PS-C09-8: FEATURES OF DAILY BLOOD PRESSURE PROFILE IN PATIENTS WITH ARTERIAL HYPERTENSION AND OBESITY

Abstract

Purpose of the study: To study the daily profile of blood pressure in patients with arterial hypertension (AH) with obesity. Materials and methods of the study: The study included 71 patients with AH I-III degree (ESH, 2018) who received inpatient treatment. Obesity was defined according to the WHO classification (1997). The daily blood pressure profile was assessed using the Medicom-Combi device (Russia). Blood pressure was measured at intervals: day - 30 minutes, night - 60 minutes. Results of the study: Patients were divided into 3 groups depending on the degree of obesity: group 1 BMI 30–34.9 kg/m2 (43 patients), group 2 BMI 35–39.9 kg/m2 (19 patients) and group 3 BMI > 40 kg/m2 (9 patients). The compared groups had similar office SBP and DBP: 144.88 ± 21.84/88.14 ± 10.75 mm Hg. vs 143.42 ± 21.86/87.89 ± 9.76 mmHg vs 145.56 ± 17.40/87.78 ± 14.81 mmHg. Analysis of ambulatory blood pressure monitoring (ABPM) revealed that 3 grade obese patients with AH had significantly higher mean daily SBP values (124.98 ± 11.16 vs 120.00 ± 7.18 vs 132.22 ± 12.85 mm Hg, p < 0.018) and DBP (73.93 ± 8.86 vs 68.21 ± 4.71 vs 74.00 ± 7.68 mm Hg, p < 0.02), mean daily SBP (127.14 ± 10 .82 vs 120.95 ± 6.88 vs 134.11 ± 11.59 mmHg, p < 0.005), mean daily DBP (75.79 ± 9.41 vs 69.42 ± 4.98 vs 77.44 ± 7 .80 mm Hg, p < 0.012) compared with AH patients with 1–2 grade obesity. Variability in SBP and DBP did not differ significantly between the groups. The load index of SBP in the daytime was high in AH patients with 3rd grade obesity. Index of SBP daytime were 37.26 ± 29.31 (group 3 patients) vs 7.04 ± 9.78 (group 2) vs 16.35 ± 19.41% (group 1) p < 0.0009. A normal daily profile of SBP/DBP had 30.23%/37.21% of patients of the 1st group vs 21.05%/42.10% of patients of the 2nd group vs 33.33%/33.33% of patients of the 3rd group had, p < 0.145. The number of non-dippers in SBP was slightly higher in the group of patients with grade 1 obesity: night reduction speed (NRS) SBP/DBP 53.48%/ 46.51% in group 1 vs 52.63%/36.84% in group 2 vs 44.44%/ 33.33% in the third, p < 0.113. In the group of patients with grade 3 obesity, persons with daily SBP/DBP ‘night-picker’ profile significantly prevailed: 22.22%/22.22% vs 21.25%/21.05% vs 16.27% /13.95%, (in groups 3, 2, 1, respectively) p < 0.001. There were no patients with an excessive decrease in SBP and DBP at night. Conclusion: Patients with hypertension and obesity have more pronounced pronounced disturbances in the daily blood pressure profile, which contribute to an increased risk of developing complications of arterial hypertension.