[The role of vitamin D in the pathogenesis of arterial hypertension.]

In recent years, accumulated numerous data on the pathogenetic links of the formation of arterial hypertension. A number of studies have shown that vitamin D deficiency, associated with age, changes in sex hormonal status, increased tone of the reninangiotensin-aldosterone system, endothelial dysfunction, and calcium metabolism, can be one of the mechanisms of development and progression of arterial hypertension. The purpose of the review was to summarize the results of the original domestic and foreign studies, prospective observations and meta-analyzes on the relationship between vitamin D deficiency and arterial hypertension.

[Nonspecific parameters of the immune inflammatory response as a link in the pathogenesis of remodeling of the vascular wall and destruction of bone tissue in women with arterial hypertension in postmenopausal women.]

Recently, they increasingly began to pay attention to the role of a nonspecific immune-inflammatory vascular response as a link in general pathogenetic mechanisms with a change in the elastic properties of arteries and phenomena of destructive bone changes, which at the subclinical level is of great importance for the prevention of the development of socially significant diseases. A total of 104 patients were examined (mean age 57.45 years), which were divided into three groups. The first group included 39 healthy women, the second group included 30 patients with hypertension and osteopenia, and the third group included 35 women with hypertension and osteoporosis. The analysis of markers of the immune inflammatory response, endothelial dysfunction, hormonal and mineral-vitamin status parameters was conducted against the background of the study of parameters of daily monitoring of arterial pressure, study of parameters of vascular wall stiffness and densitometry to clarify the predictors of cardiovascular and degenerative bone changes in postmenopausal women. A significant increase in the concentration of HF-CRP, the level of homocystemine, IL-8, parathyroid hormone, against the background of a significant decrease in the level of estrogen, progesterone, testosterone, with a persistent tendency to increase in total cholesterol, atherogenic lipid fractions, myeloperoxidase, endothelin-1 and decrease was recorded calcitonin, total and ionized calcium, with a significantly minimal value of vitamin D in the 3rd group of patients. The risks of development and progression of bone destructive changes were calculated using the logistic regression method for the group of AH with osteopenia and osteoporosis. Thus, for patients with hypertension and osteopenia, a significantly significant parameter associated with the risk of developing osteoporosis was an indicator of the velocity of the pulse wave, an increase in the level of which exceeds 12.05 m/s is associated with an increased risk of developing osteoporosis by 3.8 times. Increased levels of pro-inflammatory parameters, IL-6 and 8, TNF-α, HB-SRB, parathyroid hormone and reduced levels of progesterone and IL10, took the most active part in aggravating the degree of available bone tissue destruction. Timely specialized multidirectional study of biochemical and instrumental parameters (in particular, the study of the speed of the pulse wave and densitometry) can be the basis for the development of personalized prevention and treatment tactics for women in order to prevent socially dangerous cardiovascular and bone complications.

[Structural features of the lipid bilayer of the red blood cell membrane in people with isolated hypercholesterolemia without coronary artery disease and in patients with coronary artery disease]. / Strukturnye osobennosti lipidnogo bisloia éritrotsitarnoi membrany u lits s izolirovannoi giperkholesterinemiei bez ishemicheskoi bolezni serdtsa i bol'nykh s ishemicheskoi bolezn'iu serdtsa.

AIM: To identify the specific features of modifying the lipid composition of the red blood cell membrane in people with isolated hypercholesterolemia without coronary heart disease (CHD) and in CHD patients with different functional classes of angina pectoris. SUBJECTS AND METHODS: 92 men with Functional Class II-IV stable angina, 22 men with isolated hypercholesterolemia (HC) without CHD, and 18 healthy men with normal cholesterol levels were examined. Blood plasma cholesterol levels were determined in all the examinees. The erythrocyte membrane was examined for the levels of lipid peroxidation (LPO) products, free cholesterol, calcium, and phospholipid fractions and for the activity of Na+/K+-, Mg2+- and Ca2+-ATPases; a bicycle exercise test was carried out. RESULTS: As compared with persons with normal blood cholesterol levels, the examinees with HC without CHD were found to have higher levels of LPO products, lower levels of readily oxidizable phospholipid fractions, decreased activity of membrane-bound Na+/K+-, Mg2+-, and Ca2+-ATPases, and elevated concentrations of free cholesterol and calcium in the red blood cell membrane. Having the pronounced activity of free radical oxidation, the patients with CHD were detected to have deeper similar structural changes in the cell membrane, which became more severe with a larger number of affected coronary arteries. CONCLUSION: The findings suggest that the lipid structure of the cell membrane undergoes changes associated with its functional depression just at the preclinical stage of atherogenesis. Biomembrane structural modification in patients with angina pectoris progresses in proportion to the number of affected coronary arteries, by limiting the functional reserve of the cell and whole body.