Heart lesions in individuals with arterial hypertension of various risk levels: the possibility of diagnosis and treatment

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Abstract

Based on scientific literature and own data, the article discusses the problem of hypertensive heart disease in real outpatient practice and especially in conducting preventive examinations in the working population. It is shown that the use of modern diagnostic methods, in particular electrocardiography with dopplerography, including pulse-wave tissue mode, should be an integral study included in the professional examination, as well as medical examination, which covers an increasing number of the population of our country. Echocardiography should be performed to clarify the cardiovascular risk and confirm the electrocardiographic diagnosis of left ventricular hypertrophy (LVH), left atrial dilatation, or suspected heart diseases (coronary heart disease, atrial fibrillation, other rhythm disorders). It has been shown that concentric LVH is the strongest predictor of an increased risk of heart failure, although the degree of LVH is not always directly related to the degree of hypertension and the duration of the disease.

About the authors

Anatolii N. Britov

National Medical Research Center for Therapy and Preventive Medicine; Pirogov Russian National Research Medical University

Author for correspondence.
Email: abritov@gnicpm.ru

D. Sci. (Med.), Prof., National Medical Research Center for Therapy and Preventive Medicine, Pirogov Russian National Research Medical University

Russian Federation, Moscow

Elena M. Platonova

Medical Unit №170

Email: abritov@gnicpm.ru

Cand. Sci. (Med.), Medical Unit №170

Russian Federation, Korolyov

Nina A. Eliseeva

National Medical Research Center for Therapy and Preventive Medicine

Email: abritov@gnicpm.ru

Cand. Sci. (Med.), National Medical Research Center for Therapy and Preventive Medicine

Russian Federation, Moscow

References

  1. Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Информированность, лечение, контроль. Профилактика заболеваний и укрепление здоровья. 2001; 2: 3–7. [Shal’nova S.A., Deev A.D., Vikhireva O.V. et al. Rasprostranennost’ arterial’noi gipertonii v Rossii. Informirovannost’, lechenie, kontrol’. Profilaktika zabolevanii i ukreplenie zdorov’ia. 2001; 2: 3–7 (in Russian).]
  2. Профилактика, диагностика и лечение артериальной гипертензии. Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов. 2010. [Profilaktika, diagnostika i lechenie arterial’noi gipertenzii. Rekomendatsii Rossiiskogo meditsinskogo obshchestva po arterial’noi gipertonii i Vserossiiskogo nauchnogo obshchestva kardiologov. 2010 (in Russian).]
  3. Рекомендации по лечению артериальной гипертонии. ESH/ESC 2013. Рос. кардиол. журн. 2014; 1: 7–94. [Rekomendatsii po lecheniiu arterial’noi gipertonii. ESH/ESC 2013. Ros. kardiol. zhurn. 2014; 1: 7–94 (in Russian).]
  4. Kannel WB, Vasan RS. Framingham Heart Study. Am J Cardiol 2009; 103 (3): 426–7.
  5. Боровкова Н.Ю., Боровков Н.Н., Хорькина Ю.А. и др. Динамика показателей левого желудочка при длительной терапии ренопаренхиматозной артериальной гипертензии. 2013. [Borovkova N.Iu., Borovkov N.N., Khor’kina Iu.A. et al. Dinamika pokazatelei levogo zheludochka pri dlitel’noi terapii renoparenkhimatoznoi arterial’noi gipertenzii. 2013 (in Russian).]
  6. Вермель В.Р., Бритов А.Н. Профилактика артериальной гипертонии. 2002. [Vermel’ V.R., Britov A.N. Profilaktika arterial’noi gipertonii. 2002 (in Russian).]
  7. Кобалава Ж.Д., Чистяков Д.А., Дмитриев В.В. и др. Клинико-генетические детерминанты гипертрофии левого желудочка у больных эссенциальной гипертонией. Кардиология. 2001; 7: 39–44. [Kobalava Zh.D., Chistiakov D.A., Dmitriev V.V. et al. Kliniko-geneticheskie determinanty gipertrofii levogo zheludochka u bol’nykh essentsial’noi gipertoniei. Kardiologiia. 2001; 7: 39–44 (in Russian).]
  8. Палкин М.Н. Клинические лекции по практической кардиологии. 2011. [Palkin M.N. Clinical lectures on practical cardiology. 2011 (in Russian).]
  9. Кобалава Ж.Д., Котовская Ю.В. Артериальная гипертония: ключи к диагностике и лечению. М.: Фортэ, 2007. [Kobalava Zh.D., Kotovskaya Yu.V. Arterial hypertension: the keys to diagnosis and treatment. Moscow: Forte, 2007 (in Russian).]
  10. Тимофеева Т.Н., Шальнова С.А., Константинов В.В. и др. Распространенность факторов, влияющих на прогноз больных артериальной гипертонией и оценка общего сердечно-сосудистого риска. Кардиоваскулярная терапия и профилактика. 2005; 4 (6): 15–24. [Timofeeva T.N., Shal’nova S.A., Konstantinov V.V. et al. Rasprostranennost’ faktorov, vliiaiushchikh na prognoz bol’nykh arterial’noi gipertoniei i otsenka obshchego serdechno-sosudistogo riska. Kardiovaskuliarnaia terapiia i profilaktika. 2005; 4 (6): 15–24 (in Russian).]
  11. Шальнова С.А., Деев А.Д., Карпов Ю.А. Артериальная гипертония и ишемическая болезнь сердца в реальной практике врача-кардиолога. Кардиоваскулярная терапия и профилактика. 2006; 5 (2): 73–80. [Shal’nova S.A., Deev A.D., Karpov Iu.A. Arterial’naia gipertoniia i ishemicheskaia bolezn’ serdtsa v real’noi praktike vracha-kardiologa. Kardiovaskuliarnaia terapiia i profilaktika. 2006; 5 (2): 73–80 (in Russian).]
  12. Levy D, Salomon M, D’Agostino RB et al. Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy. Circulation 1994; 90: 1786–93.
  13. Кечкер М.И. Руководство по ЭКГ. 2000. [Kechker M.I. ECG Guide. 2000 (in Russian).]
  14. Reichek N, Devereux RB. Left ventricular hypertrophy: relationship of anatomic, echocardiographic and electrocardiographic findings. Circulation 1981; 63: 1391–8.
  15. Levy D, Garrison RJ, Savage DD et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990; 322: 1561–6.
  16. Шиллер Н., Осипов М.А. Клиническая эхокардиография. 2-е изд. 2005. [Shiller N., Osipov M.A. Clinical echocardiography. 2nd ed. 2005 (in Russian).]
  17. Lang RM, Bierig M, Devereux RB et al. Recommendations for chamber quantification. Eur J Echocardiogr 2006; 7: 79–108.
  18. Nagueh SF, Appleton CP, Gillebert TC et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 2009; 10: 165–93.
  19. Codella NC, Lee HY, Fieno DS et al. Improved left ventricular mass quantification with partial voxel interpolation: in vivo and necropsy validation of a novel cardiac MRI segmentation algorithm. Circ Cardiovasc Imaging 2012; 5: 137–46.
  20. Вилкенсхоф У., Крук И. Справочник по эхокардиографии. 2014. [Wilkenshof W., Crook I. Handbook of echocardiography. 2014 (in Russian).]
  21. Gonzalez-Maqueda I, Alegria-Ezquerra E, Gonzalez-Juanatey JR. Hypertensive heart disease: a new clinical classification (VIA), E-Journal of the ESC Council for Cardiology Practice 2009; 7 (20): 12–20.
  22. ESH/ESC Guidelines for the management of arterial hypertension. J Hypertension 2013; 31 (7): 1281–357. doi: 10.1093/euroheartj/eht151

Supplementary files

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2. Fig. 1. European scheme for assessing the total cardiovascular risk for two categories of countries with low and high baseline risk (Russia is usually referred to the latter).

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3. Fig. 2. Card for assessing cardiovascular risk in persons with hypertension, depending on the stage of the disease and the degree of increase in blood pressure.

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4. Fig. 3. Types of LV remodeling according to echocardiography.

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