STRUCTURAL-FUNCTIONAL AND MOLECULAR DIAGNOSTIC PARALLELS IN ARTERIAL HYPERTENSION IN ELDERLY PATIENTS
Relevance. Among cardiovascular diseases arterial hypertension (AH) in elderly people over 60 years old is the main risk factor for stroke, heart failure, terminal renal failure and lethal outcome. Today hypertension is defined as accelerated aging of the arterial component of the cardiovascular system with developing of remodeling processes due to age. Studies of a molecular phenotype of hypertension in elderly patients with obtaining molecular profiles of biological samples determining the clinical course of hypertension and its classification characteristics are topical nowadays. The aim of the study is to search correlations between structural, functional and molecular diagnostic parameters in patients with AH of Grade 2 of a moderate and high risk. Methods and materials: The study involved patients over 60 years old with a diagnosis of Grade 2, moderate and high risk hypertension (Group 2, n=200), taking into consideration the criteria of inclusion and noninclusion into the study. The control group (KG, Group 1) included 30 elderly people with no hypertension. Central elderly patients blood pressure (BP) in the aorta and pressure on the brachial artery were measured, indicators of daily blood pressure monitoring, structural and functional parameters of the heart were evaluated on the basis of echocardiography. There was fulfilled a qualitative proteomic analysis of blood plasma based on time-of-flight mass spectrometry with a laser desorption and ionization and quantitative assessment of the level of proteins in the blood with the help of enzyme immunoassay. Results: There was revealed an increase of the blood concentration of MPO, apoD, HIF1a, TGF@1, hyaluronidase 1, kininogen 1, fibulin 5 and their significant correlations with LVMM and ACC. Conclusions: There was determined diagnostic molecular profile of blood of elderly patients with AH of Grade 2 and confirmed the involvement of proteins in myocardial and vascular remodeling in elderly patients with AH.