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УДК 616.12-008.331.1-082
Юсупова М.Ш. ассистент
кафедра пропедевтика внутренний болезни
Максудов О. ассистент
кафедра пропедевтика внутренний болезни Андижанский государственных медицинский институт
Узбекистан, Андижан
ПЕРВИЧНАЯ ПРОФИЛАКТИКА АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ
Аннотация: Многочисленные исследования кардиоваскулярных заболеваний с позиции сердечно-сосудистого континуума свидетельствуют о ведущей роли дисбаланса нейрогуморальной системы в пользу повышенной активности симпато-адреналовой и ангиотензин-адреналовой ее составляющих. Методы оценки этих жизненно важных регуляторов весьма разнообразны, каждый из них имеет свои преимущества и недостатки.
Ключевые слова: артериальная гипертензия, первичная профилактика, кардиоваскулярная заболевания.
Yusupova M.Sh. assistant
department ofpropeification of internal diseases
Maksudov O. assistant
department ofpropeification of internal diseases Andijan State Medical Institute Uzbekistan, Andijan
PRIMARY PREVENTION OF ARTERIAL HYPERTENSION
Resume. Numerous studies of cardiovascular diseases from the perspective of the cardiovascular continuum indicate the leading role of the imbalance of the neurohumoral system in favor of the increased activity of its sympatho-adrenal and angiotensin-adrenal components. Methods for assessing these vital regulators are very diverse, each of them has its own advantages and disadvantages.
Key words: arterial hypertension, primary prevention, cardiovascular disease.
Relevance. One of the most important problems of modern cardiology is arterial hypertension (AH), which is combined with a high frequency of various complications, is the cause of death and disability of the adult population worldwide [4,8]. Due to the intensive study of theoretical and practical aspects of hypertension, the emergence of new methodological approaches to its treatment, as well as the introduction of educational and informational programs, there is a tendency to improve the prognosis and quality of life of patients[1,6].
The sympatho-adrenal system is the most important integral system of regulation, since it serves as a link between the Central nervous system and peripheral organs. One of the main effector organs of this system is the heart, since among all peripheral organs, the heart has the highest density of sympathetic innervation and, accordingly, the highest concentration of the main mediator of the sympathetic nervous system - norepinephrine. As a result of these structural and functional features, the heart is at the center of the influence of both emotional and physical stresses that a person constantly experiences during life[3,7].
On the basis of representations about the direct relationship between the severity of immune responses and the functional status of the sympatho-adrenal system, it is logical to assume that the absence of a marked activation of this system after injection of tumor cells due to weak immunogenicity of the latter, and the lowering of the tone of the system in subsequent periods the growth of the tumor — specificity of tumor.
Such changes in the activity of the sympatho-adrenal system can affect the state of antitumor immunity and cause its failure[2,5].
Purpose of research. Reduce the prevalence of arterial hypertension and risk factors, morbidity with temporary disability in an organized population by implementing a primary prevention program based on dietary restriction of table salt.
Material and methods of research. At the industrial enterprises of Uz-avto motors in Asaka, a screening survey of men and women 25-49 years of age from among workers and employees was conducted. The average age was 39.1 ±6.8 years in the main group and 39.0±7.1 years in the comparison group.
Thus, the surveyed populations were of the same type in terms of the number of men and women, working conditions, and age composition, which allowed us to use the results of the study for comparison.
Research result. At the beginning of the study date range (2018), out of the study cohort of patients (as of 2019 — 62 people), only 17 individuals had an established diagnosis of "hypertension" and were under dispensary observation. However, in some patients, the quality of medical care was not evaluated due to insufficient completeness of the clinical data available in the primary documentation. The coverage of the studied cohort of patients with clinical indicators varied significantly over the years, By 2019. the completeness of data in outpatient charts for all clinical parameters necessary for calculating indicators was sufficient in 72.6-87.1 % of patients. Prior to this, insufficient data was
reported primarily for evaluating measures to control physical activity, Smoking, and cholesterol. For the period from 2018 to 2019, the maps most fully reflected information on blood pressure control and rational nutrition. Increasing the completeness of filling out medical records is primarily associated with appropriate measures to improve the quality of medical care (especially starting from 2020).
The results of calculating clinical indicators in the studied cohort of patients with hypertension for 2018-2019 are shown in Fig. 1-6. For almost the entire period from 2018 to 2019, the implementation of measures to control the level of physical activity (figure 2), Smoking, weight and nutrition was at a good level. However, if we evaluate the overall effectiveness of these measures, then they can be considered effective in most patients only for physical activity (most patients had a sufficient level of physical activity during all years).
The remaining measures were somewhat less effective: by 2018-2020, the proportion of smokers increased slightly; the proportion of people with increased body weight practically did not decrease during the entire period, despite the ongoing educational work; the vast majority of patients with hypertension continued to eat irrationally, despite explanations on the specifics of the diet for hypertension. Cholesterol control and blood pressure control remain key "problematic" components of medical care for patients with hypertension in the CSMR.
Conclusion. To improve the effectiveness of mass preventive examinations, a short questionnaire and a tactical algorithm for screening for cardiovascular diseases were developed and implemented. The three-group system of medical examination of the population is supplemented with specific recommendations for the prevention of early forms of hypertension and FR.
It was found that dietary intervention with restriction of sodium chloride for three years significantly improves hemodynamic parameters, taste sensitivity to salt among individuals with early forms of hypertension and risk factors, does not cause side effects, and does not require significant material costs.
Использованные источники:
1. Агаджанян Н.А. Стресс. Адаптация. Репродуктивная система / Н.А. Агаджанян, Д.И. Рыжаков, Т.Е. Потемина, И.В. Радыш. — Н. Новгород: Изд-во Нижегородской ГМА, 2009. — 296 с.
2.Дубова Л.И. Определение содержания глюкозы в слюне глюкозооксидантным методом как показателя психоэмоционального напряжения в стоматологии / Л.И. Дубова // Лабораторное дело. — 1990. — № 4. — С. 70-71.
3.Логунова Л.В. Оценка активности симпатоадреналовой системы у больных с некоторыми эндокринопатиями и при токсических воздействиях в эксперименте / Л.В. Логунова, Ф.С. Дзугкоева, И.В. Можаева, С.Г. Дзугкоева // Научные труды I съезда физиологов СНГ. — Сочи, 2005. — Т. 2. — С. 109.
4 Малов Ю.С. Взаимосвязь уровней кортизола и тестостерона в крови и слюне / Ю.С. Малов, В.А. Карлов, А.К. Кучмин // Клиническая лабораторная диагностика. — 1993. — № 2. — С. 10-14.
5.Терентьев В.П. Особенности функционирования симпато-адреналовой системы у больных артериальной гипертонией с различными вариантами ремоделирования левого желудочка при его гипертрофии / В.П. Терентьев, Е.В. Белова, Б.Я. Зонис // Рос. кардиол. журнал. — 2001. — № 4. — С. 3942.
6.Bristow M.R. P-Adrenergic receptor blockade in chronic heart failure / M.R. Bristow // Circulation. — 2000. — Vol. 10. — Р. 558-569.
7. Devanathan S. Plasmon-Waveguide Resonance Studies of Ligand Binding to the Human Рг-Adrenergic Receptor / S. Devanathan, Z. Yao, Z. Salamon [et al.] // Biochemistry. — 2004. — Vol. 43, № 11. — P. 3280-3288.
8.Hines P.S. Novel epinephrine and cyclic cAMP -mediated action on BCAM/Lu dependent sickle (SS) RBC adhesion / P.S. Hines, Q. Zen, S.N. Burney [et al.] // Blood. — 2003. — Vol. 101 (8). — P. 3281-3287.
