Analysis of microcirculatory blood flow parameters during a course of transcutaneous electrical stimulation in men with newly diagnosed arterial hypertension

Abstract

Objective. To study the dynamics of microcirculatory blood flow in the skin during a course of use of the electrical stimulator AVR-051 in men of low and moderate cardiovascular risk with newly diagnosed arterial hypertension. Materials and methods. The single-center placebo-controlled study included 44 men of working age (30–60 years) with low and moderate cardiovascular risk with newly diagnosed hypertension, who were randomly divided into 2 groups. The control group (CG) included 30 men who underwent electrical stimulation with a commercial device. The placebo group (PG) included 14 men who used the AVR-051 device, with the electrostimulation function disabled. The study design included 3 visits. After visit 1 and randomization, the subjects underwent electrical stimulation/sham at home 2 times a day for 14 days. Visit 2 was carried out immediately after the end of the physiotherapy course, visit 3 was 14 days after visit 2. At each visit, a one-stage comprehensive study of microcirculation (video capillaroscopy, laser Doppler flowmetry and photoplethysmography) and 24-hour blood pressure monitoring on the left upper limb were performed. Results. In the CG, while blood pressure decreased at visits 2 and 3 by 5.5/3.5 and 7.5/3.5 mm Hg relative to the initial values, statistically significant changes at the level of the microvascular bed were recorded only at visit 3: an increase in the functional density of the capillary network by 10 cap/mm2, an increase in the amplitude of pulse oscillations of blood flow from 0.68 to 1.06 PU and the perfusion contribution of pulse oscillations from 3.89 to 8.22 %, a decrease in the augmentation index from 6.25 to 3.2 %, a decrease in the stiffness index from 7.45 to 7 cm/s and the reflection index from 37.4 to 30.2 %, respectively. In the GP, no reliable dynamics was recorded for any of the analyzed parameters. Conclusion. Positive dynamics at the level of the microvascular bed of the skin is a consequence of a decrease in blood pressure level against the background of systemic normalization of sympathetic tone. After the course of electrical stimulation, a hypotensive effect is observed in 86.7 % of men at early stages of the hypertension development, and in 20 % of them, a complete normalization of blood pressure level is observed.