scholarly journals Indicators of ambulatory blood pressure monitoring in patients with essential hypertension of the 2-nd stage depending on the type of 24-hours blood pressure profile, the state of the left ventricular diastolic filling and endothelial function of vessels

2021 ◽  
Vol 25 (4) ◽  
pp. 577-583
Author(s):  
T. Yu. Niushko ◽  
E. S. Osiadla
Keyword(s):  
Blood Pressure ◽  
Brachial Artery ◽  
Blood Pressure Monitoring ◽  
Pressure Profile ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Pressure Monitoring ◽  
Blood Pressure Profile ◽  
Target Organs ◽  
Left Ventricular Diastolic Filling

Annotation. Arterial hypertension (AH) is one of the most important risk factors for the development of cardiovascular complications and mortality in the world and it has become a medical and social problem. The prevalence of hypertension will increase to 1.56 billion by 2025, making the disease a very serious problem. The severity of clinical manifestations and prognosis in patients with hypertension are determined not only by the degree of increase in blood pressure (BP) but also the damage to target organs. The load on the cardiovascular system caused by elevated BP leads to structural remodelling of the heart and vessels. The aim – to evaluate peculiarities of indicators of ambulatory blood pressure monitoring in patients with essential hypertension of the 2nd stage depending on the type of 24-hours blood pressure profile, the state of the left ventricular diastolic filling and endothelial function of the vessels and determine independent clinical and instrumental criteria of the 24-hours profile “dipper” and “non-dipper”. The study involved 110 patients (40 men and 70 women) with hypertension of the II-nd stage, hypertensive heart, chronic heart failure of the 0-I stage (average age was 54.19±0.89 years). The patients underwent 24-hour blood pressure monitoring, echocardiography and determination the thickness of the intima-media complex (IMCT) of the brachial artery, endothelium-dependent (EDVD) and endothelium-independent (EIVD) vasodilatation. For statistical analysis, arithmetic means (M), errors of mean values (m), t - Student's t test for paired measurements were calculated. Correlation ratios were evaluated by the method of linear correlation for parametric data and the method of Spearman’s rank correlation for nonparametric data. Paired group comparisons were performed by the nonparametric Mann-Whitney method. Wilcoxon test was used in the analysis of dependent samples. Step-by-step multifactor regression was used to identify independent criteria for daily blood pressure profiles. Two types of 24-hours profile of blood pressure – “dipper” and “non-dipper” were detected. The left ventricle diastolic dysfunction (LVDD) by type of relaxation disorder was observed in all “non-dipper” patients and most “dipper” patients. Patients with DD had higher levels of BP per 24-hours, day, night, corresponding the time indexes, the magnitude of the morning increase of systolic and diastolic blood pressure, more pronounced structural changes of the heart and vessels compared with patients with preserved diastolic filling of the LV(р<0,01). The duration of the hypertensive anamnesis (p=0.0002), the thickness of the posterior wall of the LV (p=0.002), the maximum speed of early diastolic filling of the LV (E) (p<0.0001), the LV ejection fraction (p=0.001), the index of the left atrium (p=0.008), the thickness of the intima-media complex of the brachial artery (p=0.013), increase of the diameter of the brachial artery in 90 s after compression (EDVD) (p<0.0001) and in 5 min after taking of nitroglycerin (EIVD) (p=0.009) were determined as independent clinical and instrumental criteria of the “dipper” and “non-dipper” profile. Insufficient the degree of the nightly decrease of the BP, higher magnitude of the morning increase of systolic and diastolic BP cause more hemodynamic pressure on target organs and lead to more significant pathological remodeling of the LV and vessels, disorders of the LV relaxation processes and endothelial dysfunction.

scholarly journals THE EFFECTIVENESS OF COMBINATED ANTIHYPERTENSIVE TREATMENT IN PATIENTS WITH ESSENTIAL HYPERTENSION OF THE II-ND STAGE DEPENDING ON THE TYPE OF DAILY BLOOD PRESSURE PROFILE AND THE TYPE OF REMODELLING OF THE LEFT VENTRICLE

2020 ◽  
Vol 73 (1) ◽  
pp. 46-51
Author(s):  
Tetiana Y. Niushko ◽  
Olena K. Tarasiuk ◽  
Yulia K. Sikalo
Keyword(s):  
Blood Pressure ◽  
Left Ventricle ◽  
Antihypertensive Treatment ◽  
Blood Pressure Monitoring ◽  
Combined Therapy ◽  
Pressure Profile ◽  
Target Level ◽  
Pressure Monitoring ◽  
Blood Pressure Profile ◽  
Left Ventricle Remodelling

The aim: To evaluate the dynamics of structural and functional parameters of the heart, vessels in patients with hypertension of the II-nd stage under the influence of combined antihypertensive treatment depending on the type of the left ventricle remodelling and the profile of blood pressure (BP). Materials and methods: The study involved 110 patients with hypertension of the II-nd stage. The ambulatory blood pressure monitoring, echocardiography and Doppler examination of the shoulder arteries were performed. Initial treatment included bisoprolol, lisinopril, hydrochlorothiazide. With impossibility of BP lowering to the target level, amlodipine has been added. Results: higher levels of BP in the “non-dipper” patients have led to the development of more pronounced changes in the heart and vessels compared with “dipper” patients. Three-component therapy was effective in patients with lower BP. The prescription of amlodipine has been found to be necessary for the majority of “non-dipper” patients and for the minority of “dipper”. Combined therapy effectively controlled the BP at the level of the target and contributed to a decrease in the displays of remodelling of the heart and blood vessels. Conclusions: combined therapy used for 6 months reduces displays of disadaptive heart and vascular remodelling, diastolic, endothelial dysfunction. With the lack of efficacy of the therapy, which includes bisoprolol, lisinopril, hydrochlorothiazide, the adding of amlodipine to it can reach the target level of BP

scholarly journals Psychological status and daily blood pressure in pregnant wiht arterial hypertension

2006 ◽  
Vol 12 (4) ◽  
pp. 343-346
Author(s):  
L. F. Bartosh ◽  
T. V. Kanaeva ◽  
I. V. Dorogova ◽  
N. N. Mayorova ◽  
V. V. Orlov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Profile ◽  
Psychological Status ◽  
Pressure Monitoring ◽  
Pregnant Females ◽  
Hypertension In Pregnancy ◽  
Blood Pressure Profile ◽  
Psychological Features ◽  
In Pregnancy

The study addresses relation between psychological features and daily blood pressure profile in hypertensive pregnant females. Psychological testing and 24-hour blood pressure monitoring were performed. Personal featured in different patterns of blood pressure daily profile are revealed. The data obtained indicate the need of philological testing for hypertension in pregnancy in order to optimize its treatment.

scholarly journals 24-HOUR BLOOD PRESSURE PROFILE IN CHRONIC CEREBROV ASCULAR DISEASES AND SLEEP-DISORDERED BREATHING

2020 ◽  
pp. 21-30
Author(s):  
L.A. Geraskina ◽  
G.G. Sharipov ◽  
A.V. Fonyakin ◽  
M.Yu. Maksimova
Keyword(s):  
Blood Pressure ◽  
Circadian Rhythm ◽  
Sleep Disordered Breathing ◽  
Blood Pressure Monitoring ◽  
Pressure Profile ◽  
Cerebrovascular Diseases ◽  
Pressure Monitoring ◽  
Night Time ◽  
Blood Pressure Profile ◽  
Disordered Breathing

Arterial hypertension (AH) in patients with sleep-disordered breathing (SDB) is characterized by a higher level of blood pressure, increased variability and impaired circadian rhythm of blood pressure. The goal of the paper is to establish the changes in 24-hour blood pressure profile in patients with chronic cerebrovascular diseases and sleep-disordered breathing to optimize antihypertensive therapy. Materials and Methods. The trial enrolled 100 patients with chronic cerebrovascular diseases; the average age was 65 years (58.0; 74.5). Arterial hypertension was detected in 92 % of patients. All patients underwent 24-hour blood pressure monitoring. Cardiorespiratory monitoring was performed to verify sleep-disordered breathing. The authors also determined Apnea Hypopnea Index (AHI), saturation, and the duration of apnea episodes. Results. Patients with moderate and severe sleep-disordered breathing (AHI≥15) demonstrated an increased systolic blood pressure (SBP) within 24 hours, an increased diastolic blood pressure (DBP) at night (p<0.05), as well as increased SBP and DBP variability at night. A decrease in circadian rhythm of blood pressure was observed in 65–70 % of patients, including 16 % of patients with increased night-time blood pressure. These changes correlated with the severity of sleep-disordered breathing (AHI), total desaturation duration and depth (p<0.05). Conclusion. To increase the effectiveness of AH treatment and to control the target BP level in patients with chronic cerebrovascular diseases, it is necessary to find out whether patients suffer from sleep-disordered breathing, especially if night-time hypertension is detected. Keywords: cerebrovascular diseases, 24-hour blood pressure monitoring, sleep-disordered breathing. Артериальная гипертония (АГ) у больных с нарушением дыхания во сне (НДС) характеризуется более высоким уровнем АД, повышенной вариабельностью и нарушением циркадного индекса (ЦИ) АД. Цель – установить особенности изменений суточного профиля АД у больных хроническими цереброваскулярными заболеваниями (ЦВЗ) и НДС для оптимизации антигипертензивной терапии. Материалы и методы. В исследование включено 100 пациентов с ЦВЗ, средний возраст – 65 (58,0; 74,5) лет. АГ выявлена у 92 % больных. Всем пациентам выполнено суточное мониторирование АД. НДС верифицировали методом кардиореспираторного мониторирования. Определяли индекс апноэ/гипопноэ (ИАГ), сатурацию и длительность эпизодов апноэ. Результаты. При НДС умеренной и тяжелой степени (ИАГ≥15) выявлено повышение систолического АД (САД) в течение суток, диастолического АД (ДАД) ночью (p<0,05), а также повышенную вариабельность САД и ДАД в ночные часы, снижение ЦИ АД у 65–70 % больных, в т.ч. повышение АД ночью у 16 % больных. Эти изменения коррелировали с тяжестью НДС (ИАГ), суммарной длительностью и глубиной десатурации (р<0,05). Выводы. Для повышения эффективности лечения АГ и контроля целевого уровня АД больных с хроническими ЦВЗ необходимо обследовать на наличие НДС, особенно при выявлении ночной гипертонии. Ключевые слова: цереброваскулярные заболевания, суточное мониторирование артериального давления, нарушение дыхания во сне.

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