Epicardial obesity and cardiovascular risk in elderly and senile patients with arterial hypertension


DOI: https://dx.doi.org/10.18565/therapy.2021.1.32-38

Nilova O.V., Kolbasnikov S.V.

Tver State Medical University of the Ministry of Healthcare of Russia
Abstract. The aim of the research was to study the structure of risk factors among arterial hypertension (AH) patients over 60 y.o., assess target organs’ damage (TOD) at the subclinical stage of their development, as well as the influence and role of epicardial adiposal tissue at cardiometabolic risk for planning a personalized algorithm for managing AH patients of elderly and senile age.
Material and methods. 130 patients with arterial hypertension (pensioners) were examined. A detailed estimation of traditional risk factors and TOD was carried out, it was based on a survey and additional research methods (office measurement of blood pressure, biochemical blood analysis, echocardiography). The thickness of epicardial fat (EFT) was assessed and the relationship of this parameter with TOD metabolic and hemodynamic parameters was established.
Results. Risk factors for cardiovascular disease are often combined and potentiate the influence of each other at cardiovascular risk; they are potentially avoidable. In persons with visceral obesity, concentric, as well as less favorable, eccentric type of myocardial remodeling is predominating, which dictates the need to identify such kind of patients and overestimate the risk. The correlation between the thickness of the EFT and atherogenic lipoprotein fractions in persons with visceral obesity was revealed, the relationship of this parameter with the level of pulse blood pressure and the left ventricular myocardial mass index in elderly and senile people was shown. The obtained correlations between the thickness of epicardial adipose tissue and clinical and metabolic parameters indicate the interaction of these factors, which is necessary to take into account when assessing the cardiovascular risk in patients with hypertension, especially over 60 years of age.
Conclusion. With deepened examination of arterial hypertensive patients over 60 years of age, it is necessary to identify especially carefully the modifiable risk factors, metabolic markers of atherogenic and diabetogenic orientation, subclinical TOD in order of individually assessing cardiovascular risk and understanding its structure, as well as planning patient-oriented therapy.
Keywords: arterial hypertension, risk factors, cardiovascular risk, epicardial fat, hyperlipidemia, hyperuricemia, obesity
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About the Autors

Oksana V. Nilova, PhD, associate professor of the Department of polyclinic therapy and family medicine of Tver State Medical University of the Ministry of Healthcare of Russia. Address: 170100, Tver, 4 Sovetskaya Str. Tel.: +7 (915) 708-22-29. E-mail: tevirp69@mail.ru. ORCID: 0000-0002-0648-5358. SPIN-code: 1881-9917
Sergey V. Kolbasnikov, MD, professor of the Department of polyclinic therapy and family medicine of Tver State Medical University of the Ministry of Healthcare of Russia. Address: 170100, Tver, 4 Sovetskaya Str. Tel.: +7 (903) 808-89-64. E-mail: s.kolbasnikov@mail.ru. ORCID: 0000-0002-1708-455X. SPIN-code: 2127-3801

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