Ppathogenetic pathogenetic significance of subclinical inflammatory and apoptotic markers in elderly women with essential arterial hypertension

Introduction. The morphological and functional changes of the vascular wall endotheliocytes in case of essential arterial hypertension in elderly women are considered. They are due to the action of complex pathogenetic mechanisms of damage to the vascular wall, their dynamic changes with a chronic increase in blood pressure, against the background of endogenous inflammation and apoptosis, which have been little studied, which determines their relevance. The goal is to determine the importance of the processes of subclinical inflammation in the development and severity of endothelial injuries, apoptosis in hypertension in elderly patients. Materials and methods. The study involved 35 elderly women suffering from essential arterial hypertension of the II degree, II stage, who gave their consent to participate in the study. The degree of severity of endothelial dysfunction, which was established using dopplerography of the brachial artery by the linear method. The comparison group included 30 women with a normal level of blood pressure of a similar age without cardiovascular disease. The degree of dilatation of the brachial artery against the background of reactive hyperemia by more than 10% of the initial diameter was recognized as normal. The severity of subclinical inflammation was evaluated by the activity of TNF-α, HF CRP, the level of desquamated endotheliocytes, a blood test was performed using enzyme-linked immunosorbent assay (ELISA). Results. There was an increase in apoptotic activity (0.34±0.05 and 11.3±0.8), subclinical inflammation, and activation of proapoptotic receptors, which was 4 times higher (151.8±27.2 PG/ml) than in patients without this pathology (39.8±1.5 PG/ml). A strong direct correlation was found between the number of desquamated endothelial cellsendotheliocytemia and the degree of vasomotortonic dysfunction (r=0.62). In patients with arterial hypertension, the number of desquamated endothelial cells level of endotheliocytemia (1.91±0.05 cells/ml) is 1.5 times higher than in the comparison groupcontrols (1.1±0.02 cells/ml). Conclusion. With arterial hypertension in elderly patients, the formation of endothelial dysfunction has been established, its dynamic progression with increasing severity of tonic vasodilation disorders.

endothelial dysfunction, flow-dependent vasodilation, endogenous inflammation, desquamation of the endothelium, apoptosis

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