rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2010-1407rsp-1246Research ArticleСтатьиArticlesЗНАЧЕНИЕ СУТОЧНОГО МОНИТОРИРОВАНИЯ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ В ДИАГНОСТИКЕ АРТЕРИАЛЬНОЙ ГИПЕРТОНИИУ БОЛЬНЫХ ПОДАГРОЙVALUE OF 24-HOUR BLOOD PRESSURE MONITORING IN THE DIAGNOSIS OF ARTERIAL HYPERTENSION IN PATIENTSWITH GOUTМаркеловаЕ. И.MarkelovaE Ievgenia-i.m@yandex.ru <mailto:evgenia-i.m@yandex.ru>БарсковаВ. Г.BarskovaV G-Il'inaA EIl'inaA E-НасоновЕвгений ЛьвовичNasonovE L-МаркеловаЕ. И.MarkelovaE I-БарсковаВ. Г.BarskovaV G-IlyinaA EIlyinaA E-НасоновЕвгений ЛьвовичNasonovE L-201015022010481№1 (2010)6166Copyright © Маркелова Е.И., Барскова В.Г., Il'ina A.E., Насонов Е.Л., Маркелова Е.И., Барскова В.Г., Ilyina A.E., Насонов Е.Л., 20102010Маркелова Е.И., Барскова В.Г., Il'ina A.E., Насонов Е.Л., Маркелова Е.И., Барскова В.Г., Ilyina A.E., Насонов Е.Л.Markelova E.I., Barskova V.G., Il'ina A.E., Nasonov E.L., Markelova E.I., Barskova V.G., Ilyina A.E., Nasonov E.L.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1246

Цель. Изучить частоту выявления артериальной гипертензии у больных подагрой с помощью суточного мониторирования артериального давления (СМАД). Результаты. В исследование включено 93 больных подагрой, которые были условно разделены на две группы. В первую (I) вошли пациенты с нормальными показателями артериального давления (АД) при его измерении по методу Короткова - 22 человека (24%), во вторую (II) - пациенты с повышенными цифрами АД - 71 человек (76%). Всем больным проведено суточное мониторирование АД. У 100% больных в обеих группах выявлены различные нарушения параметров СМАД (увеличение среднесуточного АД, пульсового давления, индексов нагрузки давлением, нарушение суточного профиля АД), что свидетельствует о наличии скрытой АГ у больных подагрой из I группы. Выводы. Выявление нарушений показателей СМАД в группе больных подагрой с нормальными значениями АД при его измерении по методу Короткова указывает на наличие скрытой АГ у этих пациентов.

Objective: To study the detection rate of arterial hypertension in patients with gout by 24-hour blood pressure monitoring (BPM). Results. The study included 93 gouty patients who were arbitrarily divided into 2 groups: 1) 22 (24%) subjects with normal pressure, as measured by the Korotkov method; 2) 71 (76%) patients with elevated blood pressure (BP). All the patients underwent 24-hour BPM. Various 24-hour BPM abnormalities (increases in average daily BP, pulse pressure, load-induced pressure indices, impaired daily BP profile) were found in 100% of the patients in both groups), which is indicative of the presence of latent arterial hypertension in Group 1 patients with gout. Conclusion. The found 24-hour BPM abnormalities in gouty patients with normal BP, as measured by the Korotkov method, indicate that these patients have latent AH.

подаграартериальная гипертензиясуточное мониторирование АДgoutarterial hypertension24-hour blood pressure monitoringReferences<div><p>Насонова В.А., Барскова В.Г. Ранние диагностика и лечение подагры - научно обоснованное требование улучшения трудового и жизненного прогноза больных. Науч-практ ревматол 2000;l:5-7. 2. Myers A., Epstein F.H., Dodge H.J. et al. The relationship of serum uric acid to risk factors in coronary heart disease. Am J Med 1968;45:520-8.</p><p>Барскова В.Г., Ильиных Е.В., Елисеев М.С. и др. Кардиоваскулярный риск у больных подагрой. Ожирение и метаболизм 2006;3(8):40-4.</p><p>Vazguez-Mellado J., Garsia C.G., Vazguez S.G. et al. Metabolic syndrome and ischemic heart disease in gout. J Clin Rheumatol 2004;10(3):105-9.</p><p>Gutman A.B. Views on the pathgenesis and management of primary gout - 1971. J Bone Joint Surg 1972;54A:357-72.</p><p>Radic M.T., Valkenburg H.A., Davidson R.T. et al. Observations on the natural history of hyperuricemia and gout. I. An eighteen year follow-up of nineteen gouty families. Am J Med 1964;37:862-71.</p><p>Krishnan E., Baker J.F., Furst D.E., Schumacher H.R. Gout and risk of acute myocardial infarction. Arthritis Rheum 2006;54(8):2688-96.</p><p>Weiss T.E., Segaloff A. Gouty Arthritis and Gout. Springfield, III, Thomas, 1959; 7.</p><p>Wyngaarden J.B., Kelley W.N. Gout and hyperuricemia. New York, 1976;512 p.</p><p>Kuzell W.C., Schaffarzick R.W., Naugler W.E. et al. Some observations on 520 gouty patients. J Chronic Dis 1995;2:645-69.</p><p>Vazguez-Mellado J., Garsia C.G., Vazguez S.G. et al. Metabolic syndrome and ischemic heart disease in gout. J Clin Rheumatol 2004;10(3):105-9.</p><p>Johnson R.J., Kang D.-N., Feig D. et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003;41:1183-90.</p><p>Johnson R.J., Rodriguez-Iturbe B., Kang D.H. et al. A unifying pathway for essential hypertension. Am J Hypertens 2005;18:431-40.</p><p>Nakagawa T., Mazzali M., Kang D.H. et al. Hyperuricemia causes glomerular hypertrophy in the rat. Am J Nephrol 2003;23(1):2-7.</p><p>Messerli F.H., Frohlich E.D., Dreslinski G.P. et al. Serum uric acid in essential hypertension: an indicator of renal vascular involvement. Arch Inter Med 1980;93:817-21.</p><p>Puig J.G., Ruilope L.M. Uric acid as a cardiovascular risk factor in arterial hypertension. J Hypertens 1999;17:869-72.</p><p>Чазова И.Е., Ратова Л.Г. Роль суточного мониторирования артериального давления в оценке эффективности антигипертензивной терапии. (Результаты суточного мониторирования артериального давления в программе КЛИП-АККОРД). Consilium medica (прил.) 2007;1:18-26.</p><p>Manchia G. Clinical use of ambulatory blood pressure. Am J Hypertens 1989;2:505-45.</p><p>Горбунов В.М. Некоторые вопросы практического использования суточного мониторирования артериального давления. Клиницист 2008;3:30-40.</p><p>Guidelines for the management of arterial hypertension. J Hypertens 2007;25:1105-87.</p><p>Sega R., Trocino G., Lanzarotti A. et al. Alterations of cardiac structure in patients with isolated office, ambulatory or home hypertension. Data from the general PAMELA population. Circulation 2001;104:1385-92.</p><p>Mancia G., Facchetti R., Bombelli M. et al. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension 2006;47:846-53.</p><p>Fagard R.H., Van Den Broeke C., DeCort P. Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice. J Hum Hypertens 2005;19:801-7.</p><p>Hansen T.W., Jeppesen J., Rasmussen S., Ibsen H. Ambulatory blood pressure monitoring and risk of cardiovascular disease: a population based study. Am J Hypertens 2006;19:243-50.</p><p>Ohkubo T., Kikuya M., Metoki H. et al. Prognosis of masked hypertension and white-coat hypertension detected by 24-h ambulatory blood pressure monitoring. J Am Coll Cardiol 2005;46:508-15.</p><p>Bobrie G., Chatellier G., Genes N. et al. Cardiovascular prognosis of «masked hypertension» detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA 2004;291:1342-9.</p><p>Bjorklund K., Lind L., Zethelius B. et al. Isolated ambulatory hypertension predicts cardiovascular morbidity in elderly men. Circulation 2003;107:1297-302.</p><p>Рогоза A.H., Ошепкова E.B., Цагареишвили Е.В. и др. Современные неинвазивные методы измерения артериального давления для диагностики артериальной гипертонии и оценки эффективности антигипертензивной терапии. М.: Медика, 2007.</p><p>Wallace S.L., Robinson H., Masi A.T. et al. Preliminary criteria for the classification of the acute arthritis of gout. Arthritis Rheum 1977;20:895-900.</p><p>World Health Organization (WHO). Obesity: prevention and management of the global epidemic. Report of the WHO Consultation. World Health Organ Tech. Rep. Ser. 2000;894(i-xii):1-253.</p><p>World Health Organization (WHO). Prevention and management of the global epidemic of obesity. Report of the WHO Consultation on Obesity. Geneva, WHO, 1997.</p><p>Stern J., Hirsch J., Blair S. et al. Weighting the options: criteria for evaluating weight-management programs. The Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity. Obes Res 1995;3(6):591-604.</p><p>Рекомендации по профилактике, диагностике и лечению артериальной гипертензии. Российские рекомендации (второй пересмотр). Комитет экспертов Всероссийского научного общества кардиологов. Секция артериальной гипертонии ВНОК. М., 2004. Приложение к журналу «Кардиоваскулярная терапия и профилактика».</p><p>Fagard R.H., Cornelissen V.A. Incidence of cardiovascular events in white-coat, masked and sustained hypertension versus true normotension: a meta-analysis. J Hypertens 2007;25:2193-8.</p><p>Jula A., Puukka P., Karanko H. Multiple clinic and home blood pressure measurements versus ambulatory blood pressure monitoring. Hypertension 1999;34:261-6.</p><p>Martinez M.A., Sancho T., Garcia P. et al. Home blood pressure in poorly controlled hypertension: relationship with ambulatory blood pressure and organ damage. Blood Press Monit 2006;11:207-13.</p><p>Verdecchia P., Clement D., Fagard R. et al. Blood Pressure Monitoring. Task force III: Target-organ damage, morbidity and mortality. Blood Press Monit 1999;4:303-17.</p><p>Redon J., Gomez-Sanchez M., Baldo E. et al. Microalbuminuria is correlated with left ventricular hypertrophy in male hypertensive patients. J Hypertens 1991;9:148-9.</p><p>Benetos A., Safar M., Rudnichi A. et al. Pulse pressure. A predictor of long-term cardiovascular mortality in a French male population. Hypertension 1997;30:1410-5.</p><p>White W. Analysis of ambulatory blood pressure data in antihypertensive drug trials. J Hypertens 1991;9:27-32.</p><p>White W. Accuracy and analysis of ambulatory blood pressure monitoring data. Clin Cardiolog 1992;15:10-3.</p><p>Fratolla A., Parati G., Cuspidi С. et al. Prognostic value of 24-hour pressure variability. J Hypertens 1993;11:1133-7.</p><p>Parati G., Pompidossi O., Albini E. et al. Relationship of 24-hour blood pressure mean and variability and severity of target-organ damage in hypertension. J Hypertens 1987;5:93-8.</p><p>Willich S.N., Linderer T., Wegascheider K. et al. Increased morning incidence of myocardial infarction in the ISAM study. Absence with prior beta-adrenergic blockade. ISAM study group. Circulation 1989;80:853-8.</p><p>Marler J.R., Price T.R., Clark G.L. et al. Morning increase in onset of ischemic stroke. Stroke 1989;20(4):473-6.</p><p>Schillaci G., Verdecchia P., Benemio G., Porceliati С. Blood pressure rise and ischemic stroke. Lancet 1995;346:1366-7.</p><p>Muller J.E. Circadian variation in cardiovascular events. Am J Hypertens 1999;12(Pt 2):35S-42S.</p><p>Kario К., Pickering Т.G., Umeda Y. et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives. A prospective study. Circulation 2003;107:1401-6.</p><p>Somers V., Dyken M., Mark A. et al. Autonomic and hemodynamic responses during sleep in normal and sleep-apneic humans. J Hypertens 1992;10:4.</p><p>O'Brien E., Sheridan J., O'Malley K. Dippers and non-dippers. Lancet 1988;2:327.</p><p>Kario K., Matsua T., Kobayashi H. et al. Nocturnal fall of blood pressure and silent cerebrovascular damage in eldery hypertensive patients: advanced silent cerebrovascular damage in extreme dippers. Hypertension 1996;27:130-5.</p></div><br /><div><p>Насонова В.А., Барскова В.Г. Ранние диагностика и лечение подагры - научно обоснованное требование улучшения трудового и жизненного прогноза больных. Науч-практ ревматол 2000;l:5-7. 2. Myers A., Epstein F.H., Dodge H.J. et al. The relationship of serum uric acid to risk factors in coronary heart disease. Am J Med 1968;45:520-8.</p><p>Барскова В.Г., Ильиных Е.В., Елисеев М.С. и др. Кардиоваскулярный риск у больных подагрой. Ожирение и метаболизм 2006;3(8):40-4.</p><p>Vazguez-Mellado J., Garsia C.G., Vazguez S.G. et al. Metabolic syndrome and ischemic heart disease in gout. J Clin Rheumatol 2004;10(3):105-9.</p><p>Gutman A.B. Views on the pathgenesis and management of primary gout - 1971. J Bone Joint Surg 1972;54A:357-72.</p><p>Radic M.T., Valkenburg H.A., Davidson R.T. et al. Observations on the natural history of hyperuricemia and gout. I. An eighteen year follow-up of nineteen gouty families. Am J Med 1964;37:862-71.</p><p>Krishnan E., Baker J.F., Furst D.E., Schumacher H.R. Gout and risk of acute myocardial infarction. Arthritis Rheum 2006;54(8):2688-96.</p><p>Weiss T.E., Segaloff A. Gouty Arthritis and Gout. Springfield, III, Thomas, 1959; 7.</p><p>Wyngaarden J.B., Kelley W.N. Gout and hyperuricemia. New York, 1976;512 p.</p><p>Kuzell W.C., Schaffarzick R.W., Naugler W.E. et al. Some observations on 520 gouty patients. J Chronic Dis 1995;2:645-69.</p><p>Vazguez-Mellado J., Garsia C.G., Vazguez S.G. et al. Metabolic syndrome and ischemic heart disease in gout. J Clin Rheumatol 2004;10(3):105-9.</p><p>Johnson R.J., Kang D.-N., Feig D. et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003;41:1183-90.</p><p>Johnson R.J., Rodriguez-Iturbe B., Kang D.H. et al. A unifying pathway for essential hypertension. Am J Hypertens 2005;18:431-40.</p><p>Nakagawa T., Mazzali M., Kang D.H. et al. Hyperuricemia causes glomerular hypertrophy in the rat. Am J Nephrol 2003;23(1):2-7.</p><p>Messerli F.H., Frohlich E.D., Dreslinski G.P. et al. Serum uric acid in essential hypertension: an indicator of renal vascular involvement. Arch Inter Med 1980;93:817-21.</p><p>Puig J.G., Ruilope L.M. Uric acid as a cardiovascular risk factor in arterial hypertension. J Hypertens 1999;17:869-72.</p><p>Чазова И.Е., Ратова Л.Г. Роль суточного мониторирования артериального давления в оценке эффективности антигипертензивной терапии. (Результаты суточного мониторирования артериального давления в программе КЛИП-АККОРД). Consilium medica (прил.) 2007;1:18-26.</p><p>Manchia G. Clinical use of ambulatory blood pressure. Am J Hypertens 1989;2:505-45.</p><p>Горбунов В.М. Некоторые вопросы практического использования суточного мониторирования артериального давления. Клиницист 2008;3:30-40.</p><p>Guidelines for the management of arterial hypertension. J Hypertens 2007;25:1105-87.</p><p>Sega R., Trocino G., Lanzarotti A. et al. Alterations of cardiac structure in patients with isolated office, ambulatory or home hypertension. Data from the general PAMELA population. Circulation 2001;104:1385-92.</p><p>Mancia G., Facchetti R., Bombelli M. et al. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension 2006;47:846-53.</p><p>Fagard R.H., Van Den Broeke C., DeCort P. Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice. J Hum Hypertens 2005;19:801-7.</p><p>Hansen T.W., Jeppesen J., Rasmussen S., Ibsen H. Ambulatory blood pressure monitoring and risk of cardiovascular disease: a population based study. Am J Hypertens 2006;19:243-50.</p><p>Ohkubo T., Kikuya M., Metoki H. et al. Prognosis of masked hypertension and white-coat hypertension detected by 24-h ambulatory blood pressure monitoring. J Am Coll Cardiol 2005;46:508-15.</p><p>Bobrie G., Chatellier G., Genes N. et al. Cardiovascular prognosis of «masked hypertension» detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA 2004;291:1342-9.</p><p>Bjorklund K., Lind L., Zethelius B. et al. Isolated ambulatory hypertension predicts cardiovascular morbidity in elderly men. Circulation 2003;107:1297-302.</p><p>Рогоза A.H., Ошепкова E.B., Цагареишвили Е.В. и др. Современные неинвазивные методы измерения артериального давления для диагностики артериальной гипертонии и оценки эффективности антигипертензивной терапии. М.: Медика, 2007.</p><p>Wallace S.L., Robinson H., Masi A.T. et al. Preliminary criteria for the classification of the acute arthritis of gout. Arthritis Rheum 1977;20:895-900.</p><p>World Health Organization (WHO). Obesity: prevention and management of the global epidemic. Report of the WHO Consultation. World Health Organ Tech. Rep. Ser. 2000;894(i-xii):1-253.</p><p>World Health Organization (WHO). Prevention and management of the global epidemic of obesity. Report of the WHO Consultation on Obesity. Geneva, WHO, 1997.</p><p>Stern J., Hirsch J., Blair S. et al. Weighting the options: criteria for evaluating weight-management programs. The Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity. Obes Res 1995;3(6):591-604.</p><p>Рекомендации по профилактике, диагностике и лечению артериальной гипертензии. Российские рекомендации (второй пересмотр). Комитет экспертов Всероссийского научного общества кардиологов. Секция артериальной гипертонии ВНОК. М., 2004. Приложение к журналу «Кардиоваскулярная терапия и профилактика».</p><p>Fagard R.H., Cornelissen V.A. Incidence of cardiovascular events in white-coat, masked and sustained hypertension versus true normotension: a meta-analysis. J Hypertens 2007;25:2193-8.</p><p>Jula A., Puukka P., Karanko H. Multiple clinic and home blood pressure measurements versus ambulatory blood pressure monitoring. Hypertension 1999;34:261-6.</p><p>Martinez M.A., Sancho T., Garcia P. et al. Home blood pressure in poorly controlled hypertension: relationship with ambulatory blood pressure and organ damage. Blood Press Monit 2006;11:207-13.</p><p>Verdecchia P., Clement D., Fagard R. et al. Blood Pressure Monitoring. Task force III: Target-organ damage, morbidity and mortality. Blood Press Monit 1999;4:303-17.</p><p>Redon J., Gomez-Sanchez M., Baldo E. et al. Microalbuminuria is correlated with left ventricular hypertrophy in male hypertensive patients. J Hypertens 1991;9:148-9.</p><p>Benetos A., Safar M., Rudnichi A. et al. Pulse pressure. A predictor of long-term cardiovascular mortality in a French male population. Hypertension 1997;30:1410-5.</p><p>White W. Analysis of ambulatory blood pressure data in antihypertensive drug trials. J Hypertens 1991;9:27-32.</p><p>White W. Accuracy and analysis of ambulatory blood pressure monitoring data. Clin Cardiolog 1992;15:10-3.</p><p>Fratolla A., Parati G., Cuspidi С. et al. Prognostic value of 24-hour pressure variability. J Hypertens 1993;11:1133-7.</p><p>Parati G., Pompidossi O., Albini E. et al. Relationship of 24-hour blood pressure mean and variability and severity of target-organ damage in hypertension. J Hypertens 1987;5:93-8.</p><p>Willich S.N., Linderer T., Wegascheider K. et al. Increased morning incidence of myocardial infarction in the ISAM study. Absence with prior beta-adrenergic blockade. ISAM study group. Circulation 1989;80:853-8.</p><p>Marler J.R., Price T.R., Clark G.L. et al. Morning increase in onset of ischemic stroke. Stroke 1989;20(4):473-6.</p><p>Schillaci G., Verdecchia P., Benemio G., Porceliati С. Blood pressure rise and ischemic stroke. Lancet 1995;346:1366-7.</p><p>Muller J.E. Circadian variation in cardiovascular events. Am J Hypertens 1999;12(Pt 2):35S-42S.</p><p>Kario К., Pickering Т.G., Umeda Y. et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives. A prospective study. Circulation 2003;107:1401-6.</p><p>Somers V., Dyken M., Mark A. et al. Autonomic and hemodynamic responses during sleep in normal and sleep-apneic humans. J Hypertens 1992;10:4.</p><p>O'Brien E., Sheridan J., O'Malley K. Dippers and non-dippers. Lancet 1988;2:327.</p><p>Kario K., Matsua T., Kobayashi H. et al. Nocturnal fall of blood pressure and silent cerebrovascular damage in eldery hypertensive patients: advanced silent cerebrovascular damage in extreme dippers. Hypertension 1996;27:130-5.</p></div><br />

The authors declare that there are no conflicts of interest present.