Dobrynina L A, Zabitova M R, Kalashnikova L A, Gnedovskaya E V, Piradov M A
Research center of neurology, Volokolamskoe Shosse 80, Moscow, 125367, Russia.
Acta Naturae. 2018 Apr-Jun;10(2):4-15.
Hypertension (HT) and its cerebral complications are extremely vexing medical and social problems. Despite the obvious association between hypertension and the clinical and neuroimaging features of cerebral microangiopathy (CMA) (also known as cerebral small vessel disease), the causal links between them remain ambiguous. Besides, antihypertensive therapy as the only way to manage these patients does not always prevent brain damage. Knowledge about the key factors and mechanisms involved in HT and CMA development is important for predicting the risk of cerebral complications and developing new approaches to their prevention and treatment. At present, genome-wide association studies and other approaches are used to investigate the common hereditary mechanisms of HT and CMA development, which will explain a large number of CMA cases not associated with hypertension, lack of a correlation between HT severity and the degree of cerebral injury, and failure of antihypertensive therapy to prevent CMA progression. Epigenetic markers likely play a modulating role in the development of these diseases.
高血压（HT）及其脑部并发症是极为棘手的医学和社会问题。尽管高血压与脑微血管病变（CMA，也称为脑小血管病）的临床及神经影像学特征之间存在明显关联，但其因果关系仍不明确。此外，作为治疗这些患者的唯一方法，抗高血压治疗并不总能预防脑损伤。了解高血压和脑微血管病变发生发展过程中的关键因素及机制，对于预测脑部并发症风险以及开发新的预防和治疗方法至关重要。目前，全基因组关联研究及其他方法被用于探究高血压和脑微血管病变发生发展的共同遗传机制，这将解释大量与高血压无关的脑微血管病变病例、高血压严重程度与脑损伤程度之间缺乏相关性，以及抗高血压治疗无法阻止脑微血管病变进展的原因。表观遗传标记可能在这些疾病的发生发展中起调节作用。
