Ivankova A. Features of cardiorenal and metabolic disorders in patients with essential hypertension with different forms of extrasystoles

According to the results of an examination of 156 patients with essential hypertension (EH), 124 of whom had frequent symptomatic extrasystoles, was proved that the presence of frequent extrasystoles, regardless of its topical variant, is associated with dyslipidemia, hyperuricemia, and decreased levels of apelin-13 (AP13). The lowest level of AP13 was recorded in patients with hypertension and ventricular extrasystoles (VE). According to Spearman's correlation analysis, was found relationship between serum AP13 levels and the presence of frequent extrasystoles, including ventricular, some indicators of daily blood pressure monitoring, male gender, smoking and burdened heredity in patients with hypertension. The highest level of cystatin C (CysC) was recorded in patients with EH and VE, which differed significantly from the corresponding level of CysC in patients with supraventricular extrasystoles (SVE) (p <0.05), patients without arrhythmias (p <0.001) and almost healthy individuals (p <0.001). Spearman's correlation analysis showed a direct associative relationship between CysC levels and ventricular arrhythmogenesis, known cardiovascular risk factors, some indicators of daily blood pressure monitoring, concentric left ventricular hypertrophy, metabolic risk factors, and creatinine. A significant inverse correlation was found between CysC and glomerular filtration rate (GFR). The terms “apelin background” and “cystatin background” have been proposed, so a high “apelin background” (≥ 920 pg / ml) in EH patients will be accompanied by a benign course of the disease, so an increase AP13 in EH patients should be considered as positive neurohumoral changes that promote cardioprotection. In contrast, a relatively high “cystatin background” (≥ 1.16 mg / l) in hypertension will be accompanied by higher blood pressure and more malignant course of the disease, increased severity of structural remodeling of the left ventricle, more severe renal dysfunction.