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Prevalence of arterial hypertension and chronic heart failure among citizens of Blockade Leningrad

Rotar O. P., Moguchaya E. V., Ivanenko V. V., Erina A. M., Boyarinova M. A., Dudorova E. A., Orlov A. V., Kolesova E. P., Kaistrya I. V., Dorofeikov V. V., Konrady A. O., Shlyakhto E. V.
Federal State Budgetary Institution, “North-West Federal Medical Research Center” of the RF Ministry of Health Care, Akkuratova 2, St.-Petersburg 197341

Keywords: N-terminal prohormone of brain natriuretic peptide (NT-proBNP), arterial hypertension, left ventricular hypertrophy, ctizens of blockade leningrad, CHF

DOI: 10.18087/rhfj.2012.1.1648

Relevance. Risk of CVD is not determined only by genetic and environmental factors, it also depends on intrauterine growth conditions, particularly, cardio-vascular system. Objective. Evaluate prevalence of AH and CHF, as well as structural changes of myocardium in citizens of Blockade Leningrad. One of the study objectives was to compare rate of Blockade Leningrad citizens, who were born before the siege with those who were born during the blockade. Materials and methods. Citizens of Blockade Leningrad residing in Promorskiy district were invited to the examinations from December 2009 to may 2011. All subjects were interviewed according to the approved questionnaire, BP was measured, anthropomorphic measurements were made, blood glucose, lipids, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was measured, EchoCG examinations were performed. Results. During the said period, 200 patients were examined, average age 68 years (range 67–82 years), 146 female and 54 male. Only 26 subjects (13 %) were born during the siege and the majority – 162 patients (62 %) within the period from 1928 to 1941. The comparison of patients who were born before and during the siege showed that people who were born during the siege had higher rates of AH (92 % versus 77 %, 91,9 % of total amount) and comparable rate of CHF (19,2 % versus 19,1 %, 18 % of total amount). LV hypertrophy (LVH) was diagnosed in equal number of cases (42.6 % versus 38,4 %), as well as left ventricular hypertrophy more than 40 mm (43 % versus 38 %). Patients who were born before the siege had higher levels of NT-proBNP – 426.5 ng / ml versus 79.4 ng / ml (р=0.05) and more frequent increase of NT-proBNP more than 200 ng / ml – 41 % in comparison with 12.5 % of subjects born suring the siege. In the general group of citizens of Blockade Leningrad уровень SBP correlate with LV mass index (LVMI) (r=0.32, p<0.05). The correlation analysis revealed relation of NT‑proBNP levels and LVMI with SBP (r=0.77 and r=0.52) and DBP (r=0.87 and r=0.57) only in the group of subjects who were born during the siege (p=0.05 for all). Conclusion. Patients who suffered alimentary deficit in the intrauterine period had higher rates of AH and related AH with CHF and LVH in comparison with patients who starved in childhood and adolescence. Patients who were born before the siege had decreased LVEF and increased NT-proBNP more often, which can be conditioned by greater age. At present, genetic determinants are searched in this group of patients to determine alternative mechanisms of the obtained differences.
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Rotar O. P., Moguchaya E. V., Ivanenko V. V. et al. Prevalence of arterial hypertension and chronic heart failure among citizens of Blockade Leningrad. Russian Heart Failure Journal. 2012;13(1):60-63

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