Influence expression hypothyroidism on feature of development metabolic syndrome at the patients with hypertension remains not up to the end investigated. Hypothyroidism progressively increases risk development of cardiovascular diseases.
Design and method:
220 women who have made 2 clinical groups are surveyed: 1group 108 patients(53,6 ± 1,6years) with hypertension, abdominal obesity and hypothyroidism(TSH 15,4 ± 2,3 IU/ml); 2group 112 patients (55,3 ± 2,5 years) with hypertension, abdominal obesity and medicament compensated hypothyroidism function levothyroxinum natricum in the dose of 50 mg per day- at the 3months of treatment (TSH 3,1 ± 0,4IU/ml)-pathogenetically therapy.All researched carried out measurement waist circumference, blood pressure and the 24-hour BP monitoring, echocardiography, fast levels of glucose, insulin and lipids levels. Insulin sensitivity was estimated homeostasis model assessment (HOMA) method. Identical antihypertension and statin therapy was appointed in both groups.
it is marked, that patients of 1group had authentically significantly more pronounced displays of abdominal obesity (112,4 ± 2,8sm) in comparison with group (92,3 ± 2,1sm) and parameters of bodymass index differ (35,7 ± 1,2 and 30,20 ± 1,1 accordingly). In 1 group was fixed diastolic hypertension(153/111 mm Hg). In 2 group was fixed hypertension (142/81 mm Hg). In 1group it has not been revealed changes of fast levels of glucose (5,5 ± 0,2 mmol/l) and attributes of the insulin resistance(HOMA 3,4 ± 0,3),that distinguished them from patients of 2groups (HOMA2,3 ± 0,2). Distinctive feature of 1group was authentic higher in comparison to 2 group a parameter of the triglycerides levels(2,5 ± 0,4mmol/l). The given echocardiographies in 1group have shown the tendency to increase in the size of the left atrium and increase of the left ventricular mass index (124,1 ± 3,2 g/m2) in comparison to the 2group.
It is established, that manifestation of hypothyroidism in patients with abdominal obesity it is accompanied with diastolic hypertension, by more expressed lipids disorders and changes of hemodynamic parameters of the left atrium and ventriculum, not favorable type of HOMA-index. In patients of medicament compensated hypothyroidism function levotiroksinom all indexes were better, due to the combined therapy: antihypertension,statin + pathogenetically therapy.