The relationship between gastroduodenal lesions and coronary heart disease

The article provides a comprehensive analysis of the relationship between diseases of the gastroduodenal zone and coronary artery disease (CAD), which frequently coexist in the same patient, share common pathogenetic mechanisms, and mutually aggravate the course of each other. The paper discusses current concepts of the systemic processes linking these conditions, including chronic low-grade inflammation, endothelial dysfunction, activation of lipid peroxidation, disturbances of carbohydrate and lipid metabolism, and the influence of infectious and immune factors. Special attention is given to Helicobacter pylori infection, which not only causes chronic inflammatory processes in the gastric and duodenal mucosa but also contributes to the development of atherosclerosis by increasing the levels of pro-inflammatory cytokines (IL-6, TNF-α), stimulating C-reactive protein production, and impairing vascular endothelial function. The role of gastrointestinal microbiota in the development of systemic inflammation, insulin resistance, and metabolic syndrome, which represent key links in the pathogenesis of CAD, is analyzed in detail. Particular attention is paid to liver diseases – nonalcoholic fatty liver disease and viral hepatitis – which are closely associated with cardiovascular pathology through shared metabolic, vascular, and inflammatory mechanisms. The article presents current approaches to the diagnosis and treatment of patients with combined pathology, including H. pylori eradication, microbiota normalization, correction of metabolic disorders, antioxidant and hypolipidemic therapy, taking into account the functional state of the liver and gastrointestinal tract. The importance of a multidisciplinary approach involving gastroenterologists, cardiologists, and general practitioners is emphasized, aiming at personalized patient management, prevention of complications, and improvement of quality of life.

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