medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-400medsovet-9505Research ArticleДИСЛИПИДЕМИЯDISLIPIDEMIAОценка эффективности стационарного лечения липитензии у пациентов с коморбидной артериальной гипертензией 3-й стадииEvaluation of the effectiveness of inpatient treatment of lipotension in patients with comorbid arterial hypertension stage 3https://orcid.org/0000-0001-8665-6796ГорбаньВ. В.GorbanV. V.

Горбань Виталий Васильевич, д.м.н., заведующий кафедрой поликлинической терапии с курсом общей врачебной практики (семейной медицины)

350063, Россия, Краснодар, ул. Митрофана Седина, д. 4

Vitaly V. Gorban, Dr. Sci. (Med.), Head of the Department of Polyclinic Therapy with Course of General Medical Practice (Family Medicine)

4, Mitrofan Sedin St., Krasnodar, 3500063, Russia

gorbanvv@mail.ruhttps://orcid.org/0000-0002-5026-5053ГорбаньЕ. В.GorbanE. V.

Горбань Елена Витальевна, к.м.н., ассистент кафедры поликлинической терапии с курсом общей врачебной практики (семейной медицины)

350063, Россия, Краснодар, ул. Митрофана Седина, д. 4

Еlena V. Gorban, Cand. Sci. (Med.), Assistant of the Department of Polyclinic Therapy with Course of General Medical Practice (Family Medicine)

4, Mitrofan Sedin St., Krasnodar, 3500063, Russia 

msgorban@mail.ruhttps://orcid.org/0009-0009-5533-2372ЛещенкоВ. А.LeshchenkoV. A.

Лещенко Вадим Алексеевич, студент

350063, Россия, Краснодар, ул. МитрофанаСедина, д. 4

Vadim A. Leshchenko, Student

4, Mitrofan Sedin St., Krasnodar, 3500063, Russia 

leshchenko_vadim@inbox.ruhttps://orcid.org/0009-0001-9062-5746КочергаП. Е.KochergaP. E.

Кочерга Полина Евгеньевна, студент

350063, Россия, Краснодар, ул. Митрофана Седина, д. 4

Polina E. Kocherga, Student 

4, Mitrofan Sedin St., Krasnodar, 3500063, Russia 

polinusyaa@gmail.comКубанский государственный медицинский университетРоссияKuban State Medical UniversityRussian Federation20252011202501628–38Copyright © Горбань В.В., Горбань Е.В., Лещенко В.А., Кочерга П.Е., 20252025Горбань В.В., Горбань Е.В., Лещенко В.А., Кочерга П.Е.Gorban V.V., Gorban E.V., Leshchenko V.A., Kocherga P.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9505

Введение. Трудности достижения целевого уровня артериального давления (АД) и липидограммы у пациентов с артериальной гипертензией (АГ) 3-й стадии требуют учета коморбидности, низкоинтенсивного воспаления, вариабельности АД, а также эффективных комбинаций препаратов и на стационарном, и на амбулаторном этапах лечения.Цель. Оценить эффективность терапии липитензии, отражающей синтропию АГ и дислипидемии, у пациентов с АГ 3-й стадии и высокой коморбидностью в зависимости от клинико-метаболических характеристик, суточных ритмов АД и резидуального воспаления.Материалы и методы. Ретроспективный анализ 87 медицинских карт пациентов с АГ 3-й стадии (54 мужчины и 33 женщины) со средним возрастом 60,0 ± 7,8 года, соотнесенных к контролируемой (1-я группа) и неконтролируемой (2-я группа) АГ, включал оценку степени коморбидности, контроля показателей АД, вариабельности АД, индекса массы тела, маркеров воспаления (СРБ), липидограммы, а также анализ раздельной и фиксированной антигипертензивной и гиполипидемической терапии.Результаты. У 55 пациентов выявлено ожирение, а у 17 – ожирение 3-й степени. Медиана транссиндромной коморбидности составила 5,0 заболеваний на одного пациента. Суточный ритм non-dipper преобладал у 77% больных с контролируемой АГ и у всех больных АГ с коморбидными сахарным диабетом 2-го типа и ожирением 3-й степени, при котором уровень СРБ коррелировал со степенью ожирения. Антигипертензивная терапия 1 и 2 препаратами назначалась 16 и 23 пациентам соответственно, а целевой уровень ХС-ЛПНП (<1,4 ммоль/л) был достигнут лишь у 9 из 87 пациентов.Заключение. Высокая коморбидность и ожирение ассоциированы с нарушением циркадных ритмов АД и повышенным уровнем СРБ. Недостаточный контроль АД и дислипидемии указывают на необходимость применения фиксированных комбинаций антигипертензивных препаратов, комбинированной гиполипидемической терапии максимальными дозами статинов с учетом суточных профилей АД и резидуального воспаления.

Introduction. Difficulties in achieving the target level of blood pressure (BP) and lipidograms in patients with arterial hypertension (AH) of the 3rd stage require accounting for comorbidity, low-intensity inflammation, variability of blood pressure, as well as effective combinations of drugs both in the inpatient and outpatient stages of treatment.Aim. To evaluate the effectiveness therapy of lipotension, reflective synthropy of arterial hypertension (AH) and dyslipidemia, in patients with stage 3 arterial hypertension (AH) and high comorbidity depending on clinical and metabolic characteristics, circadian rhythms of blood pressure (BP) and residual inflammation.Materials and methods. Retrospective analysis of 87 medical records of patients with stage 3 AH (54 men and 33 women) with an average age of 60,0 ± 7,8 years, related to the controlled (1st group) and uncontrolled (2nd group) AH, included an assessment of the degree of comorbidity, control of blood pressure (BP), BP variability, body mass index, inflammation markers (CRP), lipidogram, as well as an analysis of separate and fixed antihypertensive and lipid-lowering therapy.Results. Obesity was detected in 58 patients, and grade 3 obesity was found in 17. The median trans-syndromic comorbidity was 5.0 diseases per patient. The non-dipper circadian rhythm was predominant in 77% of patients with controlled hypertension and in all patients with hypertension with comorbid type 2 diabetes mellitus and stage 3 obesity, in which the CRP level correlated with the degree of obesity. Antihypertensive therapy with one and two drugs was prescribed to 16 and 21 patients, respectively, and the target LDL-C level (<1.4 mmol/l) was achieved only in nine out of 87 patients.Conclusion. High polymorbidity and obesity are associated with impaired circadian rhythms of blood pressure and elevated CRP levels. Insufficient control of blood pressure and dyslipidemia indicate the need for fixed combinations of antihypertensive drugs, combined lipid-lowering therapy taking into account daily blood pressure profiles and residual inflammation.

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The authors declare that there are no conflicts of interest present.