Keywords
arterial hypertension
hypothyroidism
left ventricular remodeling
glomerular filtration rate
triglycerides
швидкість клубочкової фільтрації
How to Cite
Abstract
The current concept of cardio-renal-metabolic syndrome (CRMs) has been poorly studied in patients with arterial hypertension (AH) and hypothyroidism.
The aim of the study: to evaluate the components of the CRMs in patients with a combination of arterial hypertension, hypothyroidism, and metabolic syndrome.
Materials and methods. The main group included 130 patients with AH, hypothyroidism and metabolic syndrome (MS), (females 90.00%), median age 53 years. Control group 1 with AH and MS included 43 patients (females 76.74%); median age 61 years, duration of AH 5-15 years; overweight 37.21%, obesity I degree 44.19%, and II and III degrees 9.30%. Control group 2 consisted of 36 patients with hypothyroidism and MS without AH, median age 44 years (females 94.44%); duration of hypothyroidism 6-10 years; overweight 77.78%, obesity I degree 19.44%, II degree 2.77%. Control group 3 included 20 patients with AH, hypothyroidism and normal body weight, median age 54.0 years, all women, mostly middle (50.00%) and elderly (25.00%) age; duration of AH 5-10 years; hypothyroidism 4.5-9 years. The results were processed using variational statistics, the significance level was taken as p<0.05.
Results. In patients with CRMs with hypothyroidism the cardiac component of syndrome was changed significantly. It was manifested by lower blood pressure values, more frequent detection of low and moderate cardiovascular risk, normal left ventricular geometry and eccentric hypertrophy. Worsening of blood pressure control was accompanied by left ventricular dilatation with thinning of its wall and diastolic dysfunction. The effect of hypothyroidism on the renal component of CRMs was manifested by a more frequent decrease of glomerular filtration rate (61.5% vs. 38.5%, p<0.05). The worsening of hypothyroidism was associated with more significant renal dysfunction. The effect of hypothyroidism on the metabolic component of CRMs was expressed in a higher content of beta-lipoproteins and triglycerides. The conversion of free thyroxine to free triiodothyronine (bioconversion index) was inhibited as total cholesterol increased.
Conclusion. Hypothyroidism affects all components of the cardio-renal-metabolic syndrome.
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