CONNECTIVE TISSUE DYSPLASIA AND ARTERIAL HYPERTENSION: A MODERN APPROACH TO THE PROBLEM
(LITERATURE REVIEW)
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11293Keywords:
arterial hypertension, antihypertensive therapy, comorbidityAbstract
Arterial hypertension (AH) occupies a leading place in the structure of mortality, increases the risk of developing atherosclerotic, cardiovascular complications. AH is frequently associated with comorbid diseases. Hypertensive patients commonly have one or several co-existent pathologies. The comorbidities have mutual impact on each other, character and severity of complications. Comorbidities influence both the choice of antihypertensive drugs and target blood pressure level.
The main body. One of the risk factors that plays an important role in the pathogenesis, but is not well understood in relation to the development and progression of AH, is the presence of connective tissue dysplasia (CTD). Patients with CTD are more likely to have arterial hypotension or neurocirculatory dystonia, but later these young people often develop hypertension syndrome. The basis for the formation of AH combined with DST is dysfunction of the vascular endothelium of arterial blood flow, the severity of which depends on the duration and severity of AH, the presence of atherogenic dyslipidemias, the effectiveness of antihypertensive therapy and its angioprotective activity.
Conclusion. The presence of comorbidity in a patient, in particular the combination of DST and AH, requires an individual approach, comprehensive diagnostics (clinical, genealogical and laboratory-instrumental studies) and treatment, taking into account both existing pathologies.
References
Vereshhagyna, G.N. (2008). Systemnaya displaziya soedynytelnoy tkani. Klinicheskie sindromy, diagnostika, podkhody k lecheniyu: metodicheskoe posobye [Systemic connective tissue dysplasia. Clinical syndromes, diagnostics, approaches to treatment: a methodological guide]. Novosibirsk: NGMU [in Russian].
Voloshyn, O.M., & Chumak, O.Yu., (2017). Nedyferentsiiovana dysplaziia spoluchnoi tkanyny i respiratorni zakhvoriuvannia v ditei ta pidlitkiv (ohliad literatury) [Undifferentiated connective tissue dysplasia and respiratory diseases in children and adolescents]. Zdorovia dytyny – Child’s Health, 6 (12), 720-727 [in Ukrainian].
Gorbunova, S.Y., & Evsevieva, M.E., (2006). Osobennosty arteryalnoy gipertenzii i porazheniya serdtsa na fone displazii soedynitelnoy tkani u lits molodogo vozrasta [Features of arterial hypertension and heart damage against the background of connective tissue dysplasia in young people]. Medytsynskiy vestnik Severnogo Kavkaza – Medical Bulletin of the North Caucasus, 4, 30-34 [in Russian].
Demydov, R.O., Lapshyna, S.A., & Yakupova, S.P. (2015). Dysplaziya soedynitelnoy tkani: sovremennye podkhody k klinike, diagnostike i lecheniyu [Connective tissue dysplasia: modern approaches to the clinic, diagnosis and treatment]. Innovatsyonnye tekhnologii v meditsyne – Innovative Technologies in Medicine, 4(89), 2, 37-40 [in Russian].
Docenko, N.Ya., Boev, S.S., Shexunova, Y.A., Gerasymenko, L.V., & Dedova, V.O. (2012). Kardiologicheskye aspekty displazii soedynitelnoy tkani u vzroslykh [Cardiological aspects of connective tissue dysplasia in adults]. Kharkiv: Traditsii i dokazatelnaya meditsina [in Ukrainian].
Zemczovskyj, E.V. (2008). Nedyfferentsyrovannye displazii soedynitelnoy tkani. Popytka novogo osmysleniya kontseptsii [Undifferentiated connective tissue dysplasia. An attempt to rethink the concept]. Meditsynskiy vestnik Severnogo Kavkaza – Medical Bulletin of the North Caucasus, 2, 8-14 [in Russian].
Zemczovskyj, E.V. (2000). Soedynytelnotkannye displazii serdtsa [Connective tissue dysplasia of the heart]. Saint-Petersburg: TOO Polyteks–Nord–Vest [in Russian].
Laryna, G.Y. (2005). Arterialnaya gipertenziya pri displazii soedynitelnoy tkani: kliniko-morfologicheskye osobennosti [Arterial hypertension in connective tissue dysplasia: clinical and morphological features]. Candidate’s Extended abstract. Omsk [in Russian].
Martynov, A.Y., & Nechaeva, G.Y. (2016). Natsyonalnye rekomendatsii rossiyskogo nauchnogo medytsynskogo obshchestva terapevtov po diagnostike, lecheniyu i reabilitatsii patsyentov s displaziyami soedynitelnoy tkani [National guidelines of the Russian scientific medical society of physicians for the diagnosis, treatment and rehabilitation of patients with connective tissue dysplasia]. Meditsynskiy vestnik Severnogo Kavkaza – Medical Bulletin of the North Caucasus, 1, 11, 72 [in Russian].
Maslovskaya, M.V., & Lollyny V.A. (2014). Nedyfferentsyrovannaya displaziya soedynitelnoy tkani i malye anomalii serdtsa kak prediktor razvitiya narusheniy ritma u patsyentov s ishemycheskoy boleznyu serdtsa [Undifferentiated connective tissue dysplasia and minor cardiac anomalies as a predictor of rhythm disturbances in patients with coronary heart disease]. Vestnik VGMU – Bulletin of VSMU, 3, 13, 68-76 [in Russian].
Yvanova, Y.Y., Gnusaev, S.F., & Koval, N.Yu. (2012). Metabolicheskye aspekty nedifferentsirovannoy displazii soedinitelnoy tkani u detey [Metabolic aspects of undifferentiated connective tissue dysplasia in children]. Rossiyskiy vestnik perinatologii i pediatrii – Russian Bulletin of Perinatology and Pediatrics, 4 (1), 103-111 [in Russian].
Morozenko, D.V., & Leontyeva F.S. (2016). Metody doslidzhennia markeriv metabolizmu spoluchnoi tkanyny u suchasnii klinichnii ta eksperymentalnii medytsyni [Methods of research of markers of connective tissue metabolism in modern clinical and experimental medicine]. Molodyi vchenyi – Young Scientist, 2 (29), 168-172 [in Ukrainian].
Nechaeva, G.Y., & Martynov, A.Y, (2017). Displaziya soedynitelnoy tkani: serdechno-sosudistye izmeneniya, sovremennye podkhody k diagnostike i lecheniyu [Connective tissue dysplasia: cardiovascular changes, modern approaches to diagnosis and treatment]. Moscow: OOO “MYA” [in Russian].
Rumyanceva, V.A., & Zaklyazmynskaya, E.V. (2015). Klinicheskoe i geneticheskoe raznoobrazye nasledstvennykh displaziy soedynitelnoy tkani [Clinical and genetic diversity of hereditary connective tissue dysplasias]. Clin. Experiment. Surg. Petrovsky J., 2, 5-17 [in Russian].
Smyrnova, T.L., & Gerasymova, L.Y. (2018). Osobennosti klinicheskykh proyavleniy sindroma nedyfferentsyrovannoy displaziy soedynitelnoy tkani [Features of clinical manifestations of the syndrome of undifferentiated connective tissue dysplasia]. Cardiology Internal. Medicine, 8 (152), 40-44 [in Russian].
Tymofeeva, E.P., Karceva, T.V., & Ryabychenko, T.Y. (2012). Sovremennye predstavleniya o syndrome nedyfferentsyrovannoy displazii soedynitelnoy tkani [Modern ideas about the syndrome of undifferentiated connective tissue dysplasia]. Rossiyskiy vestnik perinatologii i pediatrii – Russian Bulletin of Perinatology and Pediatrics, 4 (1), 112-116 [in Russian].
Trysvetova, E.L. (2019). Sovremennye predstavleniya o fybromuskulyarnoy displazii koronarnykh arteriy [Modern concepts of fibromuscular dysplasia of the coronary arteries]. Ratsyonalnaya farmakoterapiya v kardiologii – Rational Pharmacotherapy in Cardiology, 15 (3), 431-438 [in Russian].
Fadeeva, T.S. (2018). Displaziya soedinitelnoy tkani: novye gorizonty problemy: monografiya [Connective tissue dysplasia: new horizons of the problem: monograph]. Cheboksary: YD “Sreda” [in Russian].
Sherstyuk, L.L. (2019). Prognostychne znachennia nedyferentsiiovanoi dysplazii spoluchnoi tkanyny u rozvytku komorbidnoi patolohii [Prognostic value of undifferentiated connective tissue dysplasia in the development of comorbid pathology]. Ukrainskyi zhurnal medytsyny, biolohii ta sportu – Ukrainian Journal of Medicine, Biology and Sports, 4 (20), 4, 158-164 [in Ukrainian].
Sherstyuk, L.L. (2018). Rol nedyferentsiiovanoi dysplazii spoluchnoi tkanyny u rozvytku arterialnoi hipertenzii u khvorykh na tsukrovyi diabet 2-ho typu [The role of undifferentiated connective tissue dysplasia in the development of hypertension in patients with type 2 diabetes mellitus]. Medytsyna neotlozhnykh sostoyaniy – Emergency Medicine, 7 (94), 65-69 [in Ukrainian].
Yakovlev, V.M., Nechaeva, G.Y., Martynov, A.Y., & Vyktorova, Y.A. (2016). Displaziya soedynitelnoy tkani v praktike vrachey pervychnogo zvena zdravoohraneniya. Rukovodstvo dlya vrachey [Dysplasia of connective tissue in the practice of primary care physicians. A guide for doctors]. Moscow: KST Ynterforum [in Russian].
Yurt, A., Vardar, E., & Selçuki, M. (2010). Biomarkers of connective tissue disease in patients with intracranial aneurysms. Journal of Clinical Neuroscience, 17, 1119-1121. DOI: https://doi.org/10.1016/j.jocn.2010.01.028
Ganesh, S.K., Morissette, R., & Xu, Z. (2014). Clinical and biochemical profiles suggest fibromusculardysplasia is a systemic disease with altered TGF- expression and connective tissue features. The FASEB Journal, 28, 3313-3324. DOI: https://doi.org/10.1096/fj.14-251207
Harsanyi, S., Zamborsky, R., & Krajciova, L. (2020). Developmental dysplasia of the hip: a review of etiopathogenesis, risk factors, and genetic aspects. Medicina, 56 (153), 1-12. DOI: https://doi.org/10.3390/medicina56040153
Bharath, K.R., Malathi, N., & Narashiman, S. (2014). Evaluation of myofibroblasts by expression of alpha smooth muscle actin: a marker in fibrosis, dysplasia and carcinoma. Journal of Clinical and Diagnostic Research, 8 (4), 14-17.
Morris, S.A., Orbach, D.B., & Geva, T. (2011). Increased vertebral artery tortuosity index is associatedwith adverse outcomes in children and young adultswith connective tissue disorders. Circulation, 124, 388-396. DOI: https://doi.org/10.1161/CIRCULATIONAHA.110.990549
Kushaeva, D.S., & Yakubova, M.M., (2018) Age features of chronic cerebrovascular insufficiency in some forms of dysplasia of cerebral arteries. European Science Review, 11, 170-174.
McKusick, V.A., Amberger, J.S., & Francomano C.A., (1996). Progress in medical genetics: map-based gene discovery and the molecular pathology of skeletal dysplasias. Am. J. Med. Genet., 63 (1), 98-105. DOI: https://doi.org/10.1002/(SICI)1096-8628(19960503)63:1<98::AID-AJMG19>3.0.CO;2-P
Boudoulas, H., Kolibach, A., & Baker P. (1989). Mitral valve prolaps and the mitral valve prolaps syndrome: a diagnostic classification and pathogenesis of symptoms. Amer. Heart J., 118, 796-818. DOI: https://doi.org/10.1016/0002-8703(89)90594-2
Yagoda, A.V., Grigoryan, Ya.S., & Gladkikh, N.N., (2014) Role of dysplastic features in evaluation of qt interval disorder іn patients with small heart anomalies. Medical News of North Caucasus, 9, 157-159. DOI: https://doi.org/10.14300/mnnc.2014.09047
