PP.17.19] ORTHOSTATIC HYPOTENSION REACTIONS IN HYPERTENSIVE PATIENTS

Abstract

Objective: The aim of our study was to investigate the relationship between the orthostatic hypotensive reactions (OHR) identified active and passive OT in patients with AH older age groups (22 M, 49 F) with AH grade I-III, av.age 68,1 ± 5,8 years. During OT BP (beat to beat) measured continuously and non-invasively using the “Task Force Monitor “(“CNSystems” Austria). The criteria for IOH was considered the onset of symptoms of cerebral hypoperfusion associated with a reduction in SBP > 40 mmHg and DBP > 20 mmHg in the first 5–15 seconds orthostasis (Wieling W., 2006) and the identification of the initial uncompleted depressor reactions of BP (Rogoza A et al., 2008). Control of cognitive function was performed by a research brief mental status (MMSE), clock drawing test and concentration test by the method of TM. The statistical analysis was carried with Statistica 6.0. Results: In 22 (31%) patients was found the OHR. The groups were comparable by age (68,5 ± 5,5 vs 66,8 ± 5,9) yrs, gender (F 13 (59%) vs 37 (76%)); duration of AH (18,7 ± 11,7 vs 15,3 ± 10,6) years. The pts in the gr. with OHR had a more frequent strokes n = 3 (14%), without OHR – TIA in 4 pts (8%). Significant differences have been found between the groups by atherosclerotic lesions (40 < plaque < 65) of the carotid arteries (in gr. OHR 10 (45%) vs 3 (6%) without OHR, p < 0,05). The study revealed significant cognitive differences in patients with OHR and without OHR. Results of the test clock drawing OHR patients were lower than in patients without the PER (7,2 ± 1.4 vs 8,3 ± 0,8, p < 0,04), during the TM in patients with PER showed a reduction in attention (21,2 ± 2,4 vs 22,5 ± 1,17. p < 0,02). During the MMSE test revealed no significant differences (25,6 ± 2,45 vs 26,8 ± 1,3.p > 0.05). Conclusions: Hypertensive patients in older age groups with various types of OHR (the initial and classic) have a reduction of memory and attention, atherosclerosis of the carotid arteries, strokes in anamnesis compared with the same category of patients without the OHR.