Abstract
Objective: To study the relationship of blood pressure variability (BPV) with parameters of vasomotor endothelial function and C-reactive protein (hsCRP) in patients with arterial hypertension (AH) combined with coronary artery disease (CAD). Design and method: A total of 80 patients with AH degree II-III and CAD were examined. 24-hour monitoring of blood pressure, endothelial dependent vasodilatation (EDV) and endothelium independent vasodilatation (EIV), level of hsCRP were evaluated. Results: In general, in the studied group of patients with BPV the statutory indicators did not exceed, however, the selection of patients with increased BPV showed that they constitute almost half of the observed sample (48.7%). Patients with increased BPV differed from patients with normal BPV by higher values of hsCRP (2.98 ± 0.71 vs 1.56 ± 0.33 mg/l, respectively), body mass index (33.91 ± 1.61 vs 29.49 ± 1.05 kg/m2), less pronounced response to the introduction of nitroglycerin in the evaluation EIV (13.23 ± 1.79 vs 17.70 ± 0.77%, p < 0.05). Correlations identified the relationship between systolic BPV day and EDV (r = −0.44, p = 0.012); hsCRP (r = 0.31, p = 0.008); systolic BPV night and EIV (r = −0.50, p = 0.003); diastolic BPV and EIV (r = −0.43, p = 0.013). The logistic regression analysis revealed that patients with depletion of EIV were 1.2 times more likely to have increased BPV OR 1,223 [95% CI 1,012–1,478; p = 0,037]. In patients with increased systolic BPV higher levels of hsCRP were observed 1.6 times more frequently OR 1.576 [95% CI 1.014–2.451; p = 0.043]. Conclusions: Relation of BPV with indicators of vasomotor endothelial function and a marker of the inflammatory response of the vascular wall that could indicate a pathogenetic relationship of the parameters, which, in turn, determine the development of adverse events in patients with AH and CAD was detected.
Published Version
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