ASSOCIATION OF INDICES OF BLOOD SERUM LIPID PROFILE AND ACHIEVEMENT/FAILURE OF THE TARGET LEVEL OF BLOOD PRESSURE IN OUTPATIENTS WITH ISOLATED ARTERIAL HYPERTENSION AND IN COMBINATION WITH CARDIOVASCULAR COMORBIDITY
DOI:
https://doi.org/10.11603/mcch.2410-681X.2024.i2.14768Keywords:
arterial hypertension, cardiovascular comorbidity, target blood pressure level, serum lipid profileAbstract
Introduction. Dyslipidemia is one of the most important factors of cardiovascular risk, the potentiation of its negative impact increases precisely in the absence of adequate blood pressure (BP) control. On the other hand, it is likely that dyslipidemia may impair BP control in patients with arterial hypertension (AH).
The aim of the study - to investigate the indices of the serum lipid spectrum and the relationships between them and achievement/failure of TBP in outpatients with isolated AH and in combination with cardiovascular comorbidity.
Research methods. The research was carried out on the basis of the municipal non-commercial enterprise “Hulsk outpatient clinic of general practice of family medicine” of the Stryiv village council (the village of Hulsk, Zviahel district, Zhytomyr region), and the municipal non-commercial enterprise “Zviahel multi-profile hospital” of the Zviahel city council, Zviahel city, Zhytomyr region. The study included 140 patients with AH, who were divided into three groups: isolated AH (n=60), AH + coronary heart disease (CHD) (n=35), AH + CHD + chronic heart failure (HF) (n=45). The serum lipid profile was assessed by the level of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triacylglycerols (TG) and the atherogenic index (AI). Statistical processing of the results was carried out using the STATISTICA 13.0 program.
Results and discussion. The atherogenic nature of changes in the serum lipid profile and the presence of dyslipidemia were established both in outpatients with isolated AH and with AH and cardiovascular comorbidity. At the same time, more pronounced dyslipidemia (statistically significant differences of all lipidogram indices vs control group) was found in patients with isolated AH (levels of TC, LDL-C, TG, VLDL-C and AI at 34.04, 54.31, 44.36, 45.00 and 88.16 %, respectively, exceeded the control; HDL-C level was 12.86 % lower than the control). Analyzing the relationship between the indices of the serum lipid profile in outpatients with isolated AH and their achievement/failure of the TBP, it was found that the levels of TC and LDL-C in individuals who did not reach the TBP were 11.86 % and 28.19 % higher, respectively, than similar data of individuals who have reached the TBP (p<0.001); the level of HDL-C was 25.00 % lower in persons who did not reach the TBP compared to those who reached the TBP (p<0.001); the AI of people who did not reach the TBP exceeded the similar index of people who reached the TBP by 58.26 % (p<0.001). As for patients with AH and cardiovascular comorbidity in this context, differences were found only in the group of AH + CHD + HF with regard to the level of HDL-C, which was 14.29 % (p=0.047) lower in individuals who did not reach the TBP compared to individuals who reached the TBP and AI, which in individuals who did not reach the TBP exceeded the similar index of individuals who reached the TBP by 45.71% (р=0.034).
Conclusion. Dyslipidemia is associated with TBP failure both in outpatients with isolated AH and with AH and cardiovascular comorbidity, while in patients with isolated AH more relationships between lipid indices and TBP failure were found than in patients with AH and cardiovascular comorbidity, which requires further research.
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