Relation of the atherosclerotic process with the manifestation of oxidative stress in arterial hypertension patients combined with rheumatoid arthritis

Abstract

Introduction. When arterial hypertension (AH) is combined with rheumatoid arthritis (RA), there are significant imbalances between the production of lipid peroxidation (LP) derivatives and the ability to neutralize these reactive substances. Aim of the study: To investigate the lipid profile, the thickness of the intimamedia complex (TIMC) of common carotid arteries in patients with rheumatoid arthritis in combination with arterial hypertension, and to correlate these indicators with the manifestations of oxidative stress, and the antioxidant system. Materials and methods: The results of the study are based on a comprehensive survey of 96 patients with stage 2 hypertension in combination with RA, 45 patients with stage 2 hypertension and 31 healthy volunteers. Research results. The stage of hypertension significantly influenced the manifestations of atherosclerotic process and oxidative stress, average TIMC indexes of the right CCA 1.28 (1.08; 1.30) mm and left CCA 1.29 (1.06; 1.30) mm in patients with RA in combination with stage 2 AH were significantly higher by 24.2% and 24%, respectively, against rates of RA patients in combination with grade 1 AH (p <0.01). The detection rate of atherosclerotic plaques in the subgroup of RA patients 102 Nataly G. Ryndina in combination with grade 2 AH was significantly higher 10 times, compared to the subgroup of RA patients in combination with stage 1 AH (p <0.01). Significant relation between LP products indices and manifestations of atherosclerotic process in patients with hypertension in combination with RA, direct linear correlation of medium strength between indices of malonic aldehyde and LDL R = + 0,57, TG R = + 0,56, TIMC R = + 0.55, respectively (p <0.05), diene ketones and TG R = + 0.52, TG R = + 0.55, respectively (p <0.05). Conclusions. The highest predictive value for the detection of atheromatous plaques in the CCA system had malonic aldehyde (AUC 0.870, 95% CI AUC 0.784 to 0.931) at the optimum distribution point > 5.25 nmol/ml, sensitivity 88.73%, and specificity 90.43%, and diene ketones (AUC 0.869, 95% CI AUC 0.784 to 0.930) sensitivity 90.36% and specificity 88.87% at the optimum distribution point > 5 c.un./ml.