Abstract
Relevance . The study of the daily dynamics of blood pressure in arterial hypertension both on the basis of the daily index and on the basis of the time load is a relevant task, since, these indicators are associated in the literature with stable changes in the neurohumoral regulation of the cardiovascular system in arterial hypertension . The aim of the study was to compare data of the time load in patients with arterial hypertension , depending on the nocturnal blood pressure profile, with integrative indicators of the activity of the cardiovascular system in the form of a Circadian index, a structural point of blood pressure, double product. Materials and Methods. The study included 72 patients who were treated at the City Clinical Hospital No 13 in Moscow and signed a voluntary consent to participate in the research and the processing of personal data. Inclusion criteria: arterial hypertension. Exclusion criteria: metabolic syndrome, secondary forms of arterial hypertension and concomitant pathology. Depending on the daily index (DI10% and DI10%) patients were divided into 2 groups: 1 group (N= 32): patients with arterial hypertension without nocturnal decrease in blood pressure (non-dippers and night-pickers100%); Group 2 (N = 40): patients with arterial hypertension who had a nocturnal decrease in blood pressure (dippers and over dippers 100%). All patients and members of the control group (N=15) underwent daily monitoring of blood pressure (24-hour Arterial Blood Pressure Monitoring). The data were statistically processed to determine the 5% level of significance of differences (p0.05) (Students test). In the comparative analysis of integrative indicators at day and at night, a variance analysis was applied. Results and Discussion . As a result of the study, it was found that the values of Circadian Index for blood pressure vary depending on the type of night decrease in blood pressure and the blood pressure time load, while daily index and structural point of blood pressure remain on the same level as a reflection of the hemodynamic allostasis existing in both groups. Conclusion. Reflection of the allostatic load on hemodynamics is change of values of double product and of the structural point of blood pressure compared with the control group. These changes are not associated with the peculiarities of the nocturnal blood pressure profile in patients with hypertension without metabolic syndrome.
Highlights
A feature of the phenotypic course of arterial hypertension (AH), in addition to the presence or absence of the formation of metabolic syndrome, is the different dynamics of the nocturnal decrease in blood pressure (BP), which, according to the literature, is based on sympathicotonia at night in patients with AH [1, 2]
In the comparative analysis of the daily dynamics of blood pressure, obtained on the basis of the analysis of arterial blood pressure monitoring (ABPM) according to the linear analysis, first of all, it should be noted that the groups were homogeneous in hemodynamic indicators: the coefficient of variation did not exceed 30 % (Table 2), which allows for further comparison of groups
Hemodynamics in arterial hypertension without metabolic syndrome exists within the framework of hemodynamic allostasis, which forms a BP time load in patients of groups 1 and 2
Summary
A feature of the phenotypic course of arterial hypertension (AH), in addition to the presence or absence of the formation of metabolic syndrome, is the different dynamics of the nocturnal decrease in blood pressure (BP), which, according to the literature, is based on sympathicotonia at night in patients with AH [1, 2]. If the assumption is correct, in addition to the load of time in % in the presence of hemodynamic allostasis, other integrative indicators of the cardiovascular system will be changed. The purpose of the study was to compare the data on the time load in% in patients with hypertension, depending on the night profile of blood pressure with the integrative indicators of the activity of the cardiovascular system in the form of the circadian index (CI), the structural point of BP (SPBP), the double product (DP). The relevance of the study is due to the fact that the existence of the organism in conditions of allostasis is the cause of its accelerated aging [3]
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