Вплив змін рівня гормонів щитоподібної залози на артеріальний тиск, процеси ремоделювання міокарду та функціонування нервової системи

Abstract

Тиреоїдна патологія, поряд з захворюваннями серцево-судинної системи відзначається найбільшою поширеністю серед неінфекційних захворювань людини. За останній час значно підвищились рівень та глибина наукового розуміння впливу порушення гормонального фону на розвиток вторинної артеріальної гіпертензії, процеси ремоделювання міокарду, патології центральної нервової системи. Знання механізмів впливів тиреоїдних гормонів на функціонування основних органів та систем людини, дозволить прискорити та поліпшити процес діагностичного пошуку з наступною розробкою індивідуальних підходів корекції наявних змін та станів з метою профілактики розвитку загрозливих для життя ускладнень.

The necessity for writing this article follows from the author’s own clinical experience. Counseling for therapeutic pathology in patients with a neurological profile, there was a tendency to ignore the study of the level of thyroid hormones in patients with arterial hypertension by family doctors, caused them to require constant correction of antihypertensive drugs, their frequent alteration and lack of effectiveness. Establishing a diagnosis of secondary arterial hypertension is unprecedented because it allows doctors to directly act on the cause of changes in blood pressure by normalizing hormonal status, while false diagnosis of essential hypertension leads to symptomatic use of antihypertensive drugs without affecting the etiological factor. There is also a lack of understanding by the patients of the essence of the thyroid gland pathology established in them, which indicates a low level of educational activities in this direction. Along with the problem of high blood pressure, a change in thyroid function is not new. However, in recent years there have been many reports of a deeper study of the effects of changes in hormone levels in thyroid hyperfunction and hypofunction on blood pressure, myocardial functional ability and the nervous system that are worthy of public attention, given the prevalence of both hypertension and thyroid disease. Differential treatment of secondary arterial hypertension of thyroid genesis is associated primarily with early prevention of lifethreatening complications (myocardial infarction, heart failure, stroke, nephrosclerosis), as well as changes in the central nervous system (dyscirculatory encephalopathy) in order to improve the quality of patient’s life. The determination of the functional ability of the thyroid gland in patients with therapeutic and neurological profiles should be included in the list of general clinical examination methods, since its change determines the course of comorbid pathology and worsens the prognosis. There is a need to study the clinical manifestations of changes in the level of thyroid hormones in patients with a therapeutic and neurological profile in order to gain a deeper understanding of the mechanisms of pathogenesis and to further develop diagnostic patterns and quickly correct existing conditions. A promising direction in medicine is the study of the functional state of the thyroid gland in patients with demyelinating diseases, taking into account their symptoms of pathology of the cardiovascular system, as well as lesions of the musculoskeletal system, renal pathology, pathology of the gastrointestinal tract. It is advisable to carry out active sanitary-educational work among patients with thyroid diseases, as well as work with family medicine doctors, general practitioners and neuropathologists in advanced training departments.