Risk Factors in Progressive Arterial Hypertension (Systemic Analysis)

Abstract

The present research aimed to access the significance of arterial hypertension risk factors and their relationships in the high-mountain villages of the Elbrus region (2100–3500 m above the sea level). For this, 260 patients were examined in total, 190 with arterial hypertension (hereinafter AH) of the 1, 2 and 3 degrees and 70 healthy individuals. Methods. All the participants underwent complex examination: echocardiography; assessment of nitric oxide (NO) metabolites in the blood; heart rate variability (HRV); blood plasma lipid spectrum. Microsoft Statistica v. 10.0.1 software package was used for statistical processing. Multiple regression equations reflected the dynamics of relationships of three or more parameters (significant differences at p <0.05). Results. AH patients showed a progressive decrease in NO, an increase in sympathetic and HRV indicators, in left ventricular (LV) myocardial mass and atherogenic plasma index. The dependence of HRV indicators, LV morphofunctional parameters, hemodynamics, plasma lipid profile on NO level was revealed. Decreased significance of modifiable risk factors and increased lesions of ‘target organs’ with the progression of arterial hypertension were found; this explains complexity of prevention and possible therapeutic strategies.