LONG-TERM BLOOD PRESSURE VARIABILITY IN STRENGTH AND ENDURANCE PROFESSIONAL ATHLETES WITH OFFICE PREHYPERTENSION OVER ANNUAL TRAINING MACROCYCLE.

Considering the high spreading of arterial hypertension (AH) in professional athletes involved in different types of physical activities, as well as the high probability of its development in individuals with high normal blood pressure (BP), we aimed at investigating the daily profile of BP during three periods of annual training summer macrocycle: the preparation, competitive and transition ones. The investigation included 30 athletes having levels of systolic BP ≥130 and <140; as well as diastolic BP ≥ 85 and <90 mmHg during a thorough office examination in the preparation phase, who were divided into two groups without changes on age, sex, the duration of the sporting career depending on the type of a performed physical activity - strength (Str) and endurance (End). The athletes underwent office BP measurements and home BP monitoring (over the course of 3-7 days (M=5.2 (0.9) days), medical consultations, anthropometric and clinical examinations on each phase of the macrocycle. Although symptoms of chronic stress and autonomic dysfunction were quite common in athletes with prehypertension, still the emergence of the detected symptoms didn't differ significantly between two groups under investigation. When comparing the average values of office and home BP, the differences between Str-group and End-group regarding all indicators during the competitive phase have been identified. In particular, the levels of home diastolic BP differ the most - in Str-group they amounted to 91.1 (5.5) mm Hg, whereas in Endgroup to 83.7 (5.9) mm Hg (р=0.002). Nevertheless, the average maximum home systolic BP in Str-group has exceeded the high normal limit and accounted for 142.5 (10.2) mm Hg, in End-group the same parameter was 133.1 (7.6) mm Hg (р=0.019). The spreading of hypertension during preparation, competitive and transition periods in the Str-group has consecutively accounted for 20%, 53.3% and 13.3%.; in End-group the BP has accounted for 6.7%, 13.3% and 6.7% respectively, herewith during the competitive phase that indicator in Str-group was much higher (р=0.02), and the relative risk of developing hypertension during the competitive phase equaled 4 (р=0.048). Therefore, the increase of AH frequency and the level of BP in athletes involved in strength exercises isn't supported by an increase of autonomic symptoms development in comparison to the athletes performing endurance exercises, i.e. the frequency of asymptomatic, masked cases has a tendency to rise. To detect hypertension in time, we suggest performing home BP monitoring for athletes with high normal blood pressure during the competitive period.

VENTRICULAR REPOLARIZATION MEASURES IN PROFESSIONAL AND AMATEUR ATHLETES WITH HIGH NORMAL ARTERIAL PRESSURE.

There is merely little data regarding changes in repolarization among professional athletes with prehypertension, especially in comparison with amateur athletes. It was previously shown that disturbances of repolarization may have an important role in the development of cardiac changes in athletes and be observed in a number of conditions, such as ventricular hypertrophy, channelopathies, and aortic aneurysm. Therefore, in this study, it has been aimed to compare the ventricular repolarization measures in professional and amateur athletes with high normal arterial pressure.Thirty professional and thirty amateur all-around track and field athletes were enrolled in this project. According to the level of sport activities and the presence of HNBP, all athletes were divided into 4 groups. The first group consisted of professional athletes with normal and optimal blood pressure (NOBP) values (<130/80 mmHg, total of 21 persons), the second group was formed by 9 professional athletes with HNBP (≥130/85 mmHg), the following 3rd (17 persons) and 4th (13 persons) groups were composed by amateur athletes with the level of arterial blood pressure up to 130/85 mmHg and higher respectively. We have indicated that professional athletes with upper normal values of blood pressure have an extension of the TpTe interval compared to other groups of athletes, the average value of this indicator comprised 86 ± 10.94 ms, which, however, was below the dangerous level of >100 ms. This group of people also showed an increase in the ratio of TpTe/QT values (p=0.001) in the absence of a significant difference in S-Tpc intervals (p=0.605). These changes indicate an increase in transmural dispersion of repolarization with the development of left ventricular remodeling of professional athletes with upper normal values of blood pressure. In order to establish a connection between the revealed features of repolarization and non-functional overreaching/overtraining and altered autonomic cardiovascular activity with sympathetic activation syndrome, other pathogenesis features, their clinical and prognostic value, further examinations are required.

[ANALYSIS OF THE ASSOCIATION BETWEEN THR83ALA POLYMORPHISM OF MATRIX GLA-PROTEIN GENE AND LOWER EXTREMITY ARTERIAL CALCIFICATION].

Lower extremity arterial calcification (AC) is a common pathological process that has independent significance in the pathogenesis of many cardiovascular diseases. There is evidence that development of AC associated with Thr83Ala polymorphism of matrix GLA-protein gene. The objective of this study was to examine the association between Thr83Ala polymorphism of matrix Cla protein (MGP) gene and AC in male and female subjects of the Ukrainian population. 40 AC and 40 healthy controls were recruited to the study. MGP exon 4 Thr83Ala polymorphism (rs 4236) was examined using the polymerase chain reaction with subsequent restriction fragment length polymorphism analysis. The obtained data show that the substitution of threonin by alanine at position 83 in a molecule of MGP can affect its functional characteristics and anticalcinogenic properties. The distribution of homozygous carriers of a major allelic variant, and heterozygous and homozygous minor allele variants of Thr83Ala polymorphism in patients with AC was 40,0%, 47,5%, and 12,5% respectively. The corresponding distribution of variants in the control group was 32,5%, 42,5% and 25,0% (p=0,352 by χ2 -test). In women who are carriers of Ala/Ala-variant, CA occurs more rarely than in men with the same genotype (p=0,036 by χ2 -test). The substitution of threonine by alanine due to MGP exon 4 Thr83Ala polymorphism is related to a decrease in the likelihood of CA in female persons in the Ukrainian population.

[Hyperhomocysteinemia and cardiovascular risk profile in ischemic heart disease and acid peptic disease comorbidity patients].

Present article is devoted to the study of the clinic features of ischemic heart desease associated with acid peptic disease. It was shown the more evident increase of myocardial infarction risk in associated pathology patients. Such results have to be caused by the special risk factor. As such factor we desided to study the hyperhomosysteinemia. During research there were discovered that the lowest vitamin B12 serum level and the highest homocysteine serum level have been registrated in associated pathology (ischemic heart disease and acid peptic disease according to long-term proton pump inhibitor use) patients. It was shown evident correlation between that changes and dyslipidemia.

[Correlation between long-term proton pump ingibitor use, homocysteine and lipoproteins serum concentrations in patients with comorbidity of ischemic heart disease and acid peptic disease].

Present article is devoted to the study of the correlation between vitamin B12 serum level, hyperhomocysteinaemia and dyslipidemia. During research there were discovered that the lowest vitamin B12 serum level and the highest homocysteine serum level have been registrated in associated pathology (ischemic heart disease and acid peptic disease according to long-term proton pump inhibitor use) patients. It was shown evident correlation between that changes and dyslipidemia. Тhe complex therapy that includes parenteral B12 supplementation leads to more effective correction of hyperhomocysteinaemia and dyslipidemia in patients with comorbidity of ischemic heart disease and acid peptic disease with long-term use of proton pump inhibitors.