[Arterial hypertension and oral disease in adolescents]. / Arterial'naya gipertenziya i bolezni polosti rta u podrostkov.

AIM: To establish significant associations between hypertension and the presence and severity of common oral diseases in adolescents. MATERIAL AND METHODS: A cross-sectional study was conductedWith participation of 130 adolescents, from which 2 groups were formed, matched by sex and age (n=65; 38 boys and 28 girls in each group). Inclusion criteria: age 10-17 years; hypertension for inclusion in the group of «cases¼ and a normal level of blood pressure for inclusion in the control group; informed voluntary consent to participate in the study. A diagnosis of hypertension was confirmed by daily monitoring of blood pressure. The frequency and severity of the clinical manifestations of the main oral diseases: caries, gingivitis, periodontitis were evaluated in the groups. Regression models have been adjusted for the index of oral hygiene and body weight. RESULTS: Hypertensive adolescents were significantly likely to have dental caries (50 (77% vs 32 (49%), p=0.001), periodontitis (26 (40%) vs 6 (9%), p=0.001) and moderate to severe gingivitis (12 (18%) vs 2 (3%), p=0.009), than in the control group. In the adjusted regression models, significant associations of hypertension with periodontitis (OR 3.9, 95% CI 1.4-10.5) and dental caries (OR 3, 95% CI 1.3-7.1) were established. It is also shown that hypertension is associated with more pronounced signs of periodontal inflammation (OR 3, CI 1.6-5.6). CONCLUSION: Results suggest that hypertension in adolescents is associated with poorer oral health. It is advisable to take this into account when developing a synergistic approach to the medical support of these patients, aimed at reducing cardiovascular risk in the long term.

Morphofunctional State of the Periodontal Tissues in Humans and Rats with Arterial Hypertension.

We performed comparative analysis of hemodynamic in the periodontal microcirculatory bed in adolescents with arterial hypertension (AH) and morphological changes in the periodontal tissues of in hypertensive ISIAH rats of comparable biological age. In the periodontal tissues of adolescents with hypertension, the blood flow velocity and index of peripheral resistance increased, while pulse pressure decreased. In ISIAH rats, the mean area of periodontal and pulp vessels increased and the area of the connective tissue decreased. These results can be used in the complex assessment of morphofunctional state periodontium during hypertension development.

[The relationship of hemodynamic parameters of periodontal microvascular bed and lipid peroxidation products in adolescents with arterial hypertension]. / Vzaimosvyaz' pokazatelei gemodinamiki mikrososudistogo rusla parodonta i produktov lipoperoksidatsii u podrostkov s arterial'noi gipertenziei.

THE AIM: Of the study was to establish the relationship of hemodynamic parameters of periodontal tissues and lipid peroxidation products in adolescents with arterial hypertension (AH). METHODS: The study included 132 adolescents (average age 14.51±1.91 years), from which 2 clinical groups (1 - the group with AH without periodontal disease (n=19, average age - 15±1.53 years) and 2 - the group with AH with periodontal diseases (n=57, average age - 14.7±1.89 years)) and 2 comparison groups (3 - the comparison group without AH and periodontal diseases (n=19, average age - 13.82±1.89 years) and 4 - comparison group without AH and with periodontal diseases (n=37, mean age - 14.57±2.01 years)) were formed. Hemodynamic analysis of the periodontal microcirculatory bed using the Doppler ultrasound method and the level of lipid peroxidation products using spectrophotometric and fluorometric methods was performed. RESULTS: In adolescents with hypertension without and with inflammatory periodontal diseases as a whole, unidirectional changes in the hemodynamics of the vascular bed of the periodontium were observed in the form of increased values of the maximum blood flow velocity in systole and an increase in the peripheral resistance index. At the same time, the group with hypertension and periodontal disease was distinguished by lower values of these indicators. In the system of lipid peroxidation, increased values of ketodienes and conjugated trienes occurred in patients with hypertension without periodontal disease and end products that actively reacting with thiobarbituric acid in patients with hypertension and periodontal disease. Correlation analysis showed the presence of intersystem relationships between the hemodynamic parameters of the vascular bed of periodontal adolescents with hypertension without periodontal disease. In the group of adolescents with arterial hypertension and periodontal disease, there was a decrease in the correlation coefficients between intersystem parameters by almost two times, as well as the appearance of pathological dependencies between toxic metabolites of the lipid peroxidation process - products that actively reacting with thiobarbituric acid and vascular blood flow indicators. CONCLUSION: It has been noted that in adolescent patients with hypertension and periodontal diseases on the background of lower vascular blood flow and accumulation of end toxic metabolites, pathological dependencies occur between them, which may contribute to more intense damage to the tissues of the periodontal complex in the presence of hypertension.

Comparative Analysis of the Morphology of Dentition in Normotensive and Hypertensive Rats Exposed to Chronic Stress.

The peculiarities of the histological structure and morphometrical parameters of the dentition in ISIAH rats (inherited stress-induced arterial hypertension) before stress and after modeling of everyday life stress regimen (chronic stress) were compared with those in WAG rats. The area of blood vessels of the periodontium, the thickness of the endothelium in the periodontal and pulp vessels, and the number of fibroblasts were increased, while the level of odontoblasts was reduced in ISIAH rats both before and after exposure to chronic stress, which can reflect more pronounced reaction to stress in hypertensive animals.

Changes in the Periodontium and Pulp in ISIAH Rats Caused by Stress Exposures in Different Modes.

It was shown that the intensity of morphological changes in the dental system tissues (periodontium and pulp) of ISIAH rats depends on the mode of stress exposure. Acute stress was associated with a significant increase in the area of periodontal and pulp vessels, a decrease in the area of connective tissue of these components, and an increase in the thickness of the vascular endothelium. Chronic stress in these animals induced an increase in the thickness of the endothelial layer of the periodontal and pulp vessels, fibromatosis (increase in the number of fibroblasts), and a sharp decrease in the level of odontoblasts.

Evaluation of Lipid Peroxidation-Antioxidant Defense System Depending on the Stage of Stress Reaction in Hypertensive ISIAH Rats.

The stages of stress reaction (anxiety and resistance) were reproduced on the model of stresssensitive hypertensive ISIAH rats. Analysis of the experimental data showed an increase in activity of the antioxidant defense system in ISIAH rats: total antioxidant activity of the blood and superoxide dismutase activity increased at the stage of anxiety and then decreased during the resistance stage.

Comparison of Reactivity of the Lipid Peroxidation-Antioxidant Defense System in Normal and Hypertensive Rats at Different Stages of Stress-Reaction.

We compared changes in the parameters of LPO-antioxidant defense system at various stages of the stress response in mature male ISIAH rats (hereditary stress-induced arterial hypertension) and WAG rats in 3 h (stage of anxiety) and 7 days (resistance stage) after a 3-h single immobilization in the supine position. It was found that post-stress reactivity of the nonspecific stress-limiting LPO system is different in normotensive and hypertensive rats. ISIAH rats, irrespective of the stage of the stress-reaction, demonstrated more intense LPO reactions (accumulation of TBA-reactive products) and reduced antioxidant defense parameters (low content of lipid-soluble vitamins, increased oxidized glutathione content) in comparison with the corresponding parameters in WAG rats.

Coupling of Lipoperoxidation Reactions with Changes in Arterial Blood Pressure in Hypertensive ISIAH Rats under Conditions of Chronic Stress.

Mature normotensive male WAG rats and stress-sensitive hypertensive ISIAH rats were exposed to "everyday life stress" modelled by alternation of immobilization and adaptation. Increased LPO intensity (increased content of substrates with unsaturated double bonds and primary and secondary LPO products) and reduced content of some antioxidant protection components (reduced retinol level and GSH/GSSG ratio) were revealed in the blood of ISIAH rats. These changes correlated with elevated mean BP. The results can reflect the significant role of LPO changes in the pathogenesis of stress-induced arterial hypertension.

Oxidative Stress as a Mechanisms of Reduced Glucose Absorption under Conditions of Immobilization Stress.

Experimental studies demonstrated inhibition of glucose absorption in the jejunum in acute and chronic 1-h daily immobilization stress, with the maximum inhibition on day 7 of immobilization. These changes correlate with the development of oxidative stress in animals over the entire duration of the experiment, which manifested by an increase in the content of the primary and end LPO products and decrease of the total antioxidant activity of the blood. Correction of these shifts with the antioxidant drug inhibits accumulation of LPO products and increases antioxidant defense and glucose absorption rate. These data prove the important role of peroxidation in regulation of glucose absorption.

[The impact of arterial hypertension in children on dental decay activity].

One hundred and ninety-five children aged 8 to 13 years, of which 113 are diagnosed with essential arterial hypertension (EAH), and 82 children from the control group without somatic diseases including EAH were examined. All children underwent dental examination. The values of the substrates and the primary products of lipid peroxidation (LPO)--double bond (DB) and diene conjugates (DC) were determined. The index of caries intensity exceeded the similar indicator in comparison with the control group of children with EAH. The intensity of the oxidation of substrates of LPO in patients with EAH compared with healthy children was also higher. The article discusses the index of low value of DB in patients with 1st stage of caries in combination with EAH, as a potential negative factor limiting the generation of biologically active compounds in systemic blood flow involved in the prevention of caries process.