CHRONOBIOLOGICAL ASPECTS OF ARTERIAL PRESSURE LEVEL IN SCHOOLCHILDREN WITH ARTERIAL PREHYPERTENSION

Abstract

Introduction. Arterial pressure has significant diurnal fluctuations, reaching its minimum and maximum values at certain hours of the day. For a complete characterization of arterial hypertension in recent years, the method of daily monitoring of arterial pressure is most often used, which makes it possible to determine the forms of the disease (labile and stable), circadian rhythms of arterial pressure and its variability. The use of this method in children may be even more important than in adults.Aim: to evaluate the chronobiological aspects of the level of arterial pressure in schoolchildren with arterial prehypertension.Materials and methods. 54 school-age children were examined, who were divided into the following groups: the main group consisted of 24 children with arterial prehypertension (high blood pressure) and the control group - 30 children with normal blood pressure.Chronobiological aspects of the level of arterial pressure in schoolchildren were assessed using daily monitoring of arterial pressure. The 24-hour blood pressure device provided long-term recording of blood pressure fluctuations during normal 24-hour activity and during patient’s sleep.Statistical processing of the obtained data was carried out using Microsoft Office Excel and Statistica 10.0 applications. Research results. When evaluating the characteristics of time indices of blood pressure in the examined children, it was found that children with prehypertension most often had an increase in systolic blood pressure at night.Comparing the features of daily blood pressure fluctuations between children with prehypertension and children from the control group, certain differences were identified that were observed in the curves of systolic blood pressure and diastolic blood pressure, especially at night.When assessing the variability of the average daily and average night levels of systolic and diastolic blood pressure in children by groups, it was found that the variability of systolic and diastolic blood pressure in children with prehypertension was probably lower than in children from the control group.Additionally, the features of the daily fluctuations in mean arterial pressure were evaluated, because it simultaneously takes into account the daily fluctuations of both systolic and diastolic blood pressure. The T-test showed that the mean arterial pressure level was probably higher in children with prehypertension (p<0,05) compared to children from the control group.Conclusions.1. There is a phenomenon of a decrease in blood pressure variability in children with prehypertension (especially at night), which can be regarded as a risk factor for the development of arterial hypertension.2. Based on the presence of a probable difference in the indicators of daily fluctuations in mean arterial pressure among children from the control group and children with prehypertension, the latter have an increase in the dynamic load on the vascular wall, which can lead to a slowdown in the blood flow velocity in the capillary bed and also act as a predictor of arterial hypertension.