Жесткость сосудистой стенки и функциональное состояние сосудов микроциркуляторного русла кожи у лиц средней возрастной группы с артериальной гипертензией

Abstract

Aim. To estimate the functional state of microvascular skin vessels depending on the stiffness of the main arteries vascular wall in middle age group of persons with arterial hypertension (AH) of I-II degree. Subjects and methods. We examined 28 patients with essential hypertension of I-II degree (21 w.) aged 43-59 years. All patients underwent assessment of the target organ damage, sphygmography, laser Doppler flowmetry (LDF) with amplitude and frequency wavelet analysis and capillaroscopy. Patients were divided into 2 groups in terms of cardio- ankle vascular index (CAVI), which reflects the morphological rigidity of the main arterial vessels. Results. In 68 % of patients pulse wave velocity (PWV) exceeded age norm. Changes in arterial stiffness were found only in 32 % of cases when CAVI index was used. In the group with high CAVI LVMI, EDD were significantly higher, while there were no differences in IMT and atherosclerotic lesions in CCA. According to the LDF and capillaroscopy, in patients with increased stiffness of the main arteries a significant decrease in dilatator response to neuropeptides from the afferent nerve endings was found, and other parameters were not different. Conclusion. The data indicate that the majority of middle age patients with hypertension of I-II degree have high values of PWV, while using index CAVI that excludes the effect of blood pressure, only 32 % of patients have increased rigidity index. The stiffness parameters (PWV and CAVI) correlate with indicators of myocardial remodeling and degree of atherosclerotic lesions of the CCA. Patients with high CAVI demonstrated nonsignificant trend toward reduction of neurogenic and myogenic tone components of precapillary arterioles in the basal skin perfusion and decreased dilatator response to neuropeptides of nociception system.