ASSESSMENT OF PERIPHERAL VASCULAR DAMAGE IN PATIENTS WITH DIFFERENT DEGREES OF BLOOD PRESSURE INCREASE

Abstract

Purpose – to investigate the frequency of peripheral arteries damage by determining theankle- brachial index (ABI) in patients with hypertension of 1-3 degrees of the older agecategory (> 55 years) using automatic devices for measuring blood pressure.Material and methods. The object of the study were patients with hypertension olderthan 55 years, 150 people (50 patients with elevated blood pressure levels 1, 2 and3 degrees), as well as 20 healthy people of the same age. The study included only patientswho did not have obvious clinical symptoms of peripheral vascular disease. The studydid not include patients with persistent cardiac arrhythmias (atrial fibrillation, frequentventricular arrhythmias, etc.). Simultaneous measurement of blood pressure on the armwith a higher level of blood pressure and on the leg in a supine position was carriedout. After that, the ankle- brachial index was calculated as the ratio of the mean systolicblood pressure (SBP) separately on the right and left ankle to the mean SAT level on thebrachial of the arm with higher BP. If ABI less than 0.9 damage of peripheral arteries ona proper side was diagnosed. Results. For a detailed analysis, we divided all patients with hypertension dependingon the value of the ankle- shoulder index into two subgroups: subgroup A includedpatients (n = 141) with hypertension with an index value> 0.9, and subgroup B (n = 9) –respectively <0.9. The mean age of patients in subgroup A was 64.5 ± 1.1 years, subgroupB – 66.5 ± 2.1 years (p> 0.05 between subgroups). SAT in subgroup A was 159.4 ± 2.9mm Hg, in subgroup B – 162.1 ± 4.2 mm Hg. (p> 0.05 between subgroups). Patients inboth subgroups did not differ in age, sex, body mass index, smoking frequency. Patients inboth subgroups had significantly elevated serum total cholesterol of 6.5 ± 0.2 mmol / l and6.7 ± 0.5 mmol / l, respectively. The degree of increase in diastolic blood pressure (BP)in subgroup A was significantly higher than 103.2 ± 1.2 mm Hg. compared with subgroupB – 78 ± 4.6 mm Hg (p <0.01). Serum creatinine levels in patients with signs of peripheralarterial lesions were higher than in patients without signs of lesions of 99.4 ± 3.6 μmol /l versus 88.2 ± 3.1 μmol / l (p <0.05). Type 2 diabetes was found in 44 % in subgroup Band in 7 % in subgroup A.Conclusions. The most common signs of peripheral vascular disease were observed inpatients older than 55 years with isolated systolic hypertension, type 2 diabetes mellitusand elevated serum creatinine.