HEART AND VESSEL REMODELING IN DIFFERENT AGE GROUPS OF PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Actuality. It is known that each of the factors (arterial hypertension (AH) and age) has a negative effect on the remodeling of both the heart and vessels, while their combined effect has not been sufficiently studied. The aim. Assessment of manifestations of cardiac and vascular remodeling (by the example of common carotid arteries (СCA) and vasomotor endothelium function (right brachial artery)) in patients with AH degree I-III in different age groups.Material and methods. The study involved 124 (86 men and 38 women) patients at the age from 27 to 81 years (average age of patients 55.7+1.01 years) with AH degree I-III. The presence and variant of myocardial remodeling with calculation of criteria of left ventricular hypertrophy (LVH), myocardial mass (MM) and MM index (MMI) of LV by indexation to the patient’s body surface area were studied in all patients by means of echocardiographic investigation (EchoCG) using the Vivid S5 3Sc-RS echocardiograph with a multifrequency sensor 2.0-3.5 MHz. Normal values of MM were considered to be 67-162 grams (g) for women and 88-224 for men, and MMI - not more than 95 and 115 g/m2, respectively. Types of LVH were determined according to recommendations of Pugliese N.R. et al. (2017), being subdivided into concentric (C) and eccentric (E) LVH. Ultrasound scanning was used to investigate CCA on both sides. The results of reactive hyperemia test on the right brachial artery and blood lipid profile were studied with the calculation of atherogenicity coefficient (AC). The data analysis was carried out with the help of Statistica 12 application package with determination of mean values (M), minimum, maximum and mean error (m), median and interquartile range for the CCA intima-media thickness (IMT). The Spearman rank correlation coefficient (r) was used to estimate the relationship between these variables. The significance level of all statistical tests was accepted at p˂0.05.The results of the study confirmed the presence of cardiac and vascular remodeling in patients with AH of different degrees with the tendency to increase in older age groups. The CCA remodeling parameter values were also significantly higher in the groups of middle-aged and elderly persons, some of which also had atherosclerotic plaques (AP). The number of patients with disturbed endothelial vasomotor function also somewhat increased with age.Conclusion. Thus, the age of the examined patients with AH had a significant influence on aggravation of the heart and vessel remodeling processes and increasing frequency of endothelial dysfunction development