scholarly journals Association between H-type arterial hypertension and vascular stiffness (a pilot study)

2021 ◽  
Vol 23 (1) ◽  
pp. 32-41
Author(s):  
Yu. M. Sirenko ◽  
O. L. Rekovets ◽  
O. O. Torbas ◽  
S. M. Kushnir ◽  
O. Yu. Sirenko
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Blood Pressure Level ◽  
Vascular Wall ◽  
Vascular Stiffness ◽  
Wall Stiffness ◽  
Body Weights ◽  
Total Homocysteine ◽  
The Relationship

Increased arterial stiffness is an important determinant of cardiovascular risk. Elevated total homocysteine (HC) levels appeared to be an independent risk factor for cardiovascular disease (CVD). To date, clinical studies on the relationship between HC and pulse wave velocity (PWV) assessment have shown conflicting results. Aim. To estimate the prevalence of hyperhomocystinemia (HHc) among patients with mild to moderate arterial hypertension and the effect of HHc on the vascular wall stiffness. Materials and methods. Our study was carried out as a part of the HYPSTER study in Ukraine. The study included 40 patients with I and II degree of arterial hypertension (AH) (average office systolic blood pressure (SBP)/diastolic (DBP) – 155.88/92.60 ± 1.63/1.43 mm Hg), heart rate – 71.40 ± 1.29 beats/min. The average age of the patients was 55.85 ± 2.09 (26–74) years. Patients with HC levels ≥10 μmol/l were defined as patients with H-type AH (HHc). Arterial stiffness was determined by PWV. Results. We found that at the beginning of the study, 75 % (30 patients with mild and moderate hypertension) had H-type hypertension with an increased level of HC. Patients with H-type AH and AH patients without HHc did not differ in age and AH duration. At the same time, patients with H-type AH had higher body weights and BMI. Office SBP in patients with H-type hypertension was higher compared to patients without HHc (156.45 ± 1.04 mm Hg vs. 152.55 ± 1.41 mm Hg at the beginning (P < 0.05) and 130.65 ± 0.96 mm Hg vs. 126.97 ± 1.08 mm Hg after 6 months (P < 0.05)) of treatment, respectively. BMI in H-type AH was 30.72 ± 0,39 kg/m2 vs. 28.34 ± 0.69 kg/m2 without HHc (P < 0.05) at the beginning of the study. It was difficult to achieve target levels of BP in the patients with H-type hypertension during the treatment and they had high initial blood pressure values. In contrast to the patients without HHc, H-type AH patients had a more pronounced degree of insulin resistance (according to the HOMA index), lower GFR both at the beginning and at the end of the treatment. According to ambulatory BP monitoring, H-type AH patients presented with a significantly higher SBP level before starting the treatment compared to those with AH without HHc. The regression analysis revealed an association between HC and PWVel, regardless of the degree of BP reduction (PWVel (6 months), m/s, β = 0.307, P = 0.001). Conclusions. Hyperhomocystinemia was observed in 75 % of patients with arterial hypertension. Homocysteine levels were associated with vascular stiffness, regardless of the reduction in blood pressure level.

scholarly journals Prospects of combined antihypertensive-psychocorrective therapy in women with arterial hypertension and anxiety-depressive disorders: clinical randomized placebo uncontrolled trial

2021 ◽  
Vol 28 (3) ◽  
pp. 61-77
Author(s):  
V. V. Skibitskiy ◽  
Yu. E. Ginter ◽  
A. V. Fendrikova ◽  
D. V. Sirotenko
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Depressive Disorders ◽  
Blood Pressure Monitoring ◽  
Aortic Pressure ◽  
Vascular Stiffness ◽  
Organ Injury ◽  
Severe Illness ◽  
Antidepressant Use

Background. Anxiety-depressive disorders (ADD) afflict almost half of patients with arterial hypertension (AH). AH aggravation by psychoemotional disorders causes a more severe illness and rapid target organ injury, particularly, the increased arterial stiffness and central aortic pressure (CAP). However, the prospects of combined antihypertensive-antidepressant treatments in AH-ADD patients remain largely unexplored.Objectives. The effect assessment in combined antihypertensive-psychocorrective therapy on circadian blood pressure (BP), vascular stiffness and CAP, anxiety and depression in women with AH and ADD.Methods. The study enrolled 60 AH-ADD women randomised between two cohorts. Cohort 1 received a fixed combination of valsartan and hydrochlorothiazide, bisoprolol and sertraline antidepressant; cohort 2 only had same combined AH therapy. Past 24 weeks of trial, all patients had a general clinical examination and daily blood pressure monitoring (DBPM) with BpLab Vasotens (Petr Telegin Ltd., Russia) and control of daily BP, CAP and vascular stiffness. The psychometric HADS and CES-D scales were used along with psychiatric counselling.Results. Past four weeks of treatment, the target blood pressure (TBP) was revealed in 60 and 36.7% patients, and in 90 and 66.6% — past eight weeks in cohorts 1 and 2, respectively. Cohort 1 vs. 2 required a lower valsartan dose to attain TBP. Past six months, both cohorts showed improved main DBPM values reflecting vascular stiffness and CAP. However, a statistical decrease in nocturnal central and peripheral BP, as well as improved BP variability and vascular stiffness were registered at antidepressant use. A normalised daily BP profile was significantly more frequent in cohort 1. In addition, sertraline had a significant ADD-reductive impact.Conclusion. An antidepressant-combined conventional AH therapy in AH-ADD women facilitated a faster TBP achievement at lower AH agent doses and the significantly improved DBPM (nocturnal specifically), arterial stiffness and CAP values. A sertraline treatment improved the psychoemotional patient state.

scholarly journals Features of arterial hypertension in postmenopausal women with abdominal obesity: The role of inflammatory response markers, leptin, and female sex hormones in the pathogenesis of vascular wall stiffness

2019 ◽  
Vol 34 (3) ◽  
pp. 103-113 ◽  
Author(s):  
K. S. Avdeeva ◽  
T. I. Petelina ◽  
L. I. Gapon ◽  
N. A. Musikhina ◽  
E. V. Zueva
Keyword(s):  
Blood Pressure ◽  
Inflammatory Response ◽  
Arterial Hypertension ◽  
Postmenopausal Women ◽  
Sex Hormones ◽  
Abdominal Obesity ◽  
Vascular Wall ◽  
Female Sex Hormones ◽  
Wall Stiffness ◽  
Group 2

Background. Despite overall efforts, arterial hypertension remains one of the most significant medical and social problems. The risk of developing arterial hypertension is tripled in obese individuals compared with people who have normal body weight. According to clinical studies, individual biochemical markers can be predictors of initiation of remodeling processes in systems at a preclinical level. Endothelial dysfunction is the initial stage in the development of atherosclerosis. Mechanisms of the vascular inflammatory response in arterial hypertension with obesity can be considered a factor that largely determines the onset and course of the disease, a cause of its aggravation, development, and progression. Cardiovascular risk factors, genetic predisposition, deficit of sex hormones, and aging affect the endothelium function.Aim. To study specifics of hypertension in postmenopausal women with abdominal obesity and to evaluate the role of inflammatory response markers, leptin, and female sex hormones in the pathogenesis of vascular wall stiffness.Material and Methods. The study included 164 patients divided into three groups. Group 1 consisted of 42 healthy women aged 44.43 ± 14.26 years; group 2 comprised 62 hypertensive women aged 60.69 ± 7.09 years; group 3 comprised 60 hypertensive women with abdominal obesity aged 57.24 ± 7.40 years. Patients of all groups received 24-hour blood pressure monitoring, sphygmography, and assessment of sex hormones, lipids, inflammatory, and biochemical parameters in blood serum.Results. Results of analysis showed that patients of group 3 had significantly higher blood pressure compared with that in group 2. Higher pulse wave velocity was observed in women of group 2. Groups 2 and 3 had lower levels of sex hormones and significant increases in the levels of inflammatory markers compared with those in control group. Multiple multidirectional correlations between the studied parameters were revealed.Conclusions. Features of hypertension in postmenopausal women with obesity consist in a systolic-diastolic variant of hypertension, an increase in systolic blood pressure variability at night, an increase in diastolic blood pressure during the daytime, and increases in systolic and diastolic blood pressure at night. The method of logistic regression allowed to identify biochemical markers that determine the elastic properties of the vascular wall in this category of patients, namely: leptin, highsensitivity C-reactive protein, and endothelin-1. 

scholarly journals The Impact of Valsartan/Amlodipine Single-Pill Combination on Blood Pressure and Vascular Stiffness in Patients with Grade 1-2 Essential Arterial Hypertension

2019 ◽  
Vol 14 (6) ◽  
pp. 831-839
Author(s):  
E. V. Borisova ◽  
A. I. Kochetkov ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Vascular Stiffness ◽  
Stage Ii ◽  
Ambulatory Bp Monitoring ◽  
Single Pill ◽  
Essential Arterial Hypertension ◽  
The Impact

Aim. To investigate the impact of valsartan/amlodipine single-pill combination (V/A SPC) on arterial stiffness parameters and 24-hours blood pressure (BP) level in the middle-aged patients with stage II grade 1-2 essential arterial hypertension (HT). Material and methods. A group of patients with stage II grade 1-2 HT who had not previously received regular antihypertensive therapy (n=38, age 49.7±7.0 years) was retrospectively formed. All the patients were treated with V/A SPC and all of them achieved target office BP (<140/90 mm Hg). 12 weeks after reaching the target BP the assessment of V/A SPC therapy effectiveness and vascular stiffness (general clinical data, ambulatory BP monitoring, volume sphygmography, echocardiography) were performed in all included HT patients. Sex- and age-matched healthy people with normal BP (n=86, age 48.8±5.8years) and in whom similar clinical and vascular stiffness data were available represented a control group. Results. According to the ambulatory BP monitoring data systolic, diastolic and pulse BP significantly (p<0.001) decreased after the treatment with V/A SPC. Volume sphygmography has showed significant decrease in right-CAVI value from 8.9±1.3 to 7.3±1.4 (p=0.021) as well as a reduction the number of patients with a right- and/or left-CAVI>9.0 from 31.6 to 10.5% (p=0,049). According to an assessment of arterial stiffness the augmentation index decreased significantly by 23.6±8.6% from -23.0±17.1 to -28.9±18.7 (p=0.034. Transthoracic echocardiography data has demonstrated decrease in effective arterial elastance from 1.73±0.35 to 1.60±0.32 mm Hg (p=0.016) and increase in the arterial compliance – from 1.30±0.38 to 1.43±0.34 mm Hg/ml (p=0.049). Conclusions. In naive patients 40-65 years old with stage II grade 1-2 HT antihypertensive therapy with V/A SPC provides effective 24 hours BP control and improves arterial stiffness parameters.

scholarly journals The Relationship between the Parameters of Blood Pressure Variability and Arterial Wall Stiffness in Patients with Arterial Hypertension

2019 ◽  
Vol 9 (3) ◽  
pp. 197-201
Author(s):  
Nigora Tursunova ◽  
Ulugbek Nizamov ◽  
Ravshanbek Kurbanov ◽  
Gulnoz Khamidullaeva ◽  
Guzal Abdullaeva ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Variability ◽  
Arterial Wall ◽  
Wall Stiffness ◽  
The Relationship

scholarly journals Antihypertensive and vasoprotective effectiveness of the chronopharmacotherapy in patients with arterial hypertension after acute cerebrovascular accident

Kardiologiia ◽  
2019 ◽  
Vol 59 (1S) ◽  
pp. 25-33 ◽  
Author(s):  
V. V. Skibitsky ◽  
A. V. Fendrikova ◽  
S. V. Opolskaya
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Cerebrovascular Accident ◽  
Vessel Wall ◽  
Vascular Wall ◽  
Aortic Pressure ◽  
Single Time ◽  
Acute Cerebrovascular Accident ◽  
Central Aortic Pressure ◽  
Wall Stiffness

Aim. To evaluate the effectiveness of combined antihypertensive chronopharmacotherapy and estimate the daily blood pressure profle (BP) parameters, such as: stiffness of the vascular wall and central aortic pressure in patients with arterial hypertension (AH) who underwent transient ischemic atack (TIA) or ischemic stroke (IS).Materials and methods. 235 patients with hypertension who underwent acute cerebrovascular accident were examined. Tere were 116 patients with TIA and 119 with IS. All patients were randomized in 4 groups according to regimen of antihypertensive drugs combination. Te 1st group (n = 59) included patients with AH, who underwent TIA and received indapamide retard 1.5 mg and valsartan 160 mg in the morning regiment of drug therapy. Te 2nd group (n = 57) included patients with AH, who underwent TIA and received indapamide retard 1.5 mg in the morning and valsartan 80 mg twice a day (morning and evening). Te 3rd group (n = 47) included patients with AH, who underwent IS and received indapamide retard 1.5 mg and valsartan at a dose of 160 mg in the morning. Te 4th group (n = 56) included patients with AH, who underwent IS and received indapamide retard 1.5 mg in the morning and valsartan 80 mg twice a day (morning and evening). Ambulatory blood pressure monitoring (ABPM), central aortic pressure (CAP) measurement and vessel wall stiffness values were evaluated before treatment and afer 12 months of therapy.Results.Before the start of combined antihypertensive chronopharmacotherapy, most of the parameters for ABPM, vessel wall stiffness values and CAP in groups 1 and 2, 3 and 4 were comparable. Achievement of the target level of BP afer 8 weeks of treatment, was signifcantly more ofen in groups with a double sartan therapy (group 2 and group 4) in compare with its single time application only in the morning hours (group 1 and group 3) (p<0.05). Statistically signifcant positive dynamics of the main values of the daily profle of blood pressure, stiffness of the vascular wall and central aortic pressure (p <0,05) were registered in all groups. However, more pronounced decline of main parameters of ABPM, stiffness of the vascular wall and central aortic pressure values were noted in group with double use sartan therapy in compare with single time sartan therapy in the morning time. (p <0.05). Signifcant positive dynamics of the main values of the ABPM, stiffness of the vascular wall and CAP were registered in patients who underwent IS and received double application sartan therapy (4th group) in compare with patients with TIA (2nd group) (p = 0.02).Conclusion.Double use sartan therapy, combined with a thiazide diuretics in patients, who underwent IS or TIA more ofen promotes to get target values of blood pressure, improve the main values of the ABPM, stiffness of the vascular wall and CAP in compare with single time sartan therapy in the morning time

Gender Differences in Vascular Stiffness Indicators and Daily Blood Pressure Profile in Patients with Arterial Hypertension and Depressive Disorders

Kardiologiia ◽  
2021 ◽  
Vol 60 (12) ◽  
pp. 83-89
Author(s):  
A. V. Fendrikova ◽  
V. V. Skibitskiy ◽  
A. V. Skibitskiy
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Pressure Profile ◽  
Vascular Wall ◽  
Men And Women ◽  
Wall Stiffness ◽  
Study Results ◽  
Diurnal Profile

Aim      To study gender-related characteristics of vascular wall stiffness (VWS), central blood pressure (CBP), and BP diurnal profile in patients with arterial hypertension (AH) and depression.Material and methods  This prospective, noninterventional study enrolled 161 patients, including 98 patients with AH and depression (50 (51 %) men and 48 (49 %) women) and 63 patients with AH without depression (32 (50.8 %) men and 31 (49.2 %) women. The 24-h BP monitoring (24-h BPM) with a BPLab Vasotens hardware system was performed for all patients. The following indexes were evaluated: mean diurnal, mean daytime, and mean nighttime systolic and diastolic BP (SBP and DBP); daytime and nighttime SBP and DBP time index; SBP and DBP variability; and suite of metrics characterizing VWS and CBP. Depression was diagnosed with the Hospital Anxiety and Depression Scale (HADS) and the Zung Self-Rating Depression Scale. Statistical analyses were performed using the STATISTICA 12 software.Results In the patient group with AH and depression, practically all indexes of 24-h BPM were higher for men than for women (р<0.05). Most 24-h BPM parameters did not differ in groups of men and women without depression. Independent of gender, 24-h BPM parameters were significantly higher in patients with both AH and depression than in AH patients without depression. Adverse changes in major indexes of VWS and CBP, were more pronounced in men than in women with AH and depression (р<0.05). Adverse changes in most VWS and CBP indexes were more statistically significant for men with AH and depression than for men without depression.Conclusion      The presence of depression in men and women with AH was associated with significant pathological changes in both BP diurnal profile and CBP and VWS parameters. Furthermore, adverse changes in indexes were more pronounced for men with depression than for women. The study results should be taken into account in administration of antihypertensive and psychocorrective drug therapy to personalize the treatment and provide not only optimization of diurnal BP profile but also vasoprotection.

scholarly journals Analysis of hemodynamic parameters and quality of life in patients with chronic kidney disease and arterial hypertension

2021 ◽  
Vol 12 (33) ◽  
pp. 274-287
Author(s):  
Tamara Muratovna Khokonova ◽  
Sofiat Khasenovna Sizhazheva ◽  
Zhaneta Huseynovna Sabanchieva ◽  
Marina Tembulatovna Nalchikova ◽  
Jannet Anvarovna Elmurzayeva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Arterial Hypertension ◽  
Vascular Wall ◽  
Vascular Stiffness ◽  
Lipid Lowering ◽  
Hemodynamic Parameters ◽  
Peripheral Hemodynamics ◽  
Wall Stiffness ◽  
Ckd Stage

Purpose. The work is devoted to study the effects of antihypertensive, lipid-lowering and metabolic therapy in office and the average hemodynamic parameters, the parameters of central pressure in the aorta, vascular wall stiffness and quality of life in patients with CKD stage 3 in combination with arterial hypertension of 1-2 degrees, and without it. Materials and methods. Were examined patients with arterial hypertension of 1-2 degrees and CKD stage 3. Measured hemodynamic parameters with the help of a daily BP monitor “BPLab”. The quality of life of patients was assessed by the questionnaire MOS SF36. Results. The greatest changes in the indicators of central hemodynamics and vascular stiffness were noted in the group of patients with comorbidity. Conclusion. The combination of antihypertensive therapy (losartan and diltiazem) with meldonium and rosuvastatin significantly decreases indices of central and peripheral hemodynamics and vascular stiffness. Add meldonium part of therapy significantly improves the quality of life of patients.

scholarly journals Blood pressure level and laboratory indicators of disease severity in patients with arterial hypertension and COVID-19

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
K Popov ◽  
A Novitskiy ◽  
Y Shvarts
Keyword(s):  
Blood Pressure ◽  
Multivariate Analysis ◽  
Arterial Hypertension ◽  
Negative Correlation ◽  
Diastolic Pressure ◽  
Negative Relationship ◽  
Laboratory Parameters ◽  
Acute Period ◽  
Nonparametric Correlation ◽  
The Relationship

Abstract Funding Acknowledgements Type of funding sources: None. Background. Many patients with COVID-19 suffer from arterial hypertension and have marked variations in blood pressure (BP) during the acute period of infection. The reasons for such changes are poorly understood. Purpose. To assess the relationship between the level of BP and the severity of changes in the main clinical and laboratory parameters in patients with arterial hypertension and with a moderate course of COVID-19 at the stage of the height of the disease. Materials and methods. The study included 86 hospitalized patients with verified coronavirus disease of moderate severity: 46 of them were male, the median age was 65 years. Patients received adequate hypertension therapy for a long time. After hospitalization, treatment was adjusted if necessary. The level of laboratory parameters in the acute period of the disease was determined, including the electrolytes, C-reactive protein (CRP), albumin, ferritin, general blood test, etc. BP measured daily. The relationship between laboratory parameters and BP level was evaluated by nonparametric correlation using the Spearman coefficient and multivariate analysis based on the "generalized nonlinear model". Results. In 67.44% of patients with hypertension, an elevated BP level (&gt;140/90) was observed against the background of moderate COVID-19. There was a significant negative correlation between the levels of CRP and BP throughout the stay in the hospital, the most significant is the 5th day of hospitalization. At the same time, a slightly stronger relationship is observed with diastolic BP (r = -0.4425) than with systolic BP (r = -0.3525). A similar trend is observed in all BP measurements. Besides, a negative correlation was found between potassium levels and BP values. The strongest association of potassium levels is with systolic BP on the day of hospitalization (r = -0.4850) and diastolic pressure on the 1st day of hospitalization (r = -0.3561). Multivariate analysis confirmed independent and reliable "influence" of CRP (p = 0.00018) and potassium (p = 0.03921) as independent predictors of diastolic pressure. Conclusions. Most patients with hypertension and moderate COVID-19 have elevated BP levels. There is a statistically significant negative relationship between the values of BP and levels of CRP and potassium. The obtained data may correspond to the existing hypothesis about the significant role of the kinin–kallikrein system in the pathogenesis of COVID-19.

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