THE DIURNAL DYNAMICS OF BLOOD PRESSURE IN PEOPLE SUFFERING FROM ARTERIAL HYPERTENSION

Sadad Alhashimi, Sheiko V.

PHYSIOLOGY

Scentific article

Cardiovascular diseases are still the main cause of high mortality and disability of the population around the world. Arterial hypertension is an important of the modifiable risk factors for cardiovascular disease at all stages of its development, regardless of gender and age. Arterial hypertension is a powerful, but potentially eliminable risk factor, which has a significant impact on morbidity and mortality in cerebrovascular diseases. Arterial hypertension is considered as a polyethological disease, in which none of the existing theories of pathogenesis fully explains all the causes of increased blood pressure. The end of the 20th century was marked not only by the intensive development of fundamental ideas about arterial hypertension, but also by a critical revision of a number of provisions on the causes, mechanisms of development and treatment of this diseasе. One of the factors determining the unfavorable prognosis in hypertensive patients with an increased likelihood of developing vascular accidents (myocardial infarction, stroke) is an increased average daily variability of blood pressure (VAD). Elevated VAD closely correlates with severity of left ventricular remodeling, severity of retinopathy, serum creatinine level. Significant increase in systolic and diastolic pressure was revealed in patients with hypertensive disease with different variants of the course, differences were available both in terms of mean pressure, both day and night. 120 patients with arterial hypertension (AB) with stable course (40 patients) and complicated course of hypertensive crises (42 patients), microalbuminuria (38 people) were taken in the study of clinical features in persons with high blood pressure, 25 people were monitored. practically healthy. The pressure was measured by a conventional method. All received experimental material was processed by parametric and nonparametric statistics using Statistica for Windows 5, Microsoft Excel-97 programs. The features of the change in the groups with uncomplicated and complicated arterial hypertension have been noted in terms of the degree of systolic pressure decrease (12.3 ± 0.86%, 10.0 ± 1.18% and 4.18 ± 1.27% with thecontrol of 16.3 ± 0,86%, respectively, p <0.01). These differences were revealed in patients with AH with uncomplicated course for systolic pressure compared to healthy, in the daytime 149.21 ± 2.3 mm Hg (p <0.05), the differences are highly significant in the complicated course of arterial pressure (151.45 ± 2.10 mm Hg and 160.55 ± 2.35 mm Hg, p <0.01). The degree of night decrease in blood pressure is significantly lower in patients with arterial hypertension with microalbuminuria (4.18 ± 1.27%, p <0.001, with crises of 10.0 ± 1.18% (p <0.01) and uncomplicated flow – 12.3 ± 0.86 mm Hg). The increase in diastolic blood pressure was similar. Mean diastolic pressure was normal for the first group – 86.71 + 1.30 mm Hg (p <0.05), elevated in the group of arterial hypertension with crises (99.7 + 1.4 mm Hg, p <0.01) and is significantly increased in hypertensive patients with microalbuminuria – 121.7 + 1.9 mmHg., (p <0.001). Full diastolic blood pressure in patients with microalbuminuria exceeded the control group by 27.5% (p <0.01) when crises by 26.2% (p <0.05) and there was not significant in patients with uncomplicated 11.2% (p> 0.05). The degree of night decrease was greatest in patients of the 1st group (12.8 + 1.19%), the smallest in group 3 (with microalbuminuria, 6.98 + 1.04, P <0.01). The most pronounced changes in the degree of decrease in systolic blood pressure were observed in the group of patients with arterial hypertension complicated by crises. This was manifested in a significant reduction of the degree of reduction in nocturnal 3 times morning rise of 23.4% compared with the control group. And the degree of night reduction in patients with arterial hypertension with crises was minimal in 2,5 times lower than in patients with AH without crises. For diastolic blood pressure, these rates were less pronounced and amounted to 42.2%. In the patients with arterial hypertension, there was a significant decrease in the variability of systolic and diastolic pressure at night. And in patients with arterial hypertension with complications, the variability of pressure did not change within 24 hours, in patients with arterial hypertension without a complication there was no decrease in systolic blood pressure at night, diastolic pressure was lower and approached control values. In the control group, the variability of night blood pressure was significantly lower in both systolic and diastolic pressures compared to patients with AH complicated by crises and microalbuminuria. Depending on the values of the average daily VAD, the patients were divided into subgroups: normal (NVAD) and elevated (PVAD) VAD. With variability of systolic and / or diastolic blood pressure exceeding 15 and / or 12 mm Hg. accordingly, VAD was assessed as an elevated (62 patients), with smaller values of VAD, regarded as normal (58 patients). Thus, using the value of the average daily VAD, it is possible to predict the condition of AH patients. The study of daily dynamics of arterial pressure on the background of arterial hypertension made it possible to predict the state of patients taking into account the conditions of the course of the disease.

hypertension, blood pressure dynamics

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 384-388 pages, index UDK 612.122.

10.29254/2077–4214–2017–4–3–141–384-388