Туберкульоз та артеріальна гіпертензія: сучасний стан проблеми (огляд літератури)

In low- and middle-income countries, tuberculosis (TB) remains a significant challenge to the healthcare system. According to the Centre for Public Health of the Ministry of Health of Ukraine, in 2023 the incidence of TB increased by 7.3 % compared to 2022. At the same time, the number of people with arterial hypertension (AH) is steadily increasing in the world. It is noted that in countries with a high incidence of AH, a high rate of TB notification is also observed. According to the STEPS National Study, 34.8 % of the population of Ukraine either has high blood pressure (BP) or takes antihypertensive medications. However, the issue of the specifics of the relationship between these pathologies in people of different ages and genders still remains insufficiently studied. There is no data on the effect of drugs used to treat TB on a person’s BP, and vice versa, whether modern antihypertensive drugs can affect the course of TB. A systematic analysis of the literature was conducted to study the prevalence of AH among TB patients, the mechanisms of the mutual aggravating effect between TB and AH were determined, and the impact of treatment of one pathology on the development and course of the other was analysed. Among TB patients, provided that the sample is homogeneous and the inclusion/exclusion criteria are clear, the frequency of AH can be determined in the range from 1.5 to 38.3 %. In contrast, no studies have been conducted to detect the frequency of TB in the population of patients with AH. In TB patients, compared with the general population, inflammation plays a key role in the pathogenesis of AH, which is combined with an increase in the level of tumor necrosis factor-α, interleukins-6 and -18, and angiotensin II. The appointment of receptor blockers of the latter in patients with concomitant pathology allows reducing the level of these pro-inflammatory cytokines. TB therapy with drugs from the rifampicin group of antibiotics reduces the effectiveness of antihypertensive therapy. The use of slow calcium channel blockers for managing hypertension not only leads to a decrease in BP, but also improves the survival of TB patients.