Possibilities of interdisciplinary approach to early detection of asymptomatic arterial hypertension


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Abstract

The latent form - asymptomatic form of arterial hypertension occurs in the general population in 15% to 24% of individuals, is more often associated with men, increased body mass index, smoking, stress, increased systolic blood pressure (BP), hypertrophy and diastolic dysfunction of the left ventricle and is considered the most dangerous a form of the disease that can result in sudden cardiac arrest. Early detection of risk factors for hypertension is of great preventive and economic importance. Objective - to develop a method for early detection of a high risk of developing asymptomatic hypertension with preventive digital X-ray fluorography studies and an interdisciplinary approach. Based on the screening survey conducted in 1411 workers, a method for early detection of high risk factors for asymptomatic hypertension was developed based on statistical significant risk factors. Research was conducted among workers at the workplace of 6 urban enterprises, with the detection of an enlarged left ventricle (ELV) in screening of the subject contingent and measuring BP levels. With elevated BP, 604 (42.8%) workers were identified, and with ELV - 236 (16.7%) cases. The combination of elevated BP and ELV was significantly more frequent (160, 67.8%) than with normal BP (76, 32.2%). Based on the statistical analysis, a logistic regression model with a high residual deviance (about 84%) is constructed, which gives satisfactory forecasts. The diagnostic test of the model, with cutoff threshold equal to pо=0.397, corresponds to: sensitivity - 75.5%, specificity - 64.4%, accuracy - 69.2%. Thus, the use of the screening diagnostic method in the detection of ELV in combination with age in men of 28 years or in women from 39 years of age reveals a high risk of developing asymptomatic forms of hypertension. These patients are taken to the control and sent to the physician by the therapist to perform the pre-examination.

About the authors

T. Yu Leshchuk

Grodno State Medical University

Email: tleshhuk@yandex.ru
аспирант (соискатель) каф. фтизиопульмонологии , врач-рентгенолог высшей квалификационной категории. 230009, Republic of Belarus, Grodno, ul. Maksima Gor'kogo, d. 80

I. S Gelberg

Grodno State Medical University

д-р мед. наук, проф. каф. фтизиопульмонологии 230009, Republic of Belarus, Grodno, ul. Maksima Gor'kogo, d. 80

A. V Kopuckij

Grodno State Medical University

ст. преподаватель каф. медицинской и биологической физики 230009, Republic of Belarus, Grodno, ul. Maksima Gor'kogo, d. 80

References

  1. Мрочек А.Г., Нечесова Т.А., Коробко И.Ю. и др. Национальные рекомендации «Диагностика, лечение и профилактика артериальной гипертензии» РНПЦ «Кардиология», Бел. науч. о-во кардиологов. Минск: Проф. изд., 2013; с. 50]
  2. Чазов Е.И., Чазова И.Е. Руководство по артериальной гипертонии. М.: Media Medica, 2005; с. 734.
  3. Оганов Р.Г. Эпидемиология артериальной гипертонии в России и возможности профилактики. Терапевтический архив. 1997; 69 (8): 66-9.
  4. Frankling S.S, Pio J.R, Wong N.D et al. Predictors of New-Onset Diastolic and Systolic Hypertension. The Framingham Heart Study. Circulation 2005; 111: 1121-7.
  5. Клиническое руководство по организации и проведению противотуберкулезных мероприятий в амбулаторно-поликлинических организациях здравоохранения. Приказ Министерства здравоохранения Республики Беларусь от 23.05.2012 №622.
  6. Линденбратен Л.Д., Королюк И.П. Медицинская радиология и рентгенология. М.: Медицина, 1993; с. 137-88.
  7. The Task Force for the management of arterial hypertension of the European Society of Hypertension and of the European Society of Cardiology. 2007 Guidelines for the management of arterial hypertension. J Hypertens 2007; 25: 1105-87.
  8. Чазова И.Е., Ратова Л.Г., Бойцов С.А., Небиеридзе Д.В. Диагностика и лечение артериальной гипертензии (Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов). Системные гипертензии. 2010; 7 (3): 5-26.
  9. Национальный центр интеллектуальной собственности РБ. Приоритетная справка по заявки на патент «Способ раннего выявления факторов высокого риска развития бессимптомной АГ» от 07.04.2017 №а20170041. l
  10. RStudio: Integrated Development for R. 2016. https://www.rstudio.com/products/rstudio/
  11. Медик В.А., Токмачев М.С. Математическая статистика в медицине. М.: Финансы и статистика, 2007.
  12. Мастицкий С.Э., Шитиков В.К. Статистический анализ и визуализация данных с помощью R. М.: ДМК Пресс, 2015.
  13. Sing T, Sander O, Beerenwinkel N, Lengauer T. ROCR: visualizing classifier performance in R. Bioinformatics 2005; 21 (20): 3940-1.
  14. Davison A.C, Hinkley D.V. Bootstrap Methods and Their Application. Cambridge University Press, 1997.
  15. Canty A, Ripley B. Boot: Bootstrap R (S-Plus) Functions. R package version 1.3-18 (2016). https: cran.r-project.org/web/packages/boot/index.html
  16. Pannal P, Marshall W, Jabor A, Magid E. A strategy to promote the rational use of laboratory tests. Clinica Chimica Acta 1996; 244: 121-7

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