Nephrogenic factors in development of arterial hypertension among patients with atherosclerosis of lower extremity arteries with complications of acute thrombotic occlusion

Abstract

Research aim. The article is devoted to the research of the mechanisms of arterial hypertension development among patients with abdominal aortic atherosclerosis and formation of chronic lower limb ischemia (Leriche’s syndrome). Materials and methods. The presence of thrombotic occlusion of the extremity arteries and its level were evaluated in 129 cases of atherosclerotic aortic lesion complicated by acute thrombotic occlusion of the lower (112) and upper (17) extremities, according to physical data the absence of pulsation (or a sharp decrease in it) on the arteries during palpation, according to the results of ultrasound Doppler scanning of the limb arteries and according to multispiral computer angiography with contrasting. Uzdg was performed on a multi-functional ultrasound scanner MyLab 70 (Esaote, Italy), in in-mode. Echocardiography was performed on Acuson 128XP device (Acuson, USA) in two-dimensional and M-modal modes. Left ventricular systolic function was evaluated in B-mode using the Simpson method (1995). The glomerular filtration rate was calculated using the Cockcroft-Gault formula. The coagulogram was studied on the device ACL Elite Top (USA). Results. With the development of thrombotic occlusion of the lower extremity arteries, the character of the course of arterial hypertension worsens. Chronic arterial hypertension is detected in most patients with aortic atherosclerosis, complicated by thrombotic occlusion of the lower and upper limb arteries. More than 80 % of hypertension is characterized by systolic-diastolic type and only a small part (less than 20 %) shows isolated systolic character. Conclusions. Operative restoration of the main blood flow in the extremities has a positive effect on the course of hypertension in most patients.