Features of the autonomic nervous system in elderly patients with paratraumatic eczema with concomitant varicosis and arterial hypertension

The combination of arterial hypertension (AH) and insulin resistance (IR) significantly increases the risk of cardiovascular complications. Research objective: Studying indices of carbohydrate metabolism, activity of renin-angiotensin-aldosterone system, calcium-regulating hormones, adrenal glucocorticoid function, the condition of the autonomic nervous system and their possible interrelation with hemodynamic parameters in AH patients with different insulin sensitivity. A comprehensive study of hormonal profile was held with use of radio immune method and that of central hemodynamics with use of echocardiography in 72 patients with arterial hypertension stage II, 1-2 degrees, male (mean age – 54.1±3.4 years), with a body mass index up to 30 kg / mІ and verified insulin resistance (IR), in 32 patients of which insulin resistance (IR) was revealed, and in 40 patients its absence was fixed. Insulin resistance was verified by the value of HOMA-IR in excess of 2,77. To assess the condition of the autonomic nervous system, studies of heart rate variability were performed. It is established that patients with hypertension with IR had increased level of plasma renin activity, levels of angiotensin II, cortisol, insulin, parathyroid hormone, decreased parasympathetic and increased sympathetic tonus. According to the results of factor analysis, AH with insulin resistance has a distinctive structure of neurohumoral regulation of the main indicators of central hemodynamics and interhormonal interactions; the direct regulatory effects of angiotensin II, insulin, progesterone, parathyroid hormone on the indicators of central hemodynamics, modulation of presorption action increases. The study not only revealed peculiarities of neurohumoral profiles in patients with hypertension depending on insulin resistance, but also determined distinctive features in structure of the regulatory process of central hemodynamics and interhormonal interactions. This should be taken into account when prescribing antihypertensive therapy.

Download Full-text

Peculiarities of vegetative provision and disorders of tolerance to exercise in children with endocrine and cardiac pathology

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(4)-13 ◽

2020 ◽

Vol 24 (4) ◽

pp. 634-639

Author(s):

K. Shtrakh ◽

O. Tsiura ◽

L. Rak ◽

N. Shevchenko

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Nervous System ◽

Autonomic Nervous System ◽

Arterial Hypertension ◽

Exercise Tolerance ◽

The State ◽

Cardiac Pathology ◽

Autonomic Nervous ◽

Autonomic Support

Annotation. The aim – to find out the features of autonomic support and exercise tolerance of the cardiovascular system in children with chronic non-infectious diseases, in the future will be able to improve the results of diagnosis and rehabilitation of patients, as well as differentially regulate the mode of the exercise regime for patients. The study included 58 children aged 10-17 years, with cardiac and endocrine pathology: group 1 – 23 children with endocrine pathology (type 1 diabetes mellitus), group 2 – 23 children with cardiac pathology (AH stages I-II). The study included clinical examinations, anthropometry, a questionnaire of physical activity by MAOFA, ECG, ultrasound examination of the heart and Rufier's test were performed. Assessment of the state of the autonomic nervous system was carried out using the Kerdo index and COT. Statistical analysis was performed using s/n program SPSS 17 4a 180844250981. It was found that there is a tendency to outstrip the normative values and increased body weight indicators in the examined children with chronic pathology of the endocrine and cardiovascular systems. According to the Rufier test, it was found that in the group of children with diabetes mellitus, 69.5±9.6% of the examined had low results. Among children with hypertension, 30.7±10.4% of the test indicators were regarded as weak, and in 26.9±5.8% – unsatisfactory. The results of Rufier's test were significantly lower in children with endocrine pathology, both in comparison with the group of children with cardiac pathology (p<0.05) and with the control group (p≤0.001). In 70.0±15.3% of cases, weak and unsatisfactory indicators of the Ruffier test were observed against the background of hyperdiastolic autonomic support. In physically nonactive adolescents, asympathicotonic and hyperdiastolic types of COT were observed. Thus, almost 70% of children with diabetes mellitus and 57% of children with arterial hypertension have reduced exercise tolerance. This is associated with hyperdiastolic autonomic support. Physical activity has a positive effect on the state of the autonomic nervous system in children with arterial hypertension and diabetes mellitus.

Download Full-text