Abstract
Background
The contributions of the effectively treated hypertension on blood viscosity remain unclear, as well as impact of clinical and demographic parameters, biochemical variables, level of anxiety.
Aim
Aim of the study is to research viscosity state in patients with effectively treated hypertension and to reveal factors affecting blood viscosity.
Materials
58 treated hypertensive patients (36 females and 24 males aged 62,9±9,7 years) with achievement of target blood pressure (BP) level (systolic BP was 130,9 (126,6; 135,4), diastolic BP - 81,4 (79,7; 83,1) mmHg. 71.7% of patients were treated with beta-blockers, 46.7% - angiotensin converting enzyme inhibitors (ACE inhibitors), 31.7% - angiotensin II receptor blockers, 38.3% - calcium channel antagonists, 18.3% - diuretics, 71.3% - statins, 60% - acetylsalicylic acid. Coronary heart disease (CHD) were presented in 24 (40%). The average cholesterol level was 5.11 (4.76; 5.46) mmol/l, creatinine 71.83±12.6 mmol/l, sodium 143.4 (143.0; 143.9) mmol/l. The level of anxiety disorders determined on Sheehan's Patient-Rated Anxiety Scale (SPRAS) was 33.7 (23.1; 39.2) points.
Methods
Whole blood viscosity at high (η1) and low (η2) shear rates, plasma viscosity (ηpl) were measured by a rotational viscometer. Aggregation of erythrocytes (η2/ η1) was studied also. The statistical analysis was carried out by nonparametric method of Spearman and multivariate regression analysis with STATISTICA 6.
Results
Hemorheological profile was as follows: η1 4,7 (4,7; 5,0) sec–1, η 2 24,6 (23,5; 26,5) sec–1, η2/η 1 5,4 (4,9; 5,3), η pl 1,52 (1,51; 1,55) sec–1. Blood viscosity in men was higher than in women in all indices studied: η1 5,4 (5,1; 5,7) sec–1 in men vs 4,6 (4,6; 5,0) sec–1 in women (p<0,001), η 2 28,6 (26,0; 31,9) sec–1 vs 23,0 (21,6; 25,8) sec–1 (p=0,004), η2/η1 - 5,3 (5,1; 5,6) vs 4,9 (4,7; 5,2) (p=0,03) respectively. It was revealed η1 correlation with patient growth (r=0,468, p=0,001), η2 –with creatinine (r=0,551, p=0,001) and sodium (r=0,488, p<0,001) level. η2 /η1 positively correlated with the level of creatinine (r=0,383, p 0,04), sodium (r=0,543, p=0,0001), and with the level of anxiety as well (r=0,374, p=0,01). The level of anxiety is defined as an independent predictor of η2/η1 in the model including gender, age, creatinine, sodium, anxiety level. In patients treated with an ACE inhibitor η2/η1 was higher compared to patients who were not prescribed: 5,3 (4,6; 5,2) vs 5,0 (5,0; 5,5), (p=0,04). However, a multivariate analysis showed a loss of the prognostic value of antyhypertesive treatment (in model included gender, age, height, creatinine, sodium). Blood viscosity does not depend on the level of total cholesterol, the presence of CHD.
Conclusion
In effectively treated hypertensive patients the level of anxiety, indirectly reflected the activity of the sympatho-adrenal system, proved to be an independent predictor of a higher value of η2/η1.
Balance between oxygen transport and blood rheology during resuscitation from hemorrhagic shock with polymerized bovine hemoglobin
