Ulcerative colitis (UC) is known to be associated with increased cardiovascular risk (CVR). Arterial hypertension (AH) is the leading factor in the development of cardiovascular diseases. Age, overweight, reduction of fiber in dietary intake, salt excess, hypodynamia, alcohol abuse, smoking, hypercholesterolemia are considered with regard to other factors of CVR. Study of CVR factors in patients with UC and AH will allow to move from reactive management strategy to preventive measures.
OBJECTIVE
To assess the factors determining cardiovascular risk in patients with ulcerative colitis and arterial hypertension.
MATERIALS AND METHODS
A cross-sectional observational study with the inclusion of 80 patients with UC, 17 of whom had AH, was carried out. Nutritional and physical activity factors, laboratory indicators, namely lipid profile, tumor necrosis factor (TNF)-α, interleukin-6 in the blood, short-chain fatty acids in the feces were investigated, duplex scanning of the extracranial vessels was performed.
RESULTS
AH has been revealed in 21.25% of patients with UC, CVR was high in 8 patients with AH, very high — in 7 patients, despite the fact that the median of LDL level in them amounted to 3.0 mmol/l. Patients with a combination of UC and AH were in the middle age group, had higher indicators of the body mass index, thickness of the intima-media complex of the common carotid artery, TNF-α than patients with UC without AH. From the behavioral factors of CVR, high level of salt intake, hypodynamia, low level of consumption of foods containing fiber have been established in patients with AH, that was reflected in the reduction of acetate content and metabolic activity of the aerobic microbiota population in the feces of comorbid patients.
CONCLUSION
The following factors of cardiovascular diseases development in patients with ulcerative colitis and arterial hypertension were identified: overweight/obesity, high level of salt intake, hypodynamia, insufficient consumption of fiber-rich foods, smoking. The factors of development of the cardiovascular diseases associated with ulcerative colitis include systemic inflammation and changes in the production of short-chain fatty acids by the gut microbiota, that affects the blood lipids.
