V.N. Kovalenko, T.V. Talayeva, V.A. Shumakov, I.M. Gorbas, I.E. Malinovskaja, V.V. Bratus Significance of systemic metabolic disturbances in the pathogenesis of essential hypertension and its outcomes.

The investigation was carried out on three different objects: patients with ischemic heart disease after acute myocardial infarction, persons randomly selected from unorganized city population and spontaneously
hypertensive rabbits. The obtained results revealed strict pathogenetic relation between arterial hypertension and systemic metabolic disturbances such as decrease of insulin sensitivity, dyslipidemia, atherogenic and
immunogenic modification of blood lipoproteins. The significant metabolic disturbances remained even after successful antihypertensive therapy and normalization of blood pressure. With application of paired correlative
analysis it was proved that the combined development of high blood pressure and proatherogenic disturbances of systemic metabolism under essential hypertension was the result of renin-angiotensin system activation, the
development of systemic inflammation and oxidative stress. These data show that the role of essential hypertension as the risk factor of atherosclerosis and ischemic heart disease is not limited by high blood
pressure and includes accompanying metabolic disturbances, development of pro-oxidative and proatherogenic state, blood lipid modification. Thus, solely antihypertensive treatment of patients with essential
hypertension without considering accompanying disturbances is not sufficient for preventing appearance and progression of atherosclerosis and ischemic heart disease.

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