Evaluation of the cytokine profile and vascular elasticity in middle-aged men with essential hypertension and combined pathology
Authors:   North-Western State Medical University named after I. I. Mechnikov, Lebedeva Irina , Kryukov Evgeny ,   Military Medical Academy named after S. M. Kirov, Tsygan Vasily ,   Military Medical Academy named after S. M. Kirov, Partsernyak Alexander ,   Military Medical Academy named after S. M. Kirov, Magradze Guram ,   City Hospital no. 15, Ustyuzhaninov Vitaly ,   City Hospital no. 15, Ayvazyan Bella ,   North-Western State Medical University named after I. I. Mechnikov, Partsernyak Sergey ,   Vvedensky Municipal Clinical Hospital
Published: June 2022

The diagnosis and management of patients with polymorbid cardiovascular pathology is a significant challenge. The pathogenesis of many cardiovascular diseases, such as arterial hypertension, coronary heart disease, angina pectoris, as well as diabetes mellitus, obesity and dyslipidemia are associated with systemic inflammation. The inflammatory process, both at the systemic and local levels, can make a significant contribution to the progression of atherosclerosis and endothelial dysfunction, and provoke the destabilization of blood pressure. Therefore, it is important to develop new approaches to the identification of patients with polymorbid pathology and chronic inflammatory processes in the body. It is known that the presence of the oral cavity inflammation increases the risk of cardiovascular disease. Periodontal pathology, leading to an increased expression of pro-inflammatory cytokines, affects the initiation of atherosclerosis, endothelial dysfunction, vasospasm, and blood pressure dysregulation. It can be assumed that the oral cavity inflammatory processes against the arterial hypertension increase the probability of early vascular aging, the overall cardiovascular risk, and also increase the chance of other diseases of the cardiological profile The research subject was to determine the vascular elasticity parameters and the dynamics of blood pressure daily profile, as well as the level of pro-inflammatory and anti-inflammatory cytokines in persons with arterial hypertension, considering the presence of inflammatory processes in the oral cavity. The structure of comorbidity and a number of laboratory and instrumental data of middle-aged men with arterial hypertension in combination with periodontitis were analyzed in comparison with patients with arterial hypertension without periodontitis and healthy volunteers of the same age. A correlation was shown between the periodontal inflammation level in men with arterial hypertension and the polymorbid cardiovascular pathology presence (diabetes mellitus, dyslipidemia, anxiety and depressive disorders, coronary heart disease, signs of left ventricular hypertrophy by ECG, high ankle-brachial index as a marker of peripheral atherosclerosis), significant variability in blood pressure, an altered cytokine profile with a predominance of pro-inflammatory cytokines, an increase in “vascular age” on the ASCORE scale, and increased vascular stiffness, assessed by 24-hour blood pressure monitoring using the “VasotensOffice” program.