Association of Arterial Hypertension with Hepatobiliary Pathology: The Occurrence of Comorbidity and Features of Metabolic Processes

Page: [138 - 147] Pages: 10

  • * (Excluding Mailing and Handling)

Abstract

Comorbidity of hypertension and hepatobiliary pathology has negative medical and social consequences, including an increase in the indicators of hospital admissions, disability and mortality.

Objective: The aim was to study the occurrence of hypertension combined with hepatobiliary diseases depending on social status, gender and age in 2003-2017 and their influence on indicators of metabolic processes in patients with a therapeutic profile.

Methods: A cross-sectional study using the inpatients’ medical record database of the clinic of Federal Research Centre for Basic and Translational Medicine (Novosibirsk, Russia), which collects demographics, diagnoses (using ICD-10 codes), procedures and examinations of all inpatients from 2003-2017 was conducted. The incidence of comorbidity of hypertension and hepatobiliary pathology depending on age, gender and social status, based on the analysis of 13496 medical records was examined. A comparative analysis of biochemical parameters characterizing the main types of metabolism (lipid, protein, carbohydrate and purine) was carried out in 3 groups of patients: with hypertension; with hepatobiliary pathology, and with a combined pathology.

Results: During the years 2003-2005, there was the greatest frequency of this comorbidity in workers, in women, in the age group 60 years and older. In 2009-2017, the highest incidence was observed in the male administrative staff. In patients with this comorbidity, more pronounced changes in carbohydrate, protein, lipid and purine metabolism were found in comparison with groups of patients with isolated diseases.

Conclusion: The results highlight the need to improve the system of prevention and treatment of comorbidity taking into account sex, age, occupation and features of metabolism.

Keywords: Hypertension, hepatobiliary diseases, comorbidity, gender, age, social status.

Graphical Abstract

[1]
Lefèvre T, d’Ivernois JF, De Andrade V, Crozet C, Lombrail P, Gagnayre R. What do we mean by multimorbidity? An analysis of the literature on multimorbidity measures, associated factors, and impact on health services organization. Rev Epidemiol Sante Publique 2014; 62(5): 305-14.
[http://dx.doi.org/10.1016/j.respe.2014.09.002] [PMID: 25444838]
[2]
Wittenberg R. The challenge of measuring multi-morbidity and its costs. Isr J Health Policy Res 2015; 4: 1.
[http://dx.doi.org/10.1186/2045-4015-4-1] [PMID: 25949796]
[3]
Belialov F. Treatment of heart disease in terms of comorbidity. Irkutsk: PIO IGMAPO 2014,; p. 308.
[4]
Roberts KC, Rao DP, Bennett TL, Loukine L, Jayaraman GC. Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada Health Promot Chronic Dis Prev Can 2015; 35(6): 87-94.
[5]
Nikolaev YuA, Sevostyanova EV, Mitrofanov IM, Polyakov VYa, Dolgova NA. Features of polymorbidity in patients of a therapeutic clinic of the cardiological and gastroenterological profile. Therapeutic archive 2016; 1: 40-5.
[6]
Oganov RG, Drapkina OM. Comorbidity: Specifics of co-development and concomitance of several diseases in one patient. Cardiovasc Ther Prev (Fidenza) 2016; 5(4): 4-9.
[http://dx.doi.org/10.15829/1728-8800-2016-4-4-9]
[7]
Ahmadi B, Alimohammadian M, Yaseri M, et al. Multimorbidity: Epidemiology and risk factors in the Golestan cohort study, Iran: A cross-sectional analysis. Medicine (Baltimore) 2016; 95(7)e2756
[http://dx.doi.org/10.1097/MD.0000000000002756] [PMID: 26886618]
[8]
Zygmuntowicz M, Owczarek A, Elibol A, Chudek J. Comorbidities and the quality of life in hypertensive patients. Pol Arch Med Wewn 2012; 122(7-8): 333-40.
[http://dx.doi.org/10.20452/pamw.1345] [PMID: 22814517]
[9]
Nikolaev YuA, Mitrofanov IM, Polyakov VYa, Dolgova NA. Arterial hypertension associated with somatic pathology in present-day practice of internal diseases. Health 2014; 6(1): 94-8.
[http://dx.doi.org/10.4236/health.2014.61015]
[10]
Dolgova NA, Shkurupy VA, Yakimova AV, Dobrovolskaya NP. Deforming dorsopathy in patients with a combination of arterial hypertension, dyslipidemia and obesity: Possible solutions of the problem. Bull Russ Acad Med Sci 2014; 34(2): 61-5.
[11]
Quiñones AR, Markwardt S, Botoseneanu A. Multimorbidity Combinations and Disability in Older Adults. J Gerontol A Biol Sci Med Sci 2016; 71(6): 823-30.
[http://dx.doi.org/10.1093/gerona/glw035] [PMID: 26968451]
[12]
Nunes BP, Flores TR, Mielke GI, Thumé E, Facchini LA. Multimorbidity and mortality in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2016; 67: 130-8.
[http://dx.doi.org/10.1016/j.archger.2016.07.008] [PMID: 27500661]
[13]
Tarlovskaya EI. Comorbidity and polymorbidity - a modern interpretation and urgent tasks facing the therapeutic community. Kardiologiia 2018; 58(Suppl. 9): 29-38.
[http://dx.doi.org/10.18087/cardio.2562] [PMID: 30312569]
[14]
Onder G, Palmer K, Navickas R, et al. Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS). Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy ageing across the life cycle (JA-CHRODIS). Eur J Intern Med 2015; 26(3): 157-9.
[http://dx.doi.org/10.1016/j.ejim.2015.02.020] [PMID: 25797840]
[15]
Quinodoz A, Déruaz-Luyet A, N’Goran AA, Herzig L. Prioritization strategies in the care of multimorbid patients in family medicine. Rev Med Suisse 2016; 12(518): 928-31.
[PMID: 27352587]
[16]
Park C, Fang J, Hawkins NA, Wang G. Comorbidity status and annual total medical expenditures in U.S. hypertensive adults. Am J Prev Med 2017; 53(6S2)(Suppl. 2): S172-81..
[http://dx.doi.org/10.1016/j.amepre.2017.07.014] [PMID: 29153118]
[17]
Nikolaev YuA, Mitrofanov IM, Pospelova TI, Dolgova NA, Polyakov VYa. Features of polymorbidity in the modern clinic of internal diseases. Bulletin of the SB RAMS 2014; 34(2): 44-9.
[18]
Arrigo M, Nijst P, Rudiger A. Optimising heart failure therapies in the acute setting. Card Fail Rev 2018; 4(1): 38-42.
[http://dx.doi.org/10.15420/cfr.2017:21:1] [PMID: 29892475]
[19]
Dorofeeva JA, Tarlovskaya EI. The quality of treatment of patients with atrial fibrillation, depending on the index of polymorbidity, preceded hospitalization for acute coronary syndrome Kardiologiia 2018; 5(S5): 54-9.
[http://dx.doi.org/10.18087/cardio.2478] [PMID: 29894677]
[20]
Oganov RG, Simanenkov VI, Bakulin IG, et al. Comorbid pathology in clinical practice. Algorithms for diagnosis and treatment. Cardiovasc Ther Prev (Fidenza) 2019; 18(1): 5-66.
[http://dx.doi.org/10.15829/1728-8800-2019-1-5-66]
[21]
Gomez-Rubio P, Rosato V, Márquez M, et al. PanGenEU Study Investigators. A systems approach identifies time-dependent associations of multimorbidities with pancreatic cancer risk. Ann Oncol 2017; 28(7): 1618-24.
[http://dx.doi.org/10.1093/annonc/mdx167] [PMID: 28383714]
[22]
Hudson B, Walker AJ, Irving WL. Comorbidities and medications of patients with chronic hepatitis C under specialist care in the UK. J Med Virol 2017; 89(12): 2158-64.
[http://dx.doi.org/10.1002/jmv.24848] [PMID: 28480974]
[23]
Mehta KY, Wu HJ, Menon SS, et al. Metabolomic biomarkers of pancreatic cancer: A meta-analysis study. Oncotarget 2017; 8(40): 68899-915.
[http://dx.doi.org/10.18632/oncotarget.20324] [PMID: 28978166]
[24]
Marrie RA. Comorbidity in multiple sclerosis: Past, present and future. Clin Invest Med 2019; 42(1): E5-E12.
[http://dx.doi.org/10.25011/cim.v42i1.32383] [PMID: 30904030]
[25]
Chazova IE, Oschepkova EV. Experience in dealing with cardiovascular diseases in Russia. Analytical Vestnik 2015; 44(597): 4-8.
[26]
Mozaffarian D, Benjamin EJ, Go AS, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2015; 131(4): e29-e322.
[http://dx.doi.org/10.1161/CIR.0000000000000152] [PMID: 25520374]
[27]
Park JB, Kario K, Wang JG. Systolic hypertension: an increasing clinical challenge in Asia. Hypertens Res 2015; 38(4): 227-36.
[http://dx.doi.org/10.1038/hr.2014.169] [PMID: 25503845]
[28]
Liu J, Ma J, Wang J, et al. Comorbidity analysis according to sex and age in hypertension patients in China. Int J Med Sci 2016; 13(2): 99-107.
[http://dx.doi.org/10.7150/ijms.13456] [PMID: 26941567]
[29]
Al-Tuwijri AA, Al-Rukban MO. Hypertension control and co-morbidities in primary health care centers in Riyadh. Ann Saudi Med 2006; 26(4): 266-71.
[http://dx.doi.org/10.5144/0256-4947.2006.266] [PMID: 16883084]
[30]
Tini G, Sarocchi M, Tocci G, et al. Arterial hypertension in cancer: The elephant in the room. Int J Cardiol 2019; 281: 133-9.
[http://dx.doi.org/10.1016/j.ijcard.2019.01.082] [PMID: 30718135]
[31]
Asmar R. Effects of treatment on arterial stiffness and central blood pressure--points to consider. J Clin Hypertens (Greenwich) 2015; 17(2): 105-6.
[http://dx.doi.org/10.1111/jch.12477] [PMID: 25641094]
[32]
Oganov RG. Arterial hypertension. Moscow: GEOTAR-Media 2008.
[33]
Komarov FI, Rapoport SI. Guide to gastroenterology M. Medical Information Agency 2010.
[34]
Bang KB, Cho YK. Comorbidities and Metabolic Derangement of NAFLD. J Lifestyle Med 2015; 5(1): 7-13.
[http://dx.doi.org/10.15280/jlm.2015.5.1.7] [PMID: 26528424]
[35]
Mikolasevic I, Milic S, Turk Wensveen T, et al. Nonalcoholic fatty liver disease - A multisystem disease? World J Gastroenterol 2016; 22(43): 9488-505.
[http://dx.doi.org/10.3748/wjg.v22.i43.9488] [PMID: 27920470]
[36]
Farrell GC, Wong VW-S, Chitturi S. NAFLD in Asia--as common and important as in the West. Nat Rev Gastroenterol Hepatol 2013; 10(5): 307-18.
[http://dx.doi.org/10.1038/nrgastro.2013.34] [PMID: 23458891]
[37]
Fargion S, Porzio M, Fracanzani AL. Nonalcoholic fatty liver disease and vascular disease: state-of-the-art. World J Gastroenterol 2014; 20(37): 13306-24.
[http://dx.doi.org/10.3748/wjg.v20.i37.13306] [PMID: 25309067]
[38]
Hassan K, Bhalla V, Regal ME. A-Kader HH. Nonalcoholic fatty liver disease: a comprehensive review of a growing epidemic. World J Gastroenterol 2014; 20: 12082–101. J Gastroenterol 2014; 20(37): 13306-24.
[39]
Ivashkin VT, Mayevskaya MV, Pavlov ChS, et al. Clinical recommendations on the diagnosis and treatment of non-alcoholic fatty liver disease of the Russian Society for the Study of the Liver and the Russian Gastroenterological Association. Rus J Gastroenterol, hepatol. Coloproctol 2016; 26(2): 24-42.
[40]
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016; 64(1): 73-84.
[http://dx.doi.org/10.1002/hep.28431] [PMID: 26707365]
[41]
Polyakov VYa, Nikolaev YuA, Obukhov IV, Gevorgyan MM. Features of clinical and functional parameters in patients with arterial hypertension combined with diseases of the hepatobiliary system in the conditions of the North. Bulletin of new medical technologies 2013; 2: 395-399..
[42]
Vya P, Nikolaev YuA, Pegova SV, et al. Features of changes of the carotid and vertebral arteries in patients with arterial hypertension associated with the pathology of the hepatobiliary system. Clin Med (Northfield Ill) 2016; 1: 39-42.
[43]
Sevostyanova EV, Polyakov VYA, Nikolaev YUA, Mitrofanov IM. Risk factors for hypertension in patients with non-alcoholic fatty liver disease clinical medicine 2018; 6: 395-399..
[44]
Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: Implications for pay for performance. JAMA 2005; 294(6): 716-24.
[http://dx.doi.org/10.1001/jama.294.6.716] [PMID: 16091574]
[45]
Ferretti F. Unhealthy Behaviours: An International Comparison. PLoS One 2015; 10(10)e0141834
[http://dx.doi.org/10.1371/journal.pone.0141834] [PMID: 26512717]
[46]
Caughey GE, Vitry AI, Gilbert AL, Roughead EE. Prevalence of comorbidity of chronic diseases in Australia. BMC Public Health 2008; 8: 221.
[http://dx.doi.org/10.1186/1471-2458-8-221] [PMID: 18582390]
[47]
Schäfer I, Hansen H, Schön G, et al. The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. First results from the multicare cohort study. BMC Health Serv Res 2012; 12: 89.
[http://dx.doi.org/10.1186/1472-6963-12-89] [PMID: 22471952]
[48]
Lochner KA, Cox CS. Prevalence of multiple chronic conditions among Medicare beneficiaries, United States, 2010. Prev Chronic Dis 2013; 10E61
[http://dx.doi.org/10.5888/pcd10.120137] [PMID: 23618541]
[49]
Mitrofanov IM, Nikolaev YuA, Dolgova NA, Pospelova TI. Regional features of polymorbidity in the modern clinic of internal diseases. Clin Med (Northfield Ill) 2013; 6: 26-9.
[50]
Sloane PD, Oudenhoven MD, Broyles I, McNabney M. Challenges to cost-effective care of older adults with multiple chronic conditions: Perspectives of Program of All-Inclusive Care for the Elderly medical directors. J Am Geriatr Soc 2014; 62(3): 564-5.
[http://dx.doi.org/10.1111/jgs.12708] [PMID: 24628628]
[51]
Sevostyanova EV, Nikolaev YuA, Mitrofanov IM, Polyakov VYa, Dolgova NA. The role of risk factors for chronic non-communicable diseases in the development of polymorbid pathology. Clin Med (Northfield Ill) 2017; 95(8): 735-41.
[52]
Nizov AA, Suchkova EI, Dashkevich OV, Trunina TP. Cardiovascular comorbidity in the real clinical practice of an ambulatory physician. Comparative register research in the Ryazan region. Cardiovasc Ther Prev (Fidenza) 2019; 18(2): 70-5.
[http://dx.doi.org/10.15829/1728-8800-2019-2-70-75]
[53]
Rijken M, van Kerkhof M, Dekker J, Schellevis FG. Comorbidity of chronic diseases: Effects of disease pairs on physical and mental functioning. Qual Life Res 2005; 14(1): 45-55.
[http://dx.doi.org/10.1007/s11136-004-0616-2] [PMID: 15789940]
[54]
Belialov F. Comorbidity in internal medicine. Bulletin of Contemporary Clinical Medicine 2010; 3(2): 44-7.
[http://dx.doi.org/10.20969/VSKM.2010.3(2).44-47.]
[55]
Schöttker B, Saum KU, Jansen EH, Holleczek B, Brenner H. Associations of metabolic, inflammatory and oxidative stress markers with total morbidity and multi-morbidity in a large cohort of older German adults. Age Ageing 2016; 45(1): 127-35.
[http://dx.doi.org/10.1093/ageing/afv159] [PMID: 26563887]
[56]
Cuffee Y, Ogedegbe C, Williams NJ, Ogedegbe G, Schoenthaler A. Psychosocial risk factors for hypertension: an update of the literature. Curr Hypertens Rep 2014; 16(10): 483.
[http://dx.doi.org/10.1007/s11906-014-0483-3] [PMID: 25139781]
[57]
Trudel X, Brisson C, Milot A, Masse B, Vézina M. Adverse psychosocial work factors, blood pressure and hypertension incidence: repeated exposure in a 5-year prospective cohort study. J Epidemiol Community Health 2016; 70(4): 402-8.
[http://dx.doi.org/10.1136/jech-2014-204914] [PMID: 26530810]
[58]
Steptoe A, Feldman PJ, Kunz S, Owen N, Willemsen G, Marmot M. Stress responsivity and socioeconomic status: A mechanism for increased cardiovascular disease risk? Eur Heart J 2002; 23(22): 1757-63.
[http://dx.doi.org/10.1053/euhj.2001.3233] [PMID: 12419295]
[59]
Ermakova MA, Aftanas LI, Shpagina LA. Characteristics of psychophysiological markers of stress in patients with arterial hypertension, depending on the degree of occupational risk. Bulletin SB RAMS 2014; 4: 42-7.
[60]
Balukova EV. Non-alcoholic fatty liver disease and the risk of cardiovascular events. Russ Med J 2013; 13: 737-40.
[61]
Brea A, Puzo J. Non-alcoholic fatty liver disease and cardiovascular risk. Int J Cardiol 2013; 167(4): 1109-17.
[http://dx.doi.org/10.1016/j.ijcard.2012.09.085] [PMID: 23141876]
[62]
Katsiki N, Perez-Martinez P, Anagnostis P, Mikhailidis DP, Karagiannis A. Is nonalcoholic fatty liver disease indeed the hepatic manifestation of metabolic syndrome. Curr Vasc Pharmacol 2018; 16(3): 219-27.
[http://dx.doi.org/10.2174/1570161115666170621075619] [PMID: 28669328]
[63]
Caserta CA, Mele A, Surace P, et al. Association of non-alcoholic fatty liver disease and cardiometabolic risk factors with early atherosclerosis in an adult population in Southern Italy. Ann Ist Super Sanita 2017; 53(1): 77-81.
[PMID: 28361809]
[64]
Ghani RA, Saqlain M, Zafar MM, Jabeen S, Naqvi SM, Raja GK. Identification of metabolic risk phenotypes predisposing to non-alcoholic fatty liver disease in a Pakistani cohort. Pak J Med Sci 2017; 33(1): 121-6.
[PMID: 28367184]
[65]
Gastaldelli A, Kozakova M, Højlund K, et al. RISC Investigators. Fatty liver is associated with insulin resistance, risk of coronary heart disease, and early atherosclerosis in a large European population. Hepatology 2009; 49(5): 1537-44.
[http://dx.doi.org/10.1002/hep.22845] [PMID: 19291789]
[66]
Zvenigorodskaya LA, Samsonova NG, Efremov LI, Cherkashova EA, Lazebnik LB. Gastrointestinal aspects of atherosclerosis. Exp Cllin Gastroenterol 2011; 2: 31-6.
[67]
Vorobyova EN, Schumacher GI, Khoreva MA, Osipova IV. Endothelial dysfunction is a key element in the pathogenesis of atherosclerosis. Russ J Cardiol 2010; 2(82): 84-91.
[68]
Aryev A, Ovsyannikova NA, Aryeva GT, et al. Geriatric polymorbidity. Prac Oncol 2015; 16(3): 83-9.
[69]
Efremov LI, Komisarenko IA. Metabolic continuum and polymorbidity in geriatrics. Exp Cllin Gastroenterol 2014; 106(6): 4-7.
[70]
Tsanava IA, Sharonova LA, Verbovoy AF. Metabolic syndrome and cardiovascular diseases. RMJ. Med Rev 2017; 11: 785-9.
[71]
Korneeva ON, Drapkina OM, Buyever AO, Ivashkin VT. Non-alcoholic fatty liver disease as a manifestation of the metabolic syndrome. Clin Perspec Gastroenterol Hepatol 2005; 4: 24.
[72]
Nikolenko LA, Goloshchapova ZA, Golovneva ES, Nikolenko ES. Risk factors for cardiovascular diseases in postmenopausal women and prophylactic methods for reducing them (literature review). RMJ 2016; 5: 328-30.
[73]
Golabi P, Otgonsuren M, de Avila L, Sayiner M, Rafiq N, Younossi ZM. Components of metabolic syndrome increase the risk of mortality in nonalcoholic fatty liver disease (NAFLD). Medicine 2018; 97(13)e0214
[http://dx.doi.org/10.1097/MD.0000000000010214] [PMID: 29595666]
[74]
Zheng L, Lv GC, Sheng J, Yang YD. Effect of miRNA-10b in regulating cellular steatosis level by targeting PPAR-alpha expression, a novel mechanism for the pathogenesis of NAFLD. J Gastroenterol Hepatol 2010; 25(1): 156-63.
[http://dx.doi.org/10.1111/j.1440-1746.2009.05949.x] [PMID: 19780876]
[75]
Smirnova AV, Suhorukov VN, Karagodin VP, Orehov AN. Epigenetic factors in atherogenesis: miRNA. Biomeditsinskaya Chem 2016; 62(2): 134-40.