers of cardiovascular risk are being actively studied. One of them is apelin-13. Objective: to assess the concentration of apelin-13 in patients with essential hypertension and frequent extrasystole. Materials and methods. 156 patients with stage II essential hypertension were examined. 124 of them had frequent symptomatic extrasystoles, 32 patients had no arrhythmias and were considered to the comparison group. 30 practically healthy normotensive persons were considered to the control group. All patients underwent a complete clinical and anthropometric examination, blood pressure measurement, automatic daily blood pressure monitoring, daily electrocardiogram monitoring, echocardiography and the assessment of serum apelin-13 concentration. Results. It was found that the concentration of apelin-13 in patients with hypertension was significantly lower compared to the control group. Moreover, the average content of apelin-13 was significantly (p = 0.02) lower in patients with extrasystole than in those without arrhythmia. The lowest concentration of apelin-13 was noticed in patients with ventricular arrhythmias. Conclusion. The results confirm the existing assumptions about the protective role of apelin-13 in preventing the progression of cardiovascular diseases due to counteracting the increase in blood pressure and life-threatening arrhythmias. Keywords: essential arterial hypertension, apelin-13, extrasystole, smoking, obesity