Objective. To investigate the prevalence, clinical features and markers of resistant isolated systolic hypertension (ISH) in elderly patients. Design and methods. 261 patients with essential arterial hypertension (AH) and mean age of 73,2 ± 7,2 were included into the study. Resistant AH was diagnosed both by the office BP and ABPM criteria. We detected and compared the ABPM parameters, myocardial, vessels and renal damage signs in the resistant ISH group with those of resistant systolic-diastolic hypertension (SDH) and controlled AH groups. Factors reliably associated with resistant ISH development were revealed by logistic regression. Results and conclusion. The resistant ISH was detected by office BP in 11,8 % and by ABPM in 12,2 % of elderly patients. The resistant SDH was diagnosed in 13,6 and 5,4 % respectively. The «white-coat» effect was found in 30,4 %. In patients with resistant ISH the systolic BP variability, Sokolow-Lyon voltage index, left ventricular ejection fraction decrease occurrence and ambulatory arterial stiffness index were greater than in the compared groups. In comparison to controlled AH the aortic pulse wave velocity was higher while ankle-brachial index was lower. We found the markers of resistant ISH to be systolic BP variability, aortic pulse wave velocity and ambulatory arterial stiffness index.
Independent prognostic value of the ambulatory arterial stiffness index and aortic pulse wave velocity in a general population
