Contribution of combined cardiometabolic pathology to the changes in aging rate in different age groups
Authors: Kolesnikova O. V. , Radchenko A. O. , Zaprovalna O. E. , Lavrenko T. A. 
Published: July 2022

Objective — to assess the rates of aging in patients with arterial hypertension (AH) of different age groups and their association with the nature of metabolic disorders and the state of prooxidant‑antioxidant balance.
Materials and methods. The study involved 151 patients with AH and various variants of metabolic disorders (dyslipidemia, obesity, nonalcoholic fatty liver disease (NAFLD)). These subjects received out‑patient or in‑patient treatment in the L. T. Malaya Therapy National Institute NAMS of Ukraine in the period of 2019 — 2021 years. The mean age was 51.4 ± 12.1 years, from them 62.3 % of women. All subjects were divided into groups depending on age: group 1 < 40 years (n = 22), group 2 — 40 — 49 years (n = 46), group 3 — 50 — 59 years (n = 49), group 4 — 60 — 69 years (n = 21), group 5 — 70 — 79 years (n = 13). Prooxidant‑antioxidant balance was calculated as the ratio of total hydroperoxides (THP) to total antioxidant activity (TAA). Biological age (BA) was assessed using V. P. Voitenko method (BA1) and method of Gorelkin A.G and B. B. Pinkhasov (BA2). The aging rate was considered as accelerated if the age delta between BA and calendar age (CA) (DBA1, DBA2, respectively) was > 0.
Results. Dyslipidemia and insulin resistance (IR) were observed in the vast majority of patients in each age group. Obesity was less common in patients < 40 and 70 — 79 years. The incidence of NAFLD gradually increased with age, with the highest prevalence among patients aged 70 — 79 years. There was a marked increase in the proportion of combined cardiometabolic pathology in patients aged 40 — 59 years compared with patients < 40 years. When compared with patients under 40 years old, patients of 40 — 59 years had significantly worse levels of total cholesterol (TC), insulin and IR index, and subjects aged 50 — 59 years demonstrated worst indices of low‑density lipoprotein cholesterol (LDL‑C), glucose and glomerular filtration rate (GFR). Significantly better redox balance was observed in the group of patients aged < 40 years compared with patients aged 40 — 69 years. The rate of aging in the vast majority of patients < 50 years was accelerated. More associations of biochemical parameters were found with BA than with CA in patients < 60 years of age. DBA2 was associated with the highest number of markers of disorders of lipid metabolism, carbohydrates, renal and hepatic function.
Conclusions. Patients aged 40 — 59 years with AH have an increase in the number of cardiometabolic conditions, which is accompanied by a significant increase in the levels of TC, LDL‑C, glucose, insulin, IR index and decreased GFR. Most patients under the age of 50 have an accelerated rates of aging in contrast to patients over the age of 50, probably due to imbalance of prooxidant‑antioxidant balance. Patients under 60 years of age are advised to assess BA, which can be used for early detection of age‑associated biochemical changes in metabolic pathology on the background of AH.