Features of arterial hypertension course in patients with psoriasis
DOI:
https://doi.org/10.14739/2310-1210.2017.2.95559Keywords:
arterial hypertension, essential hypertension, psoriasisAbstract
Risk of cardiovascular and cerebrovascular events development in psoriasis patients is higher than in population as a whole. Combination of arterial hypertension and psoriasis is widespread and understudied state, thus the objective of our work was to reveal features of this comorbid pathology formation and course.
Material and Methods. For the implementation of the set task specific features of clinical picture of arterial hypertension (presented by essential hypertension) and psoriasis were studied. Two groups of patients included 47 persons suffering from essential hypertension and 98 persons suffering from psoriasis and essential hypertension simultaneously. Dermatosis course severity was estimated clinically using PASI index, 24-hour blood pressure index was determined by means of 24-hour blood pressure monitoring. Levels of cytokines, cortisol, and insulin were determined by immunoenzymatic methods.
Results. As the result it was revealed that patients with comorbid pathology have severe and moderate degree of arterial hypertension more often than in case of arterial hypertension without dermatosis (95 % vs. 85 %). In this group of patients the specific feature of blood pressure circadian rhythm was revealed in form of its insufficient decrease in the evening and at night (non-dipper and night-peaker groups); total number of such patients made 63.64 %. Levels of cytokines (IL-β,IL-1α, IL-6, TNF-α) in the group with comorbid pathology greatly exceed the similar indices of patients without dermatosis. This fact can be explained by available severe form of psoriasis (exudative, arthropica) with expressed systemic inflammatory reactions. Interleukins levels critically increased in patients with the 3 degree of arterial hypertension in case of combined pathology. It has been found that duration of disease especially in case of psoriasis and arterial hypertension severe form combination had negative influence on adaptive mechanisms. This fact was confirmed by considerable decreasing in cortisol level (difference made 39.74 % in favor of patients with the 1–2 degree of arterial hypertension) and increasing of insulin in blood (difference made 31.91 % in favor of patients with the 1–2 degree of hypertension in case of comorbid pathology).
Conclusions. Thus, psoriasis and arterial hypertension combination creates conditions for the systemic inflammatory process formation with prominent clinical manifestations of both dermatosis and hypertension, specific features of blood pressure circadian rhythm, chronic stress and decompensation formation in case of long course of disease and hypertension severe form development.
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