Index of SMK: 575.191:612.014.24

ROLE OF THE ARTERIAL HYPERTENSIA AS INDICATOR OF CEREBROVASCULAR PATHOLOGIES

B.K.Duyssembayev, A.Sh.Oradova.

The arterial hypertension (АG) wins first place among diseases of cardiovascular system. The given diseases 20-30 % of adult population suffer. With the year’s prevalence increases and reaches 50-65 % at persons is more senior 65 years.

Key words: arterial hypertension, cerebrovascular diseases.

Relevance. Hypertension - one of the major risk factors for acute cerebrovascular events (stroke). The high frequency of ischemic stroke (IS) defines the high medical and social significance of in-depth study of hypertension in the formation of cerebrovascular disease [1].
Purpose of this study: to clarify the significance of hypertension in the formation of cerebral dizgemy (CD).
Materials: It was examined 20 patients who underwent AI. Among them, 11 men with AI in the carotid system, 9 people with AI in the vertebrobasilar system. Repeated AI observed in 5 patients. Sex: 9 women and 11 men. Age: from 40 to 75 years, mean age 52 years.
Methods of examination: WHO classification and the International Society of Hypertension, statistical processing of the conclusions of physicians from the medical history and outpatients, collecting complaints and medical history, examination of patients using physical examination methods of the survey.
Results and discussion: According to our data, the fluctuation of blood pressure (BP), including up to high numbers, was noted in all 20 subjects with AI. Among them, 11 persons suffered from primary hypertension, which was the debut of all subsequent chronic disease, and 9 secondary. Etiology of symptomatic hypertension subjects was different: renoparenhimatoznaya - in 5 patients, endocrine - in 2, cardiac - in 2.
We carried out a BP measurement in patients in acute AI. Mean blood pressure at the working background of the pharmacological correction of hypertension varied from 100/70 to 160/100 mm Hg (mean 132 ± 13,99 / 83 ± 8,01 mm Hg). Furthermore, according to the WHO classification and the International Society of Hypertension on the background of the treatment was optimal blood pressure in 2 patients, high normal - at 2, I degree (mild) hypertension - in 7, II degree (moderate) AG - in 1 patient, isolated systolic AH - in 4, III degree (severe) hypertension - not fixed. According to the outpatients maximum numbers rising BP varied from 130/90 to 260/150 mm Hg (mean 182,5 ± 27,5 / 113,5 ± 15,65 mm Hg). Only 3 patients without medication correction was revealed mild hypertension, the remaining 18 people suffered pronounced AH.
Several authors [2] finds that among all forms of hypertension on the proportion of mild to moderate for about 70-80%, in other cases have severe hypertension. We believe that it is pronounced AH, namely the rise in BP levels over 180/110 mm Hg is an indicator of the development of CD. This is a direct relationship between blood pressure levels and the risk of AI: according to the literature an increase in diastolic blood pressure at 7.5 mmHg combined with an increased risk of AI is almost 2 times. AG is directly or indirectly leads to the development of stroke [3]. We agree with the authors that the AG is in the perforating arteries of the brain lipogialinoz and fibrinoid necrosis, and stimulates atherosclerosis pretserebralnyh, large and middle cerebral arteries and heart disease. The higher figures were arterial blood pressure in patients examined by us, the more pronounced were the changes. Years of AH ranged from 3 to 30 years (mean 11,1 ± 8,26 years) since the first measurement of blood pressure, but the patients worsened over the years (from 2 to 5 years) to control BP levels. The course and complications of hypertension exacerbated long regular use of alcohol and smoking. Predominantly spirits systematically abused by 7 people, incidentally - 8. Long-term smoking was noted in 8 patients. The current AG, according to our data, also worsened the lipid profile on a background of regular non-diet, diabetes mellitus and coronary heart disease. In recent years, studies genetic mechanisms of hypertension [4]. In 18 out of 20 patients we studied the heredity of hypertension was burdened. Among them, 5 people have called the cause of death of their parents' AI. Many of our patients surveyed could not remember exactly disease parents. However, some patients mentioned symptoms, indicating the deterioration of the blood relatives on the background of high blood pressure. It should be noted that all 20 patients we studied cerebral accident occurred at the time of pressure increase on the background of family history of cardiovascular disease.
Conclusion: There is a direct correlation between rising blood pressure and risk of AI. Severe hypertension is an indicator of CD on the heredity and family history of premorbid background (in the form of exogenous harmful factors, dyslipidemia, hyperglycemia and associated cardiovascular disease).
Bibliography
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2. Vereshchagin NV, Morgunov VA Gulevskaya TS Brain pathology in atherosclerosis and arterial hypertension. - M.: Medicine, 1997. - 288.
3. Yakhno NN, Shtulman DR Diseases of the nervous system. - M.: Medicine, 2001. -744pp.
4. Martynov AI, Mukhin NA, Moiseev VS, Galyavich AS Internal Medicine. - M.: GEOTAR-Media,2005.-586pp.